Syncope is a frequent reason for elderly patients to present to an outpatient office. The underlying cause of syncope can range from benign to serious. Although serious cases of syncope are rare, appropriate workup can help detect and address potentially fatal pathologies. We present a case of a 74-year-old woman who presented with an episode of syncope with associated epigastric cramping. Sudden syncope without significant comorbidities prompted further diagnostic workup, which revealed a rare cardiac myxoma. This case underscores the importance of ruling out potentially fatal causes prior to favoring more conservative diagnoses when investigating syncope in the elderly population.