Syncope and near syncope in competitive athletes

Syncope, although common among the general population, is rare among athletes. Syncope can result from any one of several causes. The majority of cases are due to neurocardiogenic syncope, without the potential for sudden death, and due to a sudden reduction in venous return. Cardiac syncope may be due to mechanical or structural factors. A thorough history and physical examination, along with an electrocardiogram, can usually distinguish benign cases from those due to more life-threatening conditions. Those at risk for sudden death need to be identified, so they can be appropriately restricted from further athletic activity.