EP305: Syncope CSANZ 2023

Doctor Warrick Bishop - Heart Health

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients.

The episode discusses different causes of non-traumatic loss of consciousness or syncope, including cardiac, epileptic, and psychogenic reasons. Cardiac causes could be things like structural heart issues, arrhythmia, or orthostatic hypotension from standing up. Doctor Warrick highlights how an epileptic seizure may involve jerking at the onset of loss of consciousness unlike cardiac syncope. Taking a thorough history from witnesses is important to determine the likely cause. One interesting point was how tongue biting on the sides suggests epilepsy while biting the tip suggests falling during cardiac syncope. Distinguishing the etiology helps guide appropriate workup and management.

Takeaways:

• Syncope refers to a temporary loss of consciousness, often called a blackout. It can be caused by cardiac issues, epilepsy, or rare conditions like brain hemorrhages.
• Cardiac causes include structural heart problems, arrhythmias, orthostatic hypotension, and vasovagal syncope triggered by emotions or bodily stimuli.
• Epileptic seizures may involve jerking movements at the onset of loss of consciousness while cardiac causes typically do not.
• The history surrounding a syncope episode, including details from witnesses, is important for determining the underlying cause.
• Vasovagal syncope is linked to overstimulation of the parasympathetic nervous system and often involves prodromal symptoms.
• Orthostatic hypotension causes fainting when standing up due to low blood pressure.
• Structural heart issues like valve problems can trigger syncope, especially with exertion.
• Family history of sudden cardiac death raises suspicion of an inherited cardiac condition.
• Tongue biting patterns differ between cardiac and epileptic causes.
• Risk factors for coronary artery disease should be evaluated using an online heart risk checker.

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Over 9 million people around the world die from heart disease every year.

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Almost every one of those cases could have been prevented.

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Heart disease is the #1 killer in the Western World. In Australia, someone dies every 28 minutes from heart disease. That’s 51 people a day. In the US, someone has a heart attack every 40 SECONDS! Fortunately, many heart attacks are preventable. However, regular exercise and eating healthy are no guarantee you won’t succumb to this silent killer.

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