Incidence of loss of consciousness in 1,980 Air Force personnel

Epidemiology of reflex syncope

“…Reflex syncope was rare before age 10, but there was a steady increase in first occurrence between ages 10 and 20. After the initial episode, 64 % of females and 53 % of males experienced a recurrent event.Although the study of Ganzeboom et al involved a specific small population, the cumulative life-time incidence is in agreement with data of older studies, involving similarly young, but almost exclusively male populations [34,45,58]. The reported lifetime cumulative incidence in these studies ranged from 17 % to 34 %.…”

Exercise related syncope, when it?s not the heart

“…In the 1950's Dermskian and Lamb found two episodes of exercise-related syncope out of 113 syncopal attacks reported in 82 healthy young adult males (< 2 %) [18]. Another exercise-related episode was reported out of 61 cases of syncope (< 1 %) [59]. At the Academic Medical Center of the University of Amsterdam, analysis of 517 consecutive patients referred for the evaluation of unexplained loss of consciousness showed a < 1 % prevalence (5/517) for exercise-related syncope [Wieling, unpublished data].…”

“…Physical counter maneuvers designed to engage the muscle pump and augment venous return can be taught to the individual, including instructions to keep walking, to apply leg crossing prophylactically when standing still after exercise, to bend over the bicycle after cycling, and to sit or squat immediately when a faint is imminent [56,57,59]. Classical straining maneuvers practiced by jet pilots during high G exposure [112] or regular forceful coughing (so called "cough CPR") may be useful to sustain consciousness for a sufficient period of time to allow the athlete to get out of a dangerous situation and in the supine position.…”

Guidelines on management (diagnosis and treatment) of syncope

“…15% of children before the age of 18 [22] 25% of a military population aged 17-26 [23] 20% of air force personnel aged 17-46 [24] 16% during a 10-year period in men aged 40-59 [25] 19% during a 10-year period in women aged 40-49 [25] 23% during a 10-year period in elderly people (age >70) [18] However, the majority of these individuals probably do not seek medical evaluation.…”