Syncope in cardiology practice: current concepts and future perspective

General Medicine, 2026, 28(1), 56-68.

I. Bayraktarova

Department of Noninvasive Cardiology, National Heart Hospital – Sofia

Abstract. Syncope is a condition characterized by total loss of consciousness with a short duration and rapid onset, fol­lowed by a spontaneous complete recovery. Syncope is a frequently occurring event in the general population and in clin­ical practice, and underlying causes concern most often the heart, the blood pressure and the brain. The wide spectrum of causes leads to a wide array of differential diagnoses, practical approaches and patient prognosis. Standard practices also vary amongst clinical centers which directly impacts diagnostic and therapeutic results. The evolving understanding of the pathophysiology of syncope, along with the development of novel therapeutic approaches, can potentially lead to better long-term patient prognosis and quality of life. In this review, we will focus on the major aspects of patient assess­ment, pathogenesis, current diagnostic and therapeutic options. We shall also discuss the specifics of syncope in the very predominant in real life cardiology practice geriatric population.

Key words: syncope, vasovagal syncope, orthostatic hypotension, head up tilt-table test, cardioneuroablation, geriatric syncope

Address for correspondence: Dr. Iskra Bayraktarova, PhD,e-mail: i.bayraktarova@yahoo.com