Cardiac Syncope

Cardiac syncope refers to those episodes where the cause of the cerebral hypoperfusion is directly related to a cardiac disorder. Once the diagnosis of syncope has been established, special attention should be paid to identifying cardiac causes given that patients with cardiac syncope have been reported to have an overall mortality rate of approximately 50% within five years. Cardiac syncope can be classified according to its pathophysiological causes. Arrhythmias are the most common cause of cardiac syncope. Non-arrhythmic causes of cardiac syncope are usually related to structural heart disease. Therapy depends on the diagnosis and includes cardiac pacing for bradyarrhythmias, implanted cardioverter defibrillators, ablation, and drugs for tachyarrhythmias. Structural heart diseases are treated accordingly. This chapter reviews the various types of cardiac syncope and provides a concise clinical approach to the diagnosis and management of cardiac syncope.