COPD and Syncope

People living with chronic obstructive pulmonary disease (COPD) may experience syncope. Syncope is the medical term for fainting or passing out.1,2

During syncope a person loses consciousness for several seconds. It occurs when blood flow to the brain drops. Most commonly, this is due to sudden changes in posture or dehydration.1,2


Before passing out, you may start to feel "off." Some warning signs of syncope include:1

  • Feeling dizzy or lightheaded
  • Nausea
  • Heart palpitations
  • Trouble hearing
  • Dimmed vision
  • Sudden weakness

It is essential to pay attention to these warning signs. Put your body in a safe position. Lying down helps blood flow return to the brain.1

Syncope triggers

Doctors look for other causes when dehydration or postural change is not responsible. There are many things that can trigger syncope, though some are more common in people with COPD.1-4

Situational syncope

Certain actions can trigger situational syncope. Some possible triggers include:1-3

  • Coughing, sneezing, swallowing
  • Eating
  • Blowing hard, such as when playing the trumpet or flute
  • Straining with a bowel movement

The most common situational trigger with COPD is severe coughing.1-3

Cardiac syncope

Cardiac syncope can be a symptom of a serious heart condition1-3

Common causes of cardiac syncope include heart problems like abnormal heart rhythm (arrhythmia) and narrowing of the valve between the heart and the aorta (aortic valve stenosis).1

Heart problems are common in people with COPD. Between 14 and 33 percent of people diagnosed with COPD also develop heart disease. A doctor should evaluate episodes of syncope. Diagnosing and treating heart disease early is vital.1-3

Cough syncope

Cough syncope occurs after long bouts of intense coughing. It happens when the exchange of pressures between the heart, lungs, pleura, and brain are inconsistent. Those with cough syncope usually remember coughing before losing consciousness.4

More than 50 percent of cough syncope cases include twitching or movement while unconscious. Loved ones may misinterpret these symptoms as a seizure.4

In the general population, cough syncope is uncommon. Only 2 percent of syncope cases are from coughing. Cough syncope primarily affects those with COPD and men who are muscular or overweight.4

Diagnostic tests

There are several tests doctors use for diagnosing syncope. Most diagnostic tools evaluate heart function. Doctors need to ensure you are not experiencing cardiac syncope. Possible tests include:1,2

  • Physical exam
  • Exercise stress test – Tests the heart’s response to exercise or stress
  • Electrocardiogram (ECG or EKG) – Monitors electrical activity in the heart
  • Echocardiogram – Ultrasound of the heart
  • Tilt table test – Stimulates changes in posture to determine syncope cause
  • Electrophysiology study – Checks for abnormal heart rhythms

Talk to your doctor

If you experience episodes of syncope, contact your doctor. Share details you recall about your syncope episodes, including:

  • Number and frequency of episodes
  • If you were coughing before losing consciousness
  • Any pre-syncope symptoms
  • Any seizure-like symptoms
  • Medical history related to COPD or heart failure

An accurate diagnosis helps correctly treat syncope. Create a plan with your doctor for managing syncope episodes.

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