Cardiac syncope: lessons learned from Sir Roger Bannister's textbook

More than 30 pages of the textbook on autonomic failure, edited by neurologist Sir Roger Bannister and professor of neurovascular medicine Christopher Mathias, are devoted to the subject of syncope (derived from the Greek work ‘synkoptein’) (Mathias and Bannister, 1999; 2013). Forming the overture to this work is a chapter on neurocardiology in which Harvard professor Martin A. Samuels describes, for example, how a significant number of stroke patients have authentic neurogenic electrocardiographic changes.

In this article—the third in a series on neurocardiology and the work of Sir Roger Bannister—I will give an insight into these authoritative writings, beginning with the introduction to neurocardiology and moving onto syncope (defined in the textbook as ‘a transient loss of consciousness usually resulting from a temporarily inadequate cerebral blood flow’). Both cardiac- and neurally-mediated syncope are discussed, with both being highly relevant for cardiac nurses.

‘In 1942, Walter Bradford Cannon published a remarkable paper entitled “‘Voodoo’ death” (Cannon, 1942) in which he recounted anecdotal experiences, largely from the anthropology literature, of death from fright. These often remote events, drawn from widely disparate parts of the world, had several features in common. They were all induced by an absolute belief that an external force, such as a wizard, or medicine man, could, at will, cause demise and that the victim himself had no power to alter this course.