Management of Syncope
The management of syncope depends on its cause. This article will focus on reflex causes, which are the most common. When syncope is caused by heart disease either structural or arrhythmic, treatment must and can be directed toward that cause. For example, if the heart is beating too slowly or is tending to have pauses in its beating pattern, a pacemaker is the right treatment and it will be effective. If the cause is found to be aortic stenosis, narrowing of the outlet valve of the main pumping chamber, it is likely that this valve will have to be replaced and again this treatment is very effective. If the blood pressure is tending to fall immediately on standing from chair or bed, this is called orthostatic hypotension, treatment using drugs by mouth will help with addition of some physical measures including support stockings, abdominal binding and sleeping with the head of the bed raised. General measures are also valuable in this condition. These will be covered in discussion of reflex syncope.