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Updated: Jun 22, 2026

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Psychogenic syncope? A cautionary note.

Khalil Kanjwal1, Yousuf Kanjwal, Beverly Karabin

  • 1Department of Medicine, Division of Cardiovascular Medicine, Center for Autonomic Disorders, the University of Toledo Medical Center, Toledo, Ohio 43614, USA.

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Summary

Recurrent syncope may be misdiagnosed as psychogenic. Prolonged monitoring revealed cardiac causes like asystole, resolved by pacemakers.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Neurology

Background:

  • Recurrent syncope often presents diagnostic challenges.
  • Unexplained syncope is sometimes misattributed to psychogenic causes.

Observation:

  • Three patients with unexplained syncope, labeled psychogenic, underwent implantable loop recorder monitoring.
  • Monitoring revealed prolonged asystole or complete heart block as the cause of syncope.

Findings:

  • Implantable loop recorders identified significant cardiac arrhythmias in patients with unexplained syncope.
  • Pacemaker implantation successfully eliminated syncopal episodes in all reported cases.

Implications:

  • Physicians must exercise caution when diagnosing psychogenic syncope.
  • Extended cardiac rhythm monitoring is crucial for identifying underlying cardiac causes of syncope.