Fainting or “blacking out” occurs when the blood supply to your brain becomes inadequate and you therefore lose consciousness. Usually, this loss of consciousness is brief. At times, fainting can be medically insignificant. It can also be the symptom of a serious health issue. Therefore, it must be treated as an emergency to relieve symptoms and determine a cause.
"Syncope" - the medical term for fainting:
Repeated episodes should be brought to the attention of your physician. All physicians affiliated with St. Vincent’s Medical Center are well equipped to diagnose and treat the underlying problems behind “syncope,” the medical term for fainting.
Syncope is different from coma or a cerebrovascular accident, which can leave patients in a persistent state of lost consciousness.
- Loss of consciousness preceded by:
- Loss of vision
- Nausea and abdominal discomfort
- Sweating or a feeling of heat
There are a number of different causes of syncope including:
- An abnormal circulatory reflex caused by environmental, emotional or physical factors or illness. Known as vasovagal syncope, this is probably the most common cause of syncope.
- Forceful cough
- Swallowing issues
- Carotid sinus hypersensitivity
- Falling blood pressure
- A drop in blood pressure after eating.
- Standing up after reclining can cause a decrease in blood flow to the brain and result in a drop in blood pressure. This is sometimes related to certain cardiovascular medications, a low circulating blood volume caused by blood loss , dehydration, or heat exhaustion.
- Neurological problems such as stroke or TIAs.
Other major causes of fainting include
Heart disease is behind a number of causes of fainting, which usually are life threatening. Cardiac arrhythmias are the most common cause of cardiac-related syncope. Electrical problems of the heart impair the pumping action of the heart, which causes fainting.
Blockages can impair blood flow causing fainting during exertion.
When the heart's pumping ability becomes impaired, it decreases blood flow to the brain.
Structural Cardiopulmonary Disease:
Though relatively uncommon, fainting may be caused by structural disease of the heart or blood vessels or heart attack.
Additional cardiac causes may include:
Sick sinus syndrome, a sinus node dysfunction, aortic dissection and cardiomyopathy.
Exams and Tests: The cause of fainting cannot always be determined. A thorough medical history and physical examination along with an electrocardiogram, or ECG are used to make a diagnosis. After this evaluation, further testing including blood tests, Holter monitoring or an insertable cardiac monitor may be in order.
To detect an underlying cardiac cause, tests are used to identify coronary heart disease, heart failure, or arrhythmias.
Testing depends on the initial evaluation. If seizure, stroke or head injury is suspected, tilt table testing can be performed.
- Treatment consists of returning blood to the brain by lying down with legs slightly elevated above heart level or sitting down with head between the knees. To prevent the person from fainting again, do not allow the individual to get up too fast. Loosen belts, collars or other restrictive clothing.
- If the person doesn't regain consciousness within one minute, call 911 or your local emergency number.
- Check for a clear airway and watch for vomiting.
- Check for the pulse in the neck and begin CPR, if needed.
- Continue CPR until help arrives or the person responds and begins to breathe.
After the person recovers, encourage him or her to lie down until medical help arrives. Even if you believe the cause of the fainting is harmless, have the person lie down for 15-20 minutes before attempting to get up again.
Ask about any persistent symptoms, such as headache, back pain, chest pain, shortness of breath, abdominal pain, weakness or loss of function, because these may indicate a life-threatening issue.
Medical treatment for non-cardiac syncope
- Lifestyle changes:
Drink plenty of water, increase salt intake (under medical supervision), and avoid prolonged standing.
- Medications may be prescribed if episodes are frequent.
- Elderly people with low blood pressure should avoid large meals or lie down for a few hours after eating.
- Medications should be reviewed to see if they are related to the fainting.
Medical treatment for cardiac syncope
Medication and lifestyle changes can help the pumping action of the heart, help to manage blood pressure and treat arrhythmias.
Please also see
St. Vincent’s Regional Heart and Vascular Center offers the most advanced treatments for the causes of cardiac syncope.
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