This is a portable ECG device that can record the wearers heart rhythms during daily activities over an extended period of time. Since fainting usually does not occur upon command, a Holter monitor can provide a better understanding of the hearts activity during fainting episodes. For people with more than two episodes of syncope and no diagnosis on "routine testing", an insertable cardiac monitor might be used. It lasts 28–36 months and is inserted just beneath the skin in the upper chest area. Imaging
Echocardiography and ischemia testing may be recommended for cases where initial evaluation and ECG testing is nondiagnostic. For people with uncomplicated syncope (without seizures and a normal neurological exam) computed tomography or MRI is not generally needed. Likewise, using carotid ultrasonography on the premise of identifying carotid artery disease as a cause of syncope also is not indicated. Although sometimes investigated as a cause of syncope, carotid artery problems are unlikely to cause that condition. Additionally an electroencephalogram (EEG) is generally not recommended. A bedside ultrasound may be performed to rule out abdominal aortic aneurysm in people with concerning history or presentation. Differential diagnosis
Other diseases which mimic syncope include seizure, low blood sugar, and certain types of stroke. While these may appear as "fainting", they do not fit the strict definition of syncope being a sudden reversible loss of consciousness due to decreased blood flow to the brain. Management
Management of syncope focuses on treating the underlying cause. This can be challenging as the underlying cause is unclear in half of all cases.
Up to half of women over the age of 80 and a third of medical students describe at least one event at some point in their lives. Prognosis
Of those presenting with syncope to an emergency department, about 4% died in the next 30 days. The risk of a poor outcome, however, depends very much on the underlying cause. Situational syncope is not at increased risk of death or adverse outcomes. Cardiac syncope is associated with worse prognosis compared to noncardiac syncope. Factors associated with poor outcomes include history of heart failure, history of myocardial infarction, ECG abnormalities, palpitations, signs of hemorrhage, syncope during exertion, and advanced age. Society and culture
Fainting in women was a commonplace trope or stereotype in Victorian England and in contemporary and modern depictions of the period. Syncope and presyncope are common in young athletes. In 1990 the American college basketball player Hank Gathers suddenly collapsed and died during a televised intercollegiate basketball game. He had previously collapsed during a game a few months prior. He was diagnosed with exercise-induced ventricular tachycardia at the time. There was speculation that he had since stopped taking the prescribed medications on game days.Falling-out is a culture-bound syndrome primarily reported in the southern United States and the Caribbean. Etymology
The term is derived from the Late Latin syncope, from Ancient Greek συγκοπή (sunkopē) cutting up, sudden loss of strength, from σύν (sun, "together, thoroughly") and κόπτειν (koptein, "strike, cut off").