There are three principal causes of drop attacks. The first is heart block, in which the heart beats arrhythmically instead of maintaining its metronomelike regularity. In either case, the heart's pumping ability is markedly compromised and a drop attack is a predictable result. Heart block is usually diagnosed by obtaining a 24-hour reading of the heartbeat pattern using a Holter monitor, an electrocardiograph hooked up to a tape recorder. If a disordered heartbeat is detected and, particularly if the person has other symptoms, then a doctor might recommend a heart pacer, a spectacular solution for this potentially life-threatening problem.
Medications can also control erratic heartbeat.
The choice depends on what the Holter monitor reveals. A second cause for drop attacks is what is known as a TIA, which stands for transient ischemic attack. When tiny platelet clots flip off of the lining of an artery or valve leading to the brain and go upstream into the head, they can cause a small, temporary lack of circulation to that part of the brain. Unconsciousness is sometimes the result. A TIA might also be called a strokelet, or little stroke.