Fainting / Syncope

Fainting is medically termed as syncope which is a momentary loss of consciousness. Unlike a seizure, the person who faints generally gets back alertness shortly after recovering consciousness. Fainting is the consequence of a temporary loss of the brain’s blood supply. Fainting can sometimes be an indication of a more severe condition.

When you faint, you not merely feel loss of consciousness, but also loss of muscle tone and paling of color in your face (pallor). You may also feel weak or nauseated just prior to fainting, and you may have a feeling that surrounding noises are fading into the background. There is one more condition which is medically called Pre-syncope. At the time of pre-syncope someone gets symptoms of fainting and he/she might faint but then recovers without actually fainting.

Reasons behind fainting

Vasovagal syncope: Also identified as the \”common faint,\” this is the most recurrent cause of syncope. It is the outcome of an abnormal circulatory reflex. The heart pumps more vigorously and the blood vessels relax, but the heart rate does not compensate fast enough to sustain blood flow

Physical triggers— Feeling too hot or being in a crowded, stuffy, poorly ventilated surroundings are general causes of fainting. People may also faint after exercising too much or working out in extreme heat and not drinking sufficient fluids (so the body becomes dehydrated). Other factors of dehydration, like hunger or exhaustion are also responsible for causing fainting. Sometimes just standing for a very long hour or getting up too quickly after sitting or lying down can trigger someone to faint.

Emotional stress— Emotions like fright, pain, anxiety, or shock are responsible for impairment in nervous system and fall in blood pressure. This is the reason why people faint when something frightens or horrifies them, like the sight of blood.

Hyperventilation— A person who is hyperventilating is taking fast breaths, which causes carbon dioxide (CO2) to reduce in the blood. This can lead to fainting. People who are extremely stressed out, in shock, or have certain anxiety disorders may faint as a result of hyperventilation.

Drug use— A number of prohibited drugs — such as cocaine or methamphetamine — can result in fainting (and even a heart attack in some cases). Inhalant use (\”huffing\”) can make a person to faint by causing problems with a person\’s heartbeat. Fainting also is a side effect of some prescription medications.

Low blood sugar— The brain’s ability to execute works properly depends on a constant supply of sugar from the blood and keeps a person awake. People who are taking insulin shots or other medications for diabetes can grow low blood sugar and pass out if they need to take too much medicine or don\’t eat sufficient. Sometimes people without diabetes who are starving themselves (as with crash dieting) can drop their blood sugar low enough to faint.

Anemia— A person with anemia possess smaller amount of red blood cells than normal, which declines the amount of oxygen distributed to the brain and other tissues. Girls who have heavy periods or people with iron-deficit anemia for other reasons (like not taking enough iron in their diet) may be more likely to faint.

Pregnancy— During pregnancy the body usually experiences lots of changes, as well as changes in the circulatory system, which can cause a woman to faint. Besides, the body\’s fluid requirements are enhanced, so pregnant women can faint if they aren\’t drinking enough fluids. And as the uterus grows it can go forward and partly obstruct blood flow through large blood vessels, which can lessen blood supply to the brain.

Some medical conditions — like seizures or an unusual kind of migraine headache — can cause people to seem like they are fainting. But they\’re not the similar thing as fainting and are treated differently

Eating disorders— People with anorexia or bulimia can faint for numerous reasons, including dehydration, low blood sugar, and fluctuations in blood pressure or circulation caused by starvation, vomiting, or over-exercising.

Cardiac problems— An irregular heartbeat and other heart problems can results in a person to faint. If someone is fainting for a number of times, particularly at the time of exercise or exertion, doctors may suspect heart problems and prescribe tests to examine a heart condition.

Situational syncope

Some susceptible people undergo phases of syncope only in particular situations.

Causes of situational syncope include the following:

Cough syncope occurs in people with lung disease when coughing forcefully

Swallow syncope happens to the people with disease in the throat or esophagus.

Micturition syncope happens when a vulnerable person empties an overflowing bladder. It mostly happens in males who are intoxicated with alcohol.

Carotid sinus hypersensitivity happens in some aged people when turning the neck, shaving, or wearing a tight collar is problematic.

Postural syncope: This takes place when a person lying down, who feels perfectly well and conscious, sudden faints upon standing up. The brain\’s blood circulation lessens when they stand owing to a fall in blood pressure. This at times occurs in people who have lately begun or changed certain cardiovascular medications. This type of fainting results from either or both of the subsequent causes:

  1. Low circulating blood volume, caused by blood loss (external or internal), dehydration, or heat exhaustion
  2. Impaired circulatory reflexes, caused by many medications, disorders of the nervous system, or congenital problems.

Cardiac syncope: Heart disease causes a person to faint by a diversity of mechanisms. Cardiac causes of fainting are usually life threatening. The reasons are:

Cardiac rhythm abnormality (arrhythmia): Electrical problems of the heart weaken its pumping ability. This brings about a decrease in blood flow. The heart rate may be either too fast or too slow to pump blood well. This condition usually causes fainting without any alarming indications.

Cardiac obstruction: Blood flow can be blocked within the blood vessels in the chest. Cardiac obstacle can cause fainting during physical exertion. A number of diseases are responsible for obstruction, including heart attacks, diseased heart valves, pulmonary embolism, cardiomyopathy, pulmonary hypertension, cardiac tamponade, and aortic dissection.

Heart failure: The heart\’s pumping ability is damaged. This reduces the force with which blood flows through the body and may decrease blood circulation in the brain.

Neurologic syncope

Neurologic problems results in fainting (or loss of consciousness) by diverse mechanisms.

Seizures are a result of unconsciousness but are dissimilar from fainting. With seizures, the blood flow to the brain does not decrease. Unconsciousness results from disordered electrical discharges within the brain. Seizure in general causes enduring (longer than 8 seconds) shaking of the arms and legs followed by confusion and disorientation after awakening.

Stroke (bleeding in the brain) can invite syncope interrelated with headache.

Transient ischemic attack (TIA or mini-stroke) can results in fainting usually precede by double vision, loss of balance, slurred speech, or vertigo (a spinning sensation).

Fainting Symptoms
Unconsciousness is the most noticeable sign of fainting.

Vasovagal syncope

  • Before fainting, you may feel light-headed and shaky and experience blurred vision.
  • You may \”observe spots in front of your eyes.\”
  • During this time, observers may observe paleness, dilated pupils, and sweating.
  • While unconscious, you may have low pulse rate (less than 60 beats /minute).
  • You should rapidly regain consciousness.

Situational syncope

  • Consciousness comes back when the situation is over, normally very quickly

Postural syncope

  • You may have suffered from a blood loss (black stools, heavy menstrual periods) or fluid loss (vomiting, diarrhea, fever).
  • You may have felt dizziness when sitting or standing.
  • Observers may notice paleness, sweating, or signs of dehydration (dry lips and tongue).

Cardiac syncope

  • You may experience palpitations (alertness of pounding, fast, or abnormal heartbeat), chest pain, or shortness of breath.
  • Observers may note down a weak, abnormal pulse, paleness, or sweating.
  • Syncope frequently happens without warning or following exertion.

Neurologic syncope

  • You may have symptoms headache, loss of balance, inaudible speech, double vision, or vertigo (a feeling that the room is rotating).
  • Observers note- a strong pulse during the unconscious period and normal skin color.
    Seizures

People undergoing a seizure may report odd sensations that proceed the unconscious period. (This is referred to as an aura.)

  • Incontinence (incapability to hold urine or stool) is regular.
  • If witnesses are present during the seizure, they note sustained convulsions (lasting longer than 8 seconds).
  • A prolonged period of confusion, enduring several minutes, follows the seizure.
  • At the time of a seizure, people often scratch themselves or bite their tongues.

Diagnosing causes of Syncope

Doctors will recommend essential physical examination and evaluate a careful history of what happens just before and during fainting. These are very vital in deciding the cause. Individuals who faint frequently should be examined for abnormal heart rhythms with an electrocardiogram (ECG), a machine that records the electrical impulses of the heart. They normally should also be assessed with an echocardiogram (ultrasound of the heart) to see if there are abnormalities in the heart muscle or valves. In some cases, other tests may be performed, such as a Halter monitor (a 24-hour recording of the heart rhythm) or a tilt test, in which blood pressure and heart rate are determined while the person is lying down on a table and again after the patient stands up or the table is inclined upright. A CT scan is helpful only if seizure, stroke, or significant head injury is suspected.

Home Care and Treatment

If you have a history of fainting and have been treated by a medical professional, follow your doctor\’s instructions for how to handle fainting episodes. For example, if you are aware of the conditions that cause you to faint avoid or transform them.

Avoid abrupt alterations in posture. Get up from a lying or seated position gradually. If you have difficulty in blood test and make you faint, tell your doctor before having a blood test and ensure that you are lying down when the test is performed.

After the person gets well, inform him or her to take rest by lying down until medical aid appears. Even if you think the cause of the fainting is risk-free, have the person lie down for 15-20 minutes before getting up again.

Check whether there is any continual symptoms, such as headache, back pain, chest pain, shortness of breath, abdominal pain, weakness, or loss of function, because these may specify a life-threatening cause of the fainting.You can take immediate treatment steps when someone has fainted:

  • Check the person\’s airway and breathing.
  • Slacken tight clothing around the neck.
  • Lift the person\’s feet higher than the level of the heart (about 12 inches).
  • If vomiting has occurred, turn the person onto their side to prevent choking.
  • The patient should lie down for at least 10 – 15 minutes, if at all possible in a cool and quiet space. If this is not possible, sit the person forward and place their head between their knees.

Vasovagal syncope

Lifestyle alterations: Drink plenty of water, augment salt intake (under medical supervision), and avoid extended period of standing.

Medication may be prescribed if occurrences are repeated.

Postural syncope

Lifestyle alterations: Prior to getting out of bed sit up and flex calf muscles for a few minutes. Avoid dehydration. Aged people with low blood pressure after eating should avoid large meals or plan to siesta for a few hours after eating.

In nearly all cases, medications that cause fainting are withdrawn or altered.

Cardiac syncope

Medication and lifestyle alterations: These treatments are proposed to improve the heart\’s performance while restraining its demands. Controlling high blood pressure, for example, would necessitate a medication and lifestyle modifications.

You must go to a heart specialist if cardiac syncope is suspected.

In several cases, specific anti-arrhythmic medication can be recommended.