Fainting, or syncope, is a brief loss of consciousness.
- It happens when there is not enough blood supply to the brain for a brief period.
- A single episode usually lasts for less than a minute and the person recovers quickly.
There are many possible causes of fainting. Fortunately, it is not usually related to a serious medical condition. The most common cause of fainting is low blood pressure, which may be due to:
- Getting up from a bed or chair quickly (orthostatic hypotension)
- Standing for a long time
- Certain medications (especially medications to treat high blood pressure or heart disease)
- The sight of blood
- Pain, anxiety or stress
- A warm or hot environment
Some other possible causes of fainting include:
- Low blood sugar
- Psychiatric conditions
- Holding one's breath (seen mostly in young children)
- Migraines (especially in younger people)
Serious conditions that may cause fainting (or feeling near faint) include:
- Heart disease, including an irregular heartbeat (arrhythmia)
- Pulmonary embolism (a blood clot in the lung)
- Blood loss
- Seizure disorder
- Rupture of a blood vessel or bleeding in the brain
- Transient ischemic attack (TIA)
If you think you may be having a medical emergency, dial 911.
It is good to know the symptoms that may be present before fainting. Knowing these symptoms can help decrease the chance of injury. The symptoms include:
- Weakness, dizziness and lightheadedness
- Shortness of breath
- Chest pain
- Palpitations (a feeling of thumping, fluttering, skipping or racing of the heart)
- Pale, clammy skin
- Dimming of vision or ringing in the ears
If you believe you have fainted, or someone has observed you fainting, contact your healthcare provider.
- He or she will do a physical examination and ask questions about your medical history.
- Part of the exam may include measuring your pulse and blood pressure while you are lying on your back and then again after you stand. This is often done three times at one-minute intervals.
It is important to tell your healthcare provider about what happened before and after you fainted. He or she may recommend some tests if:
- You have a history of fainting more than once
- The cause of your fainting is unknown
- A serious cause is suspected
Some of the possible tests include:
- An electrical recording of your heartbeat (electrocardiogram or EKG) to see if your heart is the cause of your fainting.
- Blood tests to see if you have anemia or other medical conditions.
- Carotid sinus massage, which is when pressure is applied to the side of the neck over the carotid artery. It can help determine if a drop in blood pressure or reduced heart rate are the cause of your fainting.
- A tilt-table test, which is when your symptoms are monitored as you lie on a table that is tilted to varying degrees.
If your doctor suspects a heart condition and tests are inconclusive, additional tests may be needed. These may include:
- An echocardiogram, which is an ultrasound of the heart.
- An exercise stress test, which helps determine how your heart works while exercising.
- A medication stress test, which may be done if you are unable to exercise. This is when medication is used to make your heart work as if you are exercising.
- An event recorder, which is a small heart monitor that will record your heart rate and rhythm for a specific period. You will be told to push a button if you have any symptoms.
- A Holter monitor, which is a continuous recording of the electrical activity of your heart for 24 to 72 hours.
- Electrophysiological study (EP study), which is a test that evaluates your heart rate and rhythm. It is done using a special catheter that is threaded into your heart from a vein in your leg or arm.
Treatment of a fainting episode can vary and often depends on the cause of fainting and the presence of injuries. Inpatient treatment may be needed if the syncope is due to blood loss or you have other serious symptoms, including:
- Difficulty breathing
- Chest pain or other heart symptoms
- Severe pain or neurological symptoms
- Head trauma or other severe injury
Any treatment may require changes in medication dosages and underlying medical conditions.ment.
This care path includes the costs for evaluation and treatment of syncope or fainting in a physicians office.
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If you have fainted, contact your healthcare provider. Be prepared to discuss your symptoms and how long you have had them.
- Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
- Make a list of your medications (including over-the-counter).
- Write down any questions, symptoms or concerns you want to talk about.
- If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).
Here are some questions to ask your healthcare provider.
- What is causing my fainting? What are my treatment options?
- How serious are my symptoms? How long will it take my symptoms to improve?
- Do I have to be hospitalized? For how long?
- What tests are you recommending? What is the reason for those tests? Will the test results change my treatment plan?
- What treatment, if any, are you recommending? What other options are available?
- Do I need to take any medications? How long will I have to take the medication?
- Do I need to restrict any of my activities?
- What can I do to decrease my chances of fainting?
- Can I drive?
- What are my follow-up plans and what symptoms should I report before my next appointment?