Syncope is a brief loss of consciousness caused by a temporary decrease in blood flow to the brain. This page summarizes common causes, signs that need urgent assessment, typical diagnostic steps and which medical specialists are commonly involved in evaluation and follow-up.
Syncope can result from several mechanisms. Frequent causes include reflex (vasovagal) syncope triggered by pain, emotion or standing; orthostatic hypotension from a drop in blood pressure when standing; and cardiac causes such as arrhythmias or structural heart disease. Less common causes include neurological events or metabolic disturbances. Identifying the likely cause relies on a careful history and physical exam.
Seek urgent medical evaluation if there is prolonged unconsciousness, repeated episodes, chest pain or breathlessness during or after fainting, significant head injury, or persistent confusion or new neurological signs (for example slurred speech or weakness). When in doubt, prompt assessment in emergency services is advised.
Evaluation usually starts with history and vital signs, including lying-to-standing blood pressure measurements. Common tests include a 12‑lead ECG, blood tests, echocardiography, ambulatory rhythm monitoring (Holter or event recorder), and tilt-table testing when indicated. Neurological imaging or EEG may be considered if focal neurological features or seizures are suspected. The choice of tests is guided by clinical findings.
Initial assessment is commonly done in primary care or the emergency department. Cardiology is appropriate when a heart cause is suspected; neurology if there are neurological symptoms; geriatrics for older adults with complex needs. Follow-up and further testing depend on episode frequency, associated symptoms and underlying health conditions.
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