A cardiologist talks about blackouts and what tests you should get to find out if the problem is heart related.

Have you been having blackouts and “all the tests” are normal? Perhaps you haven’t had the right tests.

First of all, the doctor you should initially see is a cardiologist, since blackouts can be caused by serious heart problems that need immediate attention.

So just what are the tests you should insist upon for blackouts?

“One could consider an echocardiogram to make sure there are no problems with the heart valves,” says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.

Dr. Sayeed continues, “A holter monitor could check for abnormalities in the heartbeat. A stress test could look for abnormal heartbeat with exercise. A tilt table test could evaluate for blackout with different positions.”

Some people black out soon after rising from a prolonged seated position. Their blood pressure plummets and the brain is starved of oxygen, causing the blackout.

The tilt table test measures blood pressure when the patient is in various positions.

Can a seemingly healthy person, with no previous concerning symptoms, suddenly one day drop from a blackout?

“Yes, this can certainly happen, as the electrical system in the heart can suddenly decompensate, especially in an older person, and this is why they frequently come in with bruised or injured faces or head injury.”

On the other hand, a person can begin experiencing suspicious symptoms, short of an actual blackout, that progress over time, one day culminating in a full fledged loss of consciousness.

Dr. Sayeed, explains that “there can be a transition period, especially if they are just having brief episodes of abnormal heartbeat and if this progresses over time to worsen the heartbeat. The symptoms can get worse and eventually lead to syncope.

“This is usually less common and usually a more drastic sudden blackout is how patients usually present.

“But certainly a gradual onset over time can occur especially if the person can tolerate the symptoms quite well.”

If you have even ONE blackout, do not delay getting tests, because this symptom is never normal.

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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