Syncope in the athlete

Syncope during sports is concerning because it may be secondary to nonsustained ventricular arrhythmias and a precursor of sudden cardiac death. Not all syncope is life threatening. It is important to quickly identify the cause and begin to manage these conditions. Syncope during exercise is usually concerning, whereas syncope after exertion is more often benign. Neurocardiogenic syncope and postexercise collapse usually occur after cessation of exercise and are generally benign. Persistent delirium after collapse is life threatening and generally caused by hyperthermia or hyponatremia. In the work-up of syncope the history is vital and guides further work-up and management.