Hello. Thank you for your question and welcome to HCM. I understand your concern about your friend. This seems as a problem with the heart conduction system. The symptoms you described lean towards syncope which happens when the heart electrical system, no matter what the cause is, shuts down. It can happen in form of various heart blocks and/or pauses, which can produce near-syncope or clear-cut syncope with a total loss of consciousness. If this is the case, it is first warranted for him to be put on a 24-hour heart rhythm monitor and determine whether the criteria of heart blocks/pauses above 2.5 seconds, are present in the reading. This test is practically an EKG sheet, registered throughout 24 hours. If these problems are detected in the above mentioned tests, combined with the symptoms, there is an indication for a permanent pacemaker to be implanted, which is a device that fires electrical impulses when heart s natural electrical system fails to do so. It all depends on the 24-hour reading. If there are no heart conduction abnormalities detected, other origins of these phenomena should be sought. I hope this answers your query. Wish him a good health. Kind regards, Dr. Meriton