Dizzy spells and syncope: investigation and management

Cardiovascular causes of syncope are treated by removal of reversible triggers (e.g. drugs that cause bradycardia or hypotension) or by treatment of the underlying condition (e.g. permanent pacemaker for symptomatic bradycardia, aortic valve surgery for aortic stenosis). Vasovagal syncope is more difficult to treat but can be helped by avoiding identifiable triggers, use of medication and in some cases dual chamber pacing.