Syncope
What is a Syncope? Syncope is a sudden, brief loss of consciousness (a loss of postural tone) secondary to reduced blood flow to the brain & recovery is spontaneous. Pre syncope or near syncope is a ‘feeling of faint’ without actual loss of consciousness. Up to 15% children experience at least one syncopal episode prior to the end of adolescence. Most children with syncope do not have any s
What it is
Vasovagal syncope (a simple faint) is the most common cause and is triggered by emotional stress, prolonged standing, dehydration or medical procedures. Cardiac syncope (arrhythmia, structural disease, aortic stenosis, HOCM) is less common but more dangerous; orthostatic syncope is common in older patients on antihypertensives. Detailed history, witnessed account, ECG and tilt-table testing distinguish the causes.
When this is relevant
- Sudden loss of consciousness with spontaneous recovery within seconds.
- Pre-syncope (light-headedness, going to faint) that may or may not progress.
- Convulsive movements during the event - need to distinguish from seizure.
- Syncope on exertion - cardiac until proven otherwise.
- Family history of sudden cardiac death.
How we investigate
Detailed history with witness account, neurological examination, 12-lead ECG, postural blood pressures, FBC, electrolytes, thyroid, glucose. Onward: 24-hour Holter, 7-day event recorder, implantable loop recorder, tilt-table test, echocardiogram, exercise tolerance test, cardiac MRI.
Options at The Vesey
- Vasovagal counselling and physical manoeuvres - counter-pressure techniques, hydration, salt liberalisation.
- Medication review for older patients on antihypertensives or diuretics.
- Pacemaker referral for symptomatic bradycardia or high-grade AV block.
- ICD referral for malignant ventricular arrhythmia or HOCM-related syncope.
- Driving restriction counselling - DVLA requirements explicitly discussed and documented.
Do I need to stop driving after a blackout? +
DVLA rules require you to stop driving after an unexplained blackout (syncope with no clear benign cause) until the episode has been fully investigated and a cause established. We will discuss and document DVLA notification requirements at your consultation. Most patients with confirmed vasovagal syncope can resume driving after 4 weeks without recurrence.
How is a dangerous cardiac blackout different from a simple faint? +
High-risk features include syncope during exercise, syncope without warning, syncope in the supine position, associated chest pain or palpitations, family history of sudden cardiac death, structural heart disease, or abnormal ECG. Vasovagal syncope has a prodrome (warmth, sweating, nausea), occurs with triggers like pain or prolonged standing, and recovers fully and quickly. Any unexplained or exertional blackout should be assessed by a cardiologist.
What is an implantable loop recorder and when is it used? +
An implantable loop recorder (ILR) is a small device inserted under the skin of the chest (15-minute procedure under local anaesthetic) that continuously records heart rhythm for up to 3 years. It is used when blackouts are infrequent and short-term external monitors have not captured an event. We can arrange ILR insertion and remote monitoring.
Can a blackout be caused by epilepsy rather than syncope? +
Yes, and the distinction is important because treatment and driving rules differ. Features suggesting epilepsy include prolonged confusion after the event, limb jerking before loss of consciousness (not during), tongue biting, urinary incontinence during the event, and no clear cardiac trigger. We assess for both causes and refer to neurology where a seizure is likely.
Pricing at a glance
Initial cardiology consultation £260 (ECG £50). 24-hour Holter £290. 7-day event recorder £450. Tilt-table test £550. Echocardiogram £320. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book if you have had any unexplained blackout, particularly during exertion or with no warning, or with a family history of sudden death. Driving abstinence may apply pending workup - we will advise.
Cost and pathway
Initial cardiology consultation £260 (ECG £50). 24-hour Holter £290. 7-day event recorder £450. Tilt-table test £550. Echocardiogram £320.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our cardiology team
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