Some basic work up can help evaluate your cause of syncope and potentially place you on medications when necessary to prevent additional episodes. Some tests we can perform are:

• Carotid Ultrasound: Determine if you have any plaque built up in the arteries of your neck that are reducing blood flow to your brain.
• Lab work: Evalaute thyroid and electrolytes to ensure they are normal and not causing rapid heart rates
• Heart monitor: Either a holter, event, or MCT montior can help evaluate what is occuring with your heart when you are feeling dizzy or syncopal.
• Loop recorder: If you are still having syncopal episodes or previous monitors have found nothing, a loop recorder is a long term option. A small chip injected under the skin continually monitors your heart checking for syncope producing arrythmias.
• Echocardiogram: Determine if a weak heart is the cause of your syncope
• Ambulatory Blood Pressure Monitoring: A device that tracks your blood pressure and heart rate over a 24-48 period.

Vasovagal syncope is the most common type of syncope. It is caused by a sudden drop in blood pressure, which causes a drop in blood flow to the brain. When you stand up, gravity causes blood to settle in the lower part of your body, below your diaphragm. When that happens, the heart and autonomic nervous system (ANS) work to keep your blood pressure stable.

Some patients with vasovagal syncope have a condition called orthostatic hypotension. This condition keeps the blood vessels from getting smaller (as they should) when the patient stands. This causes blood to collect in the legs and leads to a quick drop in blood pressure.

Situational syncope is a type of vasovagal syncope. It happens only during certain situations that affect the nervous system and lead to syncope. Some of these situations are:

• Dehydration
• Intense emotional stress
• Anxiety
• Fear
• Pain
• Hunger 
• Use of alcohol or drugs
• Hyperventilation (breathing in too much oxygen and getting rid of too much carbon dioxide too quickly)
•  Coughing forcefully, turning the neck, or wearing a tight collar (carotid sinus hypersensitivity)
• Urinating (miturition syncope)

Postural syncope is caused by a sudden drop in blood pressure due to a quick change in position, such as from lying down to standing. Certain medications and dehydration can lead to this condition. Patients with this type of syncope usually have changes in their blood pressure that cause it to drop by at least 20 mmHg (systolic/top number) and at least 10 mmHg (diastolic/bottom number) when they stand.

Cardiac syncope is caused by a heart or blood vessel condition that affects blood flow to the brain. These conditions can include an abnormal heart rhythm (arrhythmia), obstructed blood flow in the heart due to structural heart disease (the way the heart is formed), blockage in the cardiac blood vessels (myocardial ischemia), valve disease, aortic stenosis, blood clot, or heart failure. If you have cardiac syncope, it is important to see a cardiologist for proper treatmen

Neurologic syncope is caused by a neurological condition such as seizure, stroke or transient ischemic attack (TIA). Other less common conditions that lead to neurologic syncope include migraines and normal pressure hydrocephalus

Postural-Orthostatic Tachycardia Syndrome is caused by a very fast heart rate (tachycardia) that happens when a person stands after sitting or lying down. The heart rate can speed up by 30 beats per minute or more. The increase usually happens within 10 minutes of standing. The condition is most common in women, but it can also occur in men.