Syncope (Fainting)
What Is It?
Transient loss of consciousness due to global cerebral hypoperfusion, with rapid spontaneous recovery. Most common: vasovagal (situational), orthostatic hypotension, cardiac arrhythmia. Life-threatening causes must be excluded.
How Is It Diagnosed?
Detailed history (prodrome, triggers, position), orthostatic vitals, EKG. ROSE or SFSR risk score. Echocardiogram if structural heart disease suspected. Holter/event monitor for arrhythmia. Tilt table test for vasovagal.
How Is It Treated?
Vasovagal: reassurance, avoid triggers, increase fluid and salt, compressive stockings, tilt training. Orthostatic: treat underlying cause, midodrine, fludrocortisone. Cardiac: treat arrhythmia or structural disease. Urgent cardiology for high-risk features.
Tests and Imaging Typically Needed
EKG, orthostatic blood pressures, CBC, BMP, glucose, echocardiogram, Holter monitor, tilt table test.
Approximate Self-Pay Costs
Office visit: $95-$150. EKG: $30-$60. Holter: $150-$300. Echocardiogram: $500-$900.