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Cardiolucent

Condition

Syncope/passing out

Symptoms & Risk Factors

Syncope is a temporary loss of consciousness caused by a brief drop in blood flow to the brain. Most episodes are benign — vasovagal (reflex) syncope is the single most common cause and is rarely dangerous in itself — but a meaningful subset of syncope is cardiac in origin and signals serious underlying disease such as arrhythmia, structural heart problems, severe valve disease, or pulmonary embolism. The challenge is that the episode itself does not always reveal which category it belongs to, which is why a careful, structured evaluation matters. Features that raise concern for a cardiac cause include syncope during exertion, syncope without warning, a family history of sudden cardiac death, or injury sustained during the event. Dr. Kedan evaluates syncope as a diagnostic priority, using POCUS, EKG, orthostatic measurements, and extended rhythm monitoring to identify the cause and prevent recurrence.

What Cardiolucent Evaluates

  • Detailed event history including witness account, prodrome, posture, and recovery pattern
  • Resting EKG and POCUS at the visit for immediate structural and rhythm assessment
  • Orthostatic blood pressure measurements for orthostatic and autonomic causes
  • Full transthoracic echocardiography with strain imaging when structural disease is suspected
  • Extended ambulatory rhythm monitoring — 2-week patch or longer-term loop recorder
  • Exercise stress testing when syncope occurred with exertion
  • Tilt-table testing in select cases when vasovagal physiology needs confirmation
  • Coordination with electrophysiology at Cedars-Sinai when pacemaker or ablation may be needed

What Patients Describe

  • A warning prodrome of lightheadedness, warmth, nausea, sweating, or visual graying before passing out (vasovagal pattern)
  • Loss of consciousness with rapid, complete recovery within seconds to a minute
  • Brief jerking movements during the episode that can be mistaken for seizure
  • No memory of the event itself, but full awareness afterward
  • Syncope while standing for prolonged periods, after blood draws, or with strong emotion (reflex pattern)
  • Syncope occurring during exertion or without any warning — a red flag for cardiac cause
  • Syncope causing injury, or recurrent episodes
  • Family history of unexplained sudden death — a serious warning sign

Possible Underlying Causes

  • Vasovagal (reflex) syncope — the most common and generally benign
  • Orthostatic hypotension from volume depletion, medications, or autonomic dysfunction
  • Bradyarrhythmias including high-grade AV block and sinus node dysfunction
  • Tachyarrhythmias including ventricular tachycardia and supraventricular tachycardia
  • Severe aortic stenosis or hypertrophic cardiomyopathy with outflow obstruction
  • Pulmonary embolism
  • Inherited arrhythmia syndromes (long QT, Brugada, CPVT)
  • Carotid sinus hypersensitivity in older patients
  • Medications, particularly antihypertensives and QT-prolonging agents
  • Non-cardiac causes such as seizure (which is not technically syncope but can be confused with it)

How We Investigate

Dr. Kedan's first priority is to distinguish cardiac syncope from the more common benign reflex causes, since the implications and treatments differ dramatically. POCUS and EKG at the visit answer many structural questions immediately, while orthostatic measurements and a careful event history clarify the autonomic picture. Extended rhythm monitoring is often added when an arrhythmic cause is on the differential, and exercise testing is used when the episode happened with exertion. Driving safety is reviewed explicitly. When cardiac syncope is identified, Dr. Kedan coordinates with electrophysiology and structural heart specialists at Cedars-Sinai to define the right treatment — pacemaker, ablation, ICD, or valve intervention — and resumes long-term follow-up afterward.

Common Questions

Frequently Asked Questions

What is syncope?
Syncope is a temporary loss of consciousness caused by a brief drop in blood flow to the brain. It almost always resolves on its own within seconds to a minute, but the cause can range from harmless to life-threatening. Because the danger is not always obvious from the episode itself, a careful evaluation is essential.
When should I see a doctor after fainting?
Any unexplained loss of consciousness deserves evaluation, and certain features make it more urgent: syncope during exertion, syncope without warning, syncope with chest pain or palpitations, a family history of sudden cardiac death, or an injury sustained during the episode. Recurrent fainting also warrants formal workup. Schedule a consultation promptly rather than waiting to see if it happens again.
What causes syncope?
The most common cause is vasovagal (neurally mediated) syncope — a reflex drop in heart rate and blood pressure often triggered by standing, pain, or emotion. Orthostatic hypotension, arrhythmias, structural heart disease, severe valve disease, and pulmonary embolism are other important causes. Distinguishing these is the central goal of the evaluation.
What tests will Dr. Kedan run?
A focused history and physical, an EKG, orthostatic blood pressure measurements, and echocardiography are the foundation. Extended rhythm monitoring is often added when an arrhythmic cause is suspected, and exercise stress testing is used when syncope occurred with exertion. POCUS during the visit allows immediate structural assessment without waiting for a separate study.
Is syncope dangerous?
Most vasovagal syncope is not dangerous in itself, though it can cause injury from falls. Cardiac syncope — from a serious arrhythmia or structural heart disease — carries a higher risk and requires definitive treatment. Sorting one from the other is precisely why a thorough evaluation matters.
What is the difference between syncope and a seizure?
Syncope is brief and recovery is usually rapid and complete, while seizures more often involve sustained convulsive activity and a prolonged period of confusion afterward. The two can be confused, however, particularly when syncope causes brief jerking movements due to low brain blood flow. A careful witness history and EKG are central to telling them apart.
How is syncope treated?
Vasovagal syncope is often managed with hydration, salt, counter-pressure maneuvers, medication adjustments, and avoidance of triggers. Orthostatic syncope is treated by addressing volume status, medications, and posture-related changes. Cardiac causes are treated specifically — for example, with a pacemaker for severe bradycardia, ablation for tachyarrhythmia, or valve repair for outflow obstruction.
Can I drive after fainting?
Driving restrictions after syncope vary based on the cause, recurrence risk, and local regulations. Dr. Kedan reviews driving safety with you explicitly as part of the workup so you understand what is appropriate and when normal activities can resume. Erring on the side of caution protects both you and others on the road.
How can I prevent future episodes?
For vasovagal syncope, recognizing warning symptoms (lightheadedness, warmth, nausea) and sitting or lying down quickly, along with hydration and dietary salt, often substantially reduces episodes. For other causes, addressing the underlying condition is the most reliable form of prevention. Call (310) 304-5555 to schedule a comprehensive syncope evaluation.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.