If you’ve been having blackouts or even almost-fainting episodes – even for a long time – get your heart checked out and don’t delay this for another minute.

Though blackouts or fainting episodes can have non-cardiac causes (some life-threatening), the sufferer should first get their heart checked out, because a heart problem can be immediately life-threatening.

Heart Problems that Cause Passing Out

“There are a number of cardiac causes of syncope or passing out,” says Donna P. Denier, MD, F.A.C.C., of The Cardiology Center with the Appalachian Regional Healthcare System.

“Cardiac arrhythmias are one of the more common cardiac causes of syncope. Atrial fib is not a usual cause of syncope–unless the heart rate becomes extremely fast — but other arrhythmias can be, such as supraventricular tachycardia, ventricular tachycardia, heart block or severe bradycardia [abnormally slow heart rate].

“This diagnosis is best made by continuous cardiac monitoring, ambulatory monitoring or electrophysiology testing. Probably, the most common cardiac cause of syncope is neuro-cardiogenic in origin.

“This is a typical fainting episode that is caused by an abnormal response to a prolonged upright position resulting in a sudden drop in arterial blood pressure, then followed by a slowing of heart rate.”

Blacking Out Lately? Don’t Drive!

My mother was occasionally being driven to bridge by her elderly friend who was having mysterious episodes of blacking out.

It’s a real major gamble when someone like this decides to drive, putting their lives – and those of passengers and other motorists – in peril. But quite luckily, the friend never had one of these episodes while driving.

Dr. Denier continues, “It is best diagnosed by a tilt table test which simulates the situation that typically triggers the event.

“Aortic stenosis, when the aortic valve becomes critically restricted, can result in syncope. Besides history and physical exam, echo can confirm this diagnosis.

“Echo is also helpful in diagnosing any structural heart disease such as congenital abnormality, aortic dissection, cardiomyopathy or the acute right heart strain seen in pulmonary embolism.”

Aortic dissection and pulmonary embolism are immediately life-threatening and require immediate medical attention.

Dr. Denier adds, “The majority of cases of syncope are diagnosed by history and physical exam, understanding the situational factors involved and the patient’s individual risk factors. Echo is helpful in some cases but most often does not reveal the cardiac cause of syncope.”

donna denier, md

Dr. Denier has been practicing medicine for over 15 years and is board certified by the American Board of Internal Medicine – Cardiovascular Disease.