What Exactly Is a Fainting Spell? – Cleveland Clinic

We’ve all seen the movies where someone faints after hearing shocking news. But did you know that it’s so common that it occurs in about one-third of the general population? Besides hearing some shocking news, there are a number of different things that can cause someone to pass out.

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It can start with a feeling of dizziness, followed by narrowed vision, muffled sense of hearing — until you wake up somewhere unexpected, like the floor, wondering what happened.

“Syncope — the medical term for fainting —​ is defined as a temporary loss of consciousness and muscle control caused by low blood flow to the brain,” says pediatric cardiologist Peter Aziz, MD. “To put it more simply, fainting can occur when your blood pressure or heart rate drops suddenly. ”

It’s not considered a disease itself, but rather it’s a sign or a symptom that can potentially point to an underlying condition. Although rare, fainting can be a precursor of a life-threatening illness, like a heart disorder. That’s why patients who suffer fainting spells should be evaluated promptly by a physician.

When passing out isn’t a concern

The most common cause of fainting is what physicians call vasovagal syncope. 

“It happens as a result of a fascinating chain of reactions in the body,” explains Dr. Aziz. “It can occur when your body overreacts to certain triggers, with changes in vessel tone and blood pressure, as mediated by the brain.”

These can include prolonged standing, dehydration, the sight of blood, emotional trauma, stress, having blood drawn, fear of bodily injury, straining — like having a bowel movement — and even hair combing.

These swooning signs provide comfort to doctors because often, they suggest the cause of fainting is nothing to worry about.

When vasovagal syncope is occurring, you’ll experience warning signals that include dizziness, headache, nausea, sweating, paleness, feeling warm or hot, and vision and/or hearing changes.

Although vasovagal syncope is typically harmless and requires no treatment, your doctor may instruct you to increase your fluid and salt intake, as well as sit or lie flat if these symptoms occur.

When should I worry about fainting?

While occasional fainting is harmless, if you’re older and have certain risk factors, more than one episode of fainting could signal a dangerous problem with your heart. Fainting, when associated with exercise or exertion, shouldn’t be taken lightly, either. Typically in a benign fainting spell, someone will have some recall just prior to passing out.

But when someone has no memory of the event whatsoever, it can suggest than an arrhythmia was the culprit.

Your doctor will test your heart’s electrical system with an electrocardiogram in the office. They’ll also ask questions about your family members, since family history can help provide deeper clues as to whether or not passing out is harmless (benign) or a bigger problem. 

“Your doctor will often ask if anyone in the family experiences or has experienced passing out spells, seizures, sudden unexplained death (like drowning), single car accidents or heart attacks at a young age,” says Dr. Aziz. 

All these seemingly weird questions can suggest a life-threatening arrhythmia may run in the family.

People over age 60 are more likely to faint for heart-related reasons than those who are younger. For example, it’s not unusual to take too much blood pressure medicine, which makes your pressure drop too low. Once the dose is adjusted, you should stop passing out.

Of much greater concern is fainting caused by episodes of a slow or fast rate. The most dangerous is a heart rhythm disturbance called ventricular tachycardia, or ventricular fibrillation (VFib).

In VFib, your heart fibrillates (races away in a disorganized fashion). After four to five seconds, you lose consciousness, stop breathing and have no pulse. This is called sudden cardiac arrest.

“If left untreated, this arrhythmia is universally fatal,” warns Dr. Aziz. “The only way to abort this arrhythmia if it sustains is using an automated external defibrillator (AED).”  

Sudden cardiac arrest is the most common single cause of death in our country. It’s vital to know whether you have any of these risk factors for it:

• Scarring of the heart.
• Poorly managed heart failure.
• A low ejection fraction.
• A family history of unexplained death at a young age.
• Coronary artery disease.

If you do have any of these risk factors, tell your cardiologist promptly about these fainting spells. If you are found to be at risk of VFib, or of having a sudden cardiac arrest episode, an implantable cardioverter-defibrillator (ICD) can save your life. Whenever an episode occurs, the ICD will automatically restore normal heart rhythm — within seconds.

Why fainting is more concerning in the summer

During the summer when temperatures are hot, outdoor activities are more abundant and fainting can occur more frequently due to overheating and dehydration.

“It’s important to stay vigilant and be prepared in case this happens to someone you know,” says Dr. Aziz. “Although benign fainting spells are brief and sufferers come back to their own within 10 to 15 seconds, they can still injure themselves during the event.”

If you see someone faint, don’t just stand there. Check to see if they’re conscious, and if they’re not, call 911 immediately and start administering CPR.

Despite the fact that fainting is fairly common and most instances are nothing to worry about, being attentive and aware of this topic — especially during the sizzling summer months — can potentially help save a life.​

Fainting – Heart and Blood Vessel Disorders

A person cannot lose consciousness unless brain function is generally disturbed. This disturbance usually occurs because overall blood flow to the brain is reduced. Sometimes, however, blood flow is adequate but the blood does not contain sufficient oxygen or glucose (blood sugar), which the brain needs to function.

Blood flow to the brain can be reduced in several ways. Most often, the cause is something that interferes with the normal return of blood to the heart (and thus reduces blood flow out from the heart). Less often, the cause is a disorder that interferes with blood pumping (typically a heart disorder). Although strokes reduce blood flow to the brain, they only reduce flow to part of the brain. Thus, strokes rarely cause fainting except for the few strokes that involve the part of the brain that maintains consciousness.

The most common causes of fainting are

• Strong emotion (such as fear, pain, or sight of blood)

• Coughing or straining to pass stool or urine

• Idiopathic (meaning that the cause cannot be determined)

These common causes nearly always cause fainting only when people are standing up. When they fall down, blood flow to the brain is increased, quickly restoring consciousness, although people may not feel completely normal for a few minutes to a few hours. Some people feel tired or exhausted for several hours. These causes tend not to be serious unless people are injured when they fall.

Most of these causes involve decreased return of blood to the heart. Strong emotion (particularly that triggered by the sight of blood) or pain can activate the vagus nerve. Vagus nerve activation widens blood vessels, reducing the return of blood to the heart, and slows the heart rate. Both of these factors cause light-headedness and sometimes fainting (called vasovagal syncope or neurocardiogenic syncope).

Straining during bowel movements or urination or coughing increases chest pressure. Increased chest pressure can activate the vagus nerve and also reduce the return of blood to the heart—two factors that may cause fainting.

Healthy people may faint when standing still for a long time (most common in soldiers, a phenomenon called parade ground syncope), because the leg muscles have to be active to help return blood to the heart.

Sitting or standing up too quickly can cause fainting, because the change in position causes blood to pool in the legs, resulting in a fall in blood pressure. Normally, the body quickly increases the heart rate and constricts blood vessels to maintain blood pressure The Body’s Control of Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying… read more . If the body does not compensate in these ways, light-headedness is common and fainting may rarely occur. Certain brain and spinal cord disorders, prolonged bed rest, and certain drugs (particularly those used to treat high blood pressure) can interfere with this compensation and lead to fainting when standing up Dizziness or Light-Headedness When Standing Up In some people, particularly older people, blood pressure drops excessively when they sit or stand up (a condition called orthostatic or postural hypotension). Symptoms of faintness, light-headedness… read more .

Hormonal changes in early pregnancy sometimes lead to fainting.

Less common but more serious causes include

• Heart valve disorders (most commonly, the aortic valve)

• A heart rate that is too fast or too slow

• Blockage of an artery to the lungs by a blood clot (pulmonary embolism)

• Heart attack or other heart muscle disorders

Heart valve disorders can block blood from leaving the heart. A very fast heart rate may not allow the heart enough time to refill with blood, so less blood is pumped. A very slow heart rate may not pump enough blood. Blood clots in the lungs can keep the heart from pumping enough blood. People with a heart attack rarely have fainting when the heart attack occurs (more common in older people). Other uncommon heart muscle disorders called cardiomyopathies can cause fainting, particularly during exercise, typically because of an abnormal heart rhythm.

Although most strokes do not cause fainting, a stroke or transient ischemic attack (TIA) that involves certain blood vessels at the base of the brain (posterior circulation stroke) can cause fainting. Similarly, a migraine that involves these blood vessels sometimes causes fainting.

Syncope (Fainting) | Johns Hopkins Medicine

What is syncope?

Syncope (SINK-a-pee) is another word for fainting or passing out. Someone is considered to have syncope if they become unconscious and go limp, then soon recover. For most people, syncope occurs once in a great while, if ever, and is not a sign of serious illness. However in others, syncope can be the first and only warning sign prior to an episode of sudden cardiac death. Syncope can also lead to serious injury. Talk to your physician if syncope happens more often.

Pre-syncope is the feeling that you are about to faint. Someone with pre-syncope may be lightheaded (dizzy) or nauseated, have a visual “gray out” or trouble hearing, have palpitations, or feel weak or suddenly sweaty. When discussing syncope with your doctor, you should note episodes of pre-syncope as well. 

Becoming unconscious due to a seizure, heart attack, head injury, stroke, intoxication, blow to the head, diabetic hypoglycemia or other emergency condition is not considered syncope.

Someone who faints should be moved so they are lying down to allow blood to flow to the brain. If they do not regain consciousness promptly, start CPR.

What causes syncope?

Syncope occurs when there is not enough blood flow to the brain. There are many potential causes, but the most common ones include:

Serious Cardiovascular Conditions (Cardiac Syncope)

If fainting occurs frequently and is not because of dehydration or sudden postural change, you may need to be tested for a serious heart or vascular condition. Cardiac syncope often occurs suddenly, without dizziness or other pre-syncope symptoms.
Common causes of cardiac syncope:

• Arrhythmia and abnormal heart rhythm: During episodes of heart arrhythmia, the heart works inefficiently and not enough oxygenated blood can circulate to the brain. There are many types of cardiac arrhythmias that may cause syncope. These include bradyarrhythmias (the heart beats too slowly) and tachyarrhythmias (the heart beats too fast).

• Aortic dissection, a tear in the large artery that carries blood from the heart to the rest of the body. This is a very rare but life-threatening condition.

• Aortic valve stenosis, a narrowing of the valve between the heart and the aorta. Aortic valve stenosis can be congenital (present from birth) or can develop in old age.

Reflex Syncope (Neurally Mediated Syncope, Vasovagal Syncope, Vasodepressor Syncope, the Common Faint)

Reflex syncope is the result of a reflex response to some trigger, in which the heart slows or blood vessels dilate (widen). This causes blood pressure to drop, so less blood flows to the brain and fainting (syncope) or near-fainting (pre-syncope) occurs. Reflex syncope is the most frequent cause of fainting.

Vasovagal syncope — the common faint — occurs in one third of the population. It is by far the most common form of reflex syncope. Vasovagal syncope is often triggered by a combination of dehydration and upright posture. But it can also have an emotional trigger such as seeing blood (“fainting at the sight of blood”).

Some Vasovagal Syncope Triggers

• Seeing blood (not considered a serious symptom)

• Getting an injection or having blood drawn (not considered serious)

• Standing up quickly (a “head rush” is considered pre-syncope)

• Standing upright for a long time

• Sudden and unexpected trauma, stress or pain, such as being hit

• Blood donation

Other types of reflex syncope include:

Situational syncope, a sudden reflex response to a trigger other than those listed above. Triggers include:

• Coughing, sneezing, laughing, swallowing

• Pressure on the chest after exertion or exercise

• Defecating

• Urinating (post-micturition syncope: occurs in men while standing to urinate)

• Eating a meal

• Sudden abdominal pain

• Blowing a brass instrument or lifting weights

Carotid Sinus Syncope, a response in older adults that occurs when pressure is applied to the carotid artery in the neck. A hard twist of the neck, wearing a tight collar and pressing on the artery are triggers for carotid sinus syncope.

Orthostatic Hypotension

Orthostatic (upright) hypotension (low blood pressure when standing) can also cause fainting because blood has trouble going against gravity to reach the brain. Orthostatic hypotension is defined as a fall in systolic blood pressure of 20 mmg Hg or more on standing, resulting in syncope or pre-syncope. Orthostatic hypotension is common in elderly individuals and is often exacerbated by dehydration or medications that lower blood pressure, such as diuretics. Less commonly, orthostatic hypotension can be caused by a neurologic condition such as Parkinson’s disease or multisystem atrophy, formerly known as Shy-Drager syndrome.

Postural Orthostatic Tachycardia Syndrome (POTS)

Postural orthostatic tachycardia syndrome (increased heart rate when standing), or POTS, is a rare clinical syndrome characterized by an increase in heart rate of at least 30 beats per minute on standing and orthostatic intolerance — when standing brings on symptoms such as palpitations, lightheadedness and fatigue. POTS generally appears in young women. After excluding other causes, the diagnosis is made on physical examination, medical history and tilt-table test. Treatment usually consists of increased salt and fluid intake, recumbent exercise (not standing upright) and education in avoiding triggers. POTS does not usually get worse with age.

How is syncope diagnosed?

It’s important to identify the cause of syncope, if possible, to rule out a dangerous heart condition. Depending on your symptoms and circumstances, the following tests may be used to find the cause:

On-site Diagnostic Tests

• Electrocardiogram (ECG or EKG): wires taped to various parts of your body to create a graph of your heart’s electrical rhythm

• Exercise stress test: ECG recorded while strenuously exercising

• Echocardiogramor transesophageal echocardiogram: ultrasound of the heart

• Physical examination, including orthostatic vital signs and carotid sinus massage

• Tilt table test: measurement of heart rate and blood pressure in response to upright tilt, which simulates prolonged standing

• Electrophysiology study (EP): test that examines the heart’s electrical activity from the inside; used to diagnose many heart rhythm disorders

In-home Diagnostic Monitors

• Holter monitor: a portable ECG you wear continuously for one to seven days to record your heart rhythms over time

• Event monitor: a portable ECG you wear for one or two months, which records only when triggered by an abnormal heart rhythm or when you manually activate it

How is syncope treated?

The treatment for syncope will depend upon the underlying condition but may include:

• Catheter ablation: procedure to cauterize the specific heart cells that cause abnormal heart rhythms

• Pacemakers: device inserted under the skin below the collarbone to deliver regular electrical pulses through thin, highly durable wires attached to the heart; used to treat bradycardia, heart block and some types of heart failure

• Implantable cardioverter-defibrillators (ICDs): a small implanted device that delivers an electrical pulse to the heart to reset a dangerously irregular heartbeat; often used to treat ventricular tachycardia or heart failure

• Avoiding known triggers

Why Am I Feeling Lightheaded? 9 Reasons You Feel Faint and Dizzy

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Ever fainted? It’s terrifying, but 90 percent of people who have passed out are absolutely fine, says Venkatesh Thiruganasambandamoorthy, MBBS, clinical epidemiologist at the Ottawa Hospital Research Institute and an assistant professor at the University of Ottawa. As for the other 10 percent, an underlying health condition could be to blame, and that could mean potentially serious health concerns down the road.

Fainting, no matter why it happens, is the result of a short period of time when the brain’s blood supply is decreased, explains Lawrence Phillips, MD, an assistant professor of medicine in the cardiology division at New York University Langone Medical Center.

“The cause can stem from many different parts of the body, including a person’s blood pressure going down, heart rate going down, and from neurologic reasons independent of the heart,” he says. “We try to find out why the blood pressure or heart rate would go down. Some of these reasons are common and not worrisome, but others need more evaluation.”

Even if you don’t faint from it, that drop in blood pressure or heart rate can cause lightheadedness, that very specific yet hard to describe feeling that you might pass out. (Dizziness, on the other hand, can include lightheadedness, but it also comes with the feeling that the room is spinning around you.)

It’s tricky to know when fainting or lightheadedness is a cause for concern—even doctors often feel stumped. Here, nine potential reasons you could feel lightheaded and why it happens. No matter what, always play it safe by seeking medical attention for any new symptoms, or ones that don’t resolve themselves.

Dehydration

Some people are simply predisposed to feeling lightheaded or even fainting when they get hot and sweaty and lose too much fluid. “It’s common in a hot room, like standing in church in the summer,” Thiruganasambandamoorthy says. “Heat triggers a pathway in the nervous system that causes blood pressure to drop.”

When you feel lightheaded because of dehydration—which includes symptoms like dry mouth and skin, dark-colored urine, and headaches—lying down resupplies the heart and the brain with blood, helping you to feel better pretty quickly, he says.

Surprises

A similar reaction can be triggered when your college roommate jumps out from behind the couch at your surprise birthday party. Your nervous system essentially goes into overdrive in these scenarios, Thiruganasambandamoorthy says, and your blood pressure drops suddenly, leading to lightheadedness. Usually, you do get a little bit of a warning if you’re really going to faint: You might turn a little green and feel nauseated, he says.

Standing up too quickly

Feeling lightheaded or even seeing black spots in your vision when you hop up quickly from a seated position actually has a name: orthostatic hypotension, which describes a sudden drop in blood pressure upon standing. It’s usually no big deal, but if it happens a lot or if it gets worse instead of better after a few minutes have passed, it’s worth bringing up with your doctor.

Abnormal heart rhythm

Compared to the relatively slow onset of symptoms caused by “Surprise!”-related fainting, heart-related fainting comes on fast, so you might not even notice any lightheadedness. An irregular heartbeat, called an arrhythmia, means your heart beats either too slow or too fast, which can in turn affect the blood supply that reaches your brain, Dr. Phillips says.

This kind of sudden fainting, often without any warning, is most concerning, says Melissa S. Burroughs Peña, MD, assistant professor of clinical medicine in the division of cardiology at the University of California, San Francisco.

“Someone might be in the middle of talking and all of a sudden pass out and wake up on the floor without remembering feeling anything beforehand,” she explains. That kind of experience immediately makes emergency docs think of abnormal heart rhythms, which are the most common cause of sudden cardiac death, according to the Mayo Clinic.

Heart valve problems

Your heart relies on four valves to evenly distribute blood throughout your entire body. However, some people develop problems with their heart valves at birth, meaning their hearts have to work harder to function properly. These congenital issues are likely to occur in younger people, Dr. Burroughs Peña says, whereas people 60 and up are at a higher risk of an arrhythmia. Valve problems can restrict blood flow and may cause lightheadedness or dizziness, especially during exercise, she says.

Medication side effects

Certain meds, like painkillers and some anti-anxiety pills, can produce dizziness or lightheadedness. This happens because they affect your brain directly or they slow your heart rate or lower your blood pressure in a way that can provoke those symptoms, Dr. Phillips says.

“Sometimes when a patient has recurrent lightheadedness and I can’t explain why, I’ll be surprised to find it listed among less common side effects in pharmacy reports,” add Dr. Burroughs Peña, so your doctor may need to double-check your medication list.

There’s also a small chance you could be allergic to a medication you’re taking, she adds. In rare instances when people have a life-threatening allergic reaction to a drug, they might become lightheaded or even pass out. “It’s a very dramatic immune system reaction,” she says, which results in the blood vessels dilating and blood pressure dropping. “It’s still a blood pressure change that causes the lightheadedness, but it’s an immune reaction that causes it.”

Low blood sugar

If you’ve skipped a meal, you probably know what it’s like to feel seriously hangry. That’s because not eating enough can seriously mess with your blood sugar levels—and when your blood sugar dips too low, you may feel lightheaded, since your brain isn’t getting the fuel—aka glucose (a type of sugar)—that it needs for energy.

This is more of a metabolic concern, Dr. Burroughs Peña says. Most of the time, grabbing a bite to eat will resolve your symptoms. Pro tip: Stocking up on satiating, non-perishable snacks in your desk drawer (like protein bars) can help you stay fueled on crazy busy days.

But if you have diabetes and take medication to lower blood sugar, lightheadedness should be taken seriously, as it might be a sign your blood sugar is dipping dangerously low, she adds, which can lead to seizures and unconsciousness.

Flu

The flu, a respiratory infection caused by a virus, can cause some nasty symptoms, like fever, muscle aches, chills, sore throat, headaches, and a stuffy nose. But if you’re feeling lightheaded? Blame dehydration and low blood sugar: You probably don’t feel much like eating or drinking, but both can keep lightheadedness and other awful flu symptoms at bay, Dr. Burroughs Peña says. Not sure what you can stomach? Here’s exactly what to eat when you have a cold or flu.

Stroke

If you feel lightheaded (or dizzy) in conjunction with muscle weakness, difficulty speaking, or numbness and tingling, a stroke (when blood flow gets cut off from an area in the brain) may be behind the symptoms, Dr. Phillips says, and you should seek emergency medical attention immediately.

The decrease in blood flow that leads to feeling lightheaded could be caused by a blood clot in the brain, Dr. Burroughs Peña says, which can cause what’s called an ischemic stroke.

Sarah Klein
Sarah Klein is a Boston-based writer, editor, and personal trainer currently with LIVESTRONG.com, and previously of Health.com, Prevention magazine, and The Huffington Post.

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Here’s Why You Feel Dizzy When You Stand Up

If you’ve ever had that feeling of dizziness when standing up too fast, you may wonder what’s going on. 

Depending on the cause, it may not be a long-term problem. But if you feel faint or actually lose consciousness, talk to your doctor as soon as possible.

“The feeling that you’re about to faint is called ‘presyncope,’” says Lia F. Crispell, certified registered nurse practitioner at ConvenientCare in Wilkes-Barre. “It happens when the brain doesn’t get enough blood, oxygen or glucose to function properly, even momentarily.”

The common causes of lightheadedness

People who experience presyncope usually dismiss it and move on with their day. “This isn’t a good idea since some of the causes can be serious. It’s always best to get a diagnosis from a doctor,” says Crispell. Especially because dizziness can be a symptom of an underlying medical condition.

Potential causes of presyncope include:

Orthostatic hypotension

Also called postural hypotension, this is the head rush you sometimes feel when you stand up. It can happen to anyone — and it tends to happen more often if you’re taking certain medications and as you age.

Heart arrhythmia

This condition (also known as an abnormal heart rate) is when your heart beats too fast, too slow or in a way that causes a sudden decrease in the blood supply to your brain. Any of these can make you feel faint.

Medications

Medicines prescribed for pain, heart conditions and high blood pressure can affect your circulatory system and — you guessed it — feeling dizzy. If it happens a lot, talk to your doctor about adjusting your dosage.

Dehydration

Not drinking enough fluids can cause nausea, weakness, dizziness, low blood pressure and fainting. The good news: Rehydrating will alleviate your symptoms quickly.

Anemia

Anemia is a lack of healthy red blood cells or hemoglobin in your blood, which carry oxygen to your organs — including your brain. The hallmark of anemia is tiredness, but it can also cause you to feel faint and dizzy.

Autonomic neuropathy

This nerve disease disrupts electrical signals between your brain and heart, blood vessels and sweat glands. Feelings of faintness come from its effect on your heart rate and blood pressure.

Stress and panic attacks

Ever had an anxiety attack? You probably breathed more rapidly and deeply, both of which can lead to lightheadedness and dizziness.

What to do if you feel faint

When you get that lightheaded feeling, lie down or sit down and place your head between your knees. 

“The most important thing to do if you feel faint is to get to a safe place,” says Crispell. “By doing so, if you do lose consciousness, you’ll avoid injury from falling or bumping your head.”

After the fainting spell passes, contact your healthcare provider as soon as possible for a checkup. A trained medical professional can pinpoint the exact cause of your presyncope.

Next steps:

Meet Lia Crispell, CRNP

Urgent care, primary care and emergency care: What’s the difference?

Find a Geisinger ConvenientCare near you. Visit geisinger.org/urgent.

Dizziness and Fainting in Children and Teens

​By: Caitlin Haxel, MD, FAAP
& Juan Villafane, MD, FAAP

Passing out or fainting―also known by the medical term syncope―is common among young people, especially teenagers.

As many as

1 in 4 healthy children and adolescents have fainted at some point. Has your child?

Although the experience can be frightening, it’s
usually not caused by anything serious. Most young people recover quickly after fainting, typically in less than one minute.

What causes a healthy child to faint?

Most often, fainting happens in otherwise healthy children when there is a temporary drop in the flow of oxygen-rich blood to the brain (blood pressure). Usually, the child recovers quickly. This is called
simple fainting.

Triggers for simple fainting can include:

• 
  Not drinking enough fluids―especially during
  hot weather or in overheated spaces. Dehydration is the most common cause of fainting in children. Not drinking enough fluids also reduces blood volume and lowers blood pressure.

• 
  Standing still for a long time in one place. This can cause the blood to pool in the legs because of gravity or standing up quickly.

• 
  Overheating―especially in overcrowded environments.

• 
  Strong emotions in response to pain, blood, or something shocking or scary. This can cause the part of the brain that controls blood pressure, breathing rate, and heart rate to suddenly switch gears and get out of sync.

• 
  Hyperventilating or breathing too fast. This can happen due to anxiety or fear, because it causes rapid changes in our blood supply to the brain.  

• 
  Breath-holding spells. These are common in young children during
  temper tantrums or when they are in pain.
  Breath-holding spells generally are not serious, and most children outgrow them by 6 years of age.

• 
  Certain movements, such as coughing, swallowing, weight lifting, going to the bathroom, or even hair-grooming may stretch or press on sensitive nerve endings. This trigger is rare and usually affects teens; with the vast majority outgrowing it.

What are some warning signs and symptoms before fainting?

About 5 to 10 seconds before fainting, there are a number of warning signs including:

• Dizziness or lightheadedness

• Nausea

• A surge of warmth and sweating, or sudden cold feeling

• Blurry or spotty vision

• “Ringing” in the ears

• Pale or ashy appearance

• Faster heart rate (called  tachycardia)

If my child has fainted before, should I tell her teachers and coaches?

Yes. They can help watch for signs and help her to the floor if it happens again and help avoid risks like having her stand at the end of a row in crowded bleachers.

Can fainting be a sign of a more serious medical condition?

In some cases, fainting can be a sign of an underlying health problem or condition, such as:

• 
  Iron-deficiency.
  Anemia, when there’s insufficient iron in the blood to deliver enough oxygen to brain, can cause of fainting in rapidly growing teens—especially girls who get
  heavy periods.

• 
  Internal bleeding. A blow to the head (such as a
  concussion) or belly.

• 
  Diabetes. Sudden drops in blood sugar can cause fainting. The brain needs sugar for energy.
  Diabetes also can cause increased urination that leads to dehydration. If a child with diabetes faints, it is considered a diabetic emergency.
  Use this form from “Helping the Student with Diabetes Succeed: A Guide for School Personnel” to prepare a hypoglycemia emergency care plan.

• 
  Eating disorders.
  Anorexia and bulimia can cause fainting from dehydration, low blood sugar, and changes in blood pressure or circulation caused by starvation, vomiting, or over exercising.

• 
  Heart issues.
  Irregular heartbeats (cardiac arrythmia) or structural problems (heart or valve) can cause fainting. Fainting that happens during exercise always needs medical follow-up.

• 
  Migraines. Fainting is a symptom of certain types of
  migraine headaches.

• 
  Alcohol and drug use. Alcohol makes blood vessels dilate or widen which can cause the blood pressure to drop. Some
  illegal drugs, like methamphetamines, affect heart function and can lead to fainting.

• 
  Pregnancy. Changes to the circulatory system in pregnancy can affect blood pressure and increase the body’s need for fluids.

• 
  Postural orthostasis tachycardia syndrome (POTS). This condition affects an estimated
  1 in 100 teens who get a rapid heartbeat and lightheadedness or fainting when standing, especially after lying down. Episodes often start after viral illness, trauma, or major surgery.

• 
  Addison’s Disease/adrenal insufficiency. Children with this condition don’t produce enough hormones, such as cortisol, that help control the response to stress, blood pressure, and blood sugar levels.

How is more serious fainting diagnosed and treated?

For child who faints on several occasions, or if there are signs of a more serious medical condition, your pediatrician may refer your child to a
pediatric cardiologist. While there, your child may receive various kinds of heart tests. See

Common Types of Cardiac Testing.

Red flag symptoms of possible heart issues with fainting:  

• Fainting during exercise

• Abnormal or especially fast heartbeats, particularly if they occur prior to fainting

• Family history of
  sudden cardiac death. Your pediatrician may ask about any close relatives who died from unintentional injuries or
  drowning, which may have involved cardiac-related fainting.

Can I prevent my child from fainting?

Your pediatrician can recommend ways to help prevent simple fainting. 

Here are some ideas:

• 
  Stay hydrated and eat well. Make sure your child drinks plenty of water or other
  healthy beverages each day. Limit caffeine and avoid skipping meals.

• 
  Monitor blood pressure. If your child’s blood pressure is low or normal, your pediatrician may suggest a change in his or her diet. .

• 
  Flex muscles in the legs, shift positions, and bend at the waist occasionally when standing for a long time to help circulation and blood flow to the brain.

• 
  Take breaks from the heat. Avoid standing for long periods in warm environments, such as practice fields in the sun or crowded places. Limit time in hot showers, saunas, hot tubs, and Jacuzzis.

• 
  Help your child learn to recognize the early signs of fainting. When his symptoms start, remind him to put his head between his legs or lay down.

Are there medications to help prevent fainting?

Medications may be prescribed in certain cases. Some types of steroids, beta blockers, and anti-arrhythmic drugs and selective serotonin reuptake inhibitor (SSRI) anti-depressants may help some patients. More research is needed to determine the effectiveness of these medications in children and teens.

Remember:

Most children and teens who faint recover quickly and without any lasting harm. Knowing how to help prevent fainting spells, like getting plenty of fluids, can help avoid the scary experience of passing out.
Any time your child does faint, be sure to tell your pediatrician.

Additional Information:

About Dr. Haxel:

Caitlin Haxel, MD, FAAP, is a pediatric cardiology fellow focusing on advanced imaging and fetal cardiology at the Children’s Hospital Colorado in Aurora, Colorado. She completed her medical education at State University of New York in Brooklyn, New York followed by her pediatric residency and pediatric cardiology fellowship at New York Presbyterian-Morgan Stanley Children’s Hospital at Columbia University Medical Center in New York, NY.  Within the American Academy of Pediatrics, Dr. Haxel is a member of the Section on Cardiology and Cardiac Surgery Publications and Communications Committee.

About Dr. Villafane:

Juan Villafane, MD, FAAP, is a pediatric cardiologist. Within the American Academy of Pediatrics, Dr. Villafane is a member of the Section on Cardiology and Cardiac Surgery Publications and Communications Committee. 

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

When Your Child Has Dizziness or Fainting

Your child has recently felt dizzy, lightheaded, or has fainted (“passed out”). This may have happened once or more than once. You may be very worried. But dizziness and fainting are not often signs of a major health problem in children. Breath-holding spells in younger children are also harmless.

What can cause dizziness or fainting?

A sudden decrease in blood flow to the head can cause someone to feel dizzy or faint. Things that take blood away from the head include:

• A fast change in position (such as standing up quickly)

• Not eating

• Standing without moving for a long period

• Hot showers (because blood rushes away from the head to cool the skin)

• Fever or illness

• Anemia (not enough oxygen-carrying red blood cells in the body)

• Dehydration (not enough water in the body)

• Arrhythmia (an abnormally fast, slow, or irregular heart beat) or other heart defect

What are the symptoms of dizziness or fainting?

Dizziness is a feeling of lightheadedness. Fainting is a loss of consciousness. Both can also cause a mild headache, feeling nauseated or “queasy,” and disorientation or confusion. It is very normal for a child who has fainted to have small muscle twitches or jerks. However, these are different from a seizure in that they are very brief and in different muscle groups. In most cases, your child will regain consciousness on his or her own and should have no lasting problems beyond several minutes of the event. See your child’s doctor if he or she has persistent symptoms.

How are dizziness and fainting diagnosed?

The healthcare provider will examine your child, and ask about his or her symptoms and overall health. Your child will likely be asked if he or she is lightheaded or feels a spinning sensation (called vertigo). The healthcare provider will also ask if other family members have a history of feeling lightheaded or of fainting. The healthcare provider may also order tests to rule out certain causes of dizziness or fainting. These tests may check:

How are dizziness and fainting treated?

If an underlying cause of dizziness is found, your child’s healthcare provider will discuss treatment with you. Otherwise, you can help your child by relieving his or her symptoms. If your child feels dizzy:

If your child has fainted:

• Lay him or her down on a flat surface.

• Raise your child’s feet above heart level using a pillow or other object.

• After your child wakes up, give him or her a drink such as orange juice to increase hydration and raise blood sugar.

• If your child’s symptoms don’t resolve with these simple measures, call your child’s healthcare provider. Sometimes children need to be treated with intravenous (IV) fluid.

How are dizziness and fainting prevented?

Since dehydration can lead to dizziness or fainting, you may be told to increase the amount of water your child drinks. You may also be told to increase your child’s salt intake for a certain amount of time. Salt helps the body to hold water. This may mean giving your child a small bag of potato chips or pretzels as directed by the healthcare provider. Sports drinks may also be suggested to help keep your child’s salt and fluid levels up. Very rarely, children with recurrent fainting episodes are treated with medicine if the episodes become too frequent or bothersome.

What are the long-term concerns?

If your child has fainted more than a couple of times, he or she might need to see a cardiologist. This is a doctor who treats heart problems. The cardiologist can do tests to help decide whether a heart problem is causing the fainting. Otherwise, most children who feel dizzy or faint once in a while do not have any long-term problems.

When should I call my healthcare provider?

Call your child’s healthcare provider right away if your child has any of the following

• Fainting during exercise, such as active play or sports

• Fainting episode lasting longer than 30 seconds

• Repeated episodes of fainting or dizziness

• Dizziness or fainting with chest pain

• Racing or irregular heart beat

• Repeated jerking of the arms, legs, or face muscles that may be a seizure

• Family history of sudden cardiac death

90,000 Fainting. Symptoms, causes and treatment

Fainting is a short-term loss of consciousness caused by a short-term decrease in metabolism in the brain, against the background of poor blood supply.

More than a third of people have experienced fainting in their lives. Most of the cases of this condition are associated with various external or internal factors and are not a sign of serious illness.But if fainting is often repeated, then you should pay special attention to this and contact a qualified specialist (neurologist or cardiologist).

Fainting often occurs suddenly, but sometimes it is preceded by a number of changes that can be noticed. A light-headed state is characterized by: increased sweating, nausea, dizziness, pallor of the skin, a feeling of darkening in the eyes, severe and severe weakness, tinnitus, frequent yawning, numbness of the arms and legs.If, in a pre-fainting state, you take a sitting or lying position of the body, then there will be a redistribution of blood in the vessels, an increase in pressure in them, which will prevent the onset of fainting. If it does happen, it will not be so sudden and the risk of injury from a fall will decrease. After fainting, confusion is observed in most cases, but this is a short-term phenomenon. Fainting is not accompanied by cessation of breathing or heartbeat, involuntary urination, bowel movements, and vomiting.

When fainting, the following changes occur: coldness of the arms and legs, slowing of the pulse, the pupils do not change their sensitivity to light, but can be narrowed or, conversely, dilated, decreased pressure, pale skin; breathing becomes shallow and more rare, sometimes there is increased salivation or dry mouth. The duration of fainting may be several seconds, but no more than 2-3 minutes. The recumbent position will improve the blood supply to the brain and help the person recover from this state as quickly as possible.

By themselves, fainting is not dangerous, but in some cases it is the first sign of a serious illness. Therefore, after fainting, it is very important to find out the reason for its appearance and analyze the circumstances that led to it.

Initial examination of the patient is usually carried out by a general practitioner, pediatrician or neurologist. In the future, you may need to consult a cardiologist, endocrinologist, surgeon, psychiatrist and other specialists. Of the examination methods, a general analysis of blood and urine, a biochemical blood test, determination of blood sugar, ECG, EEG, ECHO-KG, ultrasound Doppler examination of the vessels of the head and neck, MRI or CT of the brain, X-ray of the spine help in diagnosing the causes of fainting.

Do not disregard any cases of fainting. If external factors or their combination played a role, then we must try to avoid such situations in the future. In CITILAB CLINIC you can always find a doctor who can help you find the cause of fainting and eliminate it. At your service we can both modern laboratory and ultrasound diagnostics and a large number of experienced doctors of various specialties. Registration by phone 211-00-81

What are the types of fainting and how are they dangerous

Ladies in tight corsets, swooning goats and twins, fear and happiness, gluttonous brain and heart with proletarian manners, sniffing and sighing – in the material of the department of science “Newspapers.Ru ”about fainting in literature and in life, their causes and interesting research in this area.

Five minutes, then – normal flight

A person rises abruptly from a soft low chair, experiences stress and excitement, puts on an overly tight collar or sees a drop of blood – and his head begins to spin, darkens in his eyes, the body loses control over itself, nausea appears and weakness …

In the English language for these symptoms there is a beautiful word lightheadedness (literally – “light-headedness”), which well conveys a feeling of weakness and dizziness on the verge of fainting.The sensation of the position of our body in space is formed on the basis of data received from our senses, primarily vision and balance (inner ear). When the readings of these “sensors” are inconsistent (for example, during fast rotation and overturns on attractions), chaos ensues in the “control room”, and it is rather difficult not to lose control of the complex mechanism of the body. The same problem arises in the event of malfunctions in the “control room” itself: when the blood supply is disturbed, the brain does not have enough power, and it is not able to process the incoming signals, no matter how accurate they are.

This condition precedes fainting – a short-term (up to several minutes) loss of consciousness due to cerebrovascular accident. And our brain, despite its small mass, is unusually gluttonous: it consumes about 1/5 of oxygen and the same amount of glucose, which the blood carries throughout the body. Unsurprisingly, its sensitivity to lack of oxygen is so high.

For fainting, convulsive seizures are uncharacteristic (more likely then it is epileptic seizure ) and respiratory failure (like in coma ), therefore, soon after taking a horizontal position in which the heart does not need to overcome gravity, pumping blood to the brain, the latter is saturated with oxygen , and the person soon comes to his senses.Therefore, fainting itself does not pose a great danger, unless, of course, the fallen person did not hit when falling or had an accident while driving a vehicle. However, it can be caused by serious illnesses, so it doesn’t hurt to see a doctor and do an ECG to check if fainting is due to a violation of the nervous regulation of blood vessels, heart problems, anemia, or low blood sugar.

Dangerous vertical and “matters of the heart”

One of the most common types of fainting is orthostatic.

Probably, everyone at least once felt weakness, dizziness or darkening in the eyes, suddenly getting out of bed.

Normally, when a person takes an upright position, the veins in the legs narrow to make it easier for the heart to raise blood upward. If a person is sick for a long time, observing bed rest, suffers from disorders of the nervous regulation of blood vessels, or just sat motionless for a long time, and then decided to abruptly take an upright position, the body cannot immediately adapt to this, the pressure drops, and orthostatic fainting may occur.

To diagnose a tendency to fainting and to study the state of the autonomic nervous system, a test is used on a special orthostatic table, where the patient is asked to first lie motionless in a horizontal position, and then the table is raised at an angle of 60–80 degrees.At this time, the patient’s blood pressure, heart rate are continuously measured, and subjective sensations are taken into account.
If for orthostatic syncope the characteristics of the vessels – “pipes” for supplying power to our brain are important, then for cardiogenic syncope the determining factor is the work of the heart – a pump that drives blood through these vessels. Fainting can be a symptom of coronary heart disease, myocarditis, aortic stenosis (narrowing of the walls of the aorta – the largest artery that leaves the heart – due to the fact that its valve flaps have grown together) and other dangerous diseases.Listening to heart sounds and an electrocardiogram analyzed by doctors will help identify them.

Swooning Ladies … and Goats

Examples of the third type of swoon are abundant in Victorian English literature. All languid young ladies in corsets, as if on command, fainting at the climax of the plot, are stereotypical victims of vasovagal fainting.

Such fainting can be provoked by being in a stuffy room, trauma, severe pain, excessive physical exertion, excitement (excitement means any strong emotion, including a positive one).

“The stormy stream of joy that rushed into her soul after so many days of despair broke her strength. She fainted. When she regained consciousness and was put to bed in her room, she asked to be left alone, “- describes the swoon of Madame de Renal in the novel” Red and Black “by Marie-Henri Beyle, familiar to the reader under the pseudonym Stendhal.

And this is an excerpt from Oliver Twist, Dickens’s most famous work: “The girl said nothing more; She tore her hair in a frenzy and attacked the Jew so swiftly that she would have left traces of her revenge on him if Sykes had not grabbed her hands at the right moment, after which she made several vain attempts to free herself and fainted.

Another cause of vasovagal syncope is fright. Only now, in the famous “swooning goats” from Tennessee, fright does not occur at all vasovagal swoon, but a short-term (about 10 seconds) muscle paralysis, in which the animal remains conscious. Such a violation of motor function is called myotonia , therefore it is more correct to call goats myotonic.

“Parasympathetic revolution”

Vasovagal syncope is often found in healthy people and is accompanied by nausea, pallor, weak pulse, low blood pressure and sweating.The mechanism for this fainting is as follows: when blood returns from the veins slowly, the sympathetic nervous system (which determines the behavior in a “fight or flight”) causes the heart to beat faster to compensate.

There is a feedback from the heart that it is contracting excessively quickly (keeping silent about the fact that quantity does not mean quality), and power passes into the hands of the parasympathetic system, whose “election promises” are to include a scenario of relaxation and tranquility.

Because of these “neurological revolutions” blood vessels dilate, pressure drops, and the heart continues to beat slowly – workers in factories have vacations, peasants in villages celebrate the victory of the proletariat.Meanwhile, the intellectual elite in the cities is left without bread – the brain is starving and the body faints.

Nervous medics and drivers

With the end of the Victorian era and the removal of corsets, behaviors changed, but people did not stop falling into vasovagal fainting. On the contrary, today about 50% of syncope is of this type.

On June 29 this year, Canadian scientists published 90,027 a study of 90,028 pre-syncope and syncope in medical college students while in the operating room.The multifactorial survey involved 180 people (including 106 girls) from the first to the fourth year. 42% of them felt bad at least once in the operating room, and 6% lost consciousness (most often they were girls). Only 28% of students knew how to avoid fainting, and the most used source of this knowledge was fellow students (59%). The most common precaution among Canadian students before entering the operating room is to quench their hunger and thirst.

Although vasovagal syncope in itself is not so dangerous, and the reasons for them are not as frightening as in the case of cardiogenic syncope, they can pose a threat to the life of the victim and others if they happen to vehicle drivers.Thus, in a 90,027 study of 90,028 scientists from Denmark and the United States, published in April 2016 in the same journal where Barack Obama recently published his scientific work, data on 41,039 patients aged 47–78 years suffering from fainting are presented.

In two years, 1791 people from this group were involved in a car accident, 78.1% of which ended in injuries for them, and six were fatal.

These figures are twice the average rate of car accidents among the Danish population.Therefore, doctors recommend paying more attention to the tendency to fainting in drivers in order to improve road safety.

Fainting twins

Genes are often to blame for vasovagal syncope. This is confirmed by the study of twins, published in 2012 in journal Neurology. The volunteers were same-sex twins aged from nine to 69 years. At least one in each couple had a history of syncope in their medical history.It was logical to assume that in the presence of a significant genetic predisposition to fainting in identical twins, it will occur more often than in fraternal twins.

05 September 10:54

A telephone survey showed that the presence of a predisposition in one of identical twins increases this risk in the second twice as compared to fraternal twins.

Questions about other relatives allowed scientists to establish that twins have a much higher coincidence rate than other relatives.

According to the authors, this means that this condition is inherited, and not one gene is responsible for it, but a combination of several.

Fearful Eight

This is not a name for another Tarantino blockbuster (unless he is reading this article now and decides to make a film about people who pass out at the sight of blood during fights and gunfire), this is a list of of eight points, which should make doctors alert.In July 2016, it was formulated by 90,027 Canadian scientists based on observations of 4030 patients suffering from fainting in six Canadian hospitals.

147 victims within a month after discharge faced serious problems again.

Not too little to recklessly let everyone go home, but not too much to keep everyone in the hospital all day while doctors decide if they can be discharged.

An analysis of all 4,030 cases revealed factors that, when found together, significantly increase the risk that something much less harmless is behind the fainting.These included a history of heart disease, abnormal blood pressure, elevated blood levels of troponin protein, abnormalities found on an electrocardiogram, a high, according to doctors, the likelihood of a new fainting after discharge, and whether the fainting was caused by finding injured in a stuffy room, as a result of prolonged standing or strong emotional stress.

Scientists believe that taking into account the presence of a combination of these factors will help to quickly identify patients whose health is at serious risk, freeing up the time of doctors and other patients who spend four to seven hours waiting for test results.

If you don’t want to fall, sneak around

“Periodic fainting seriously affects the quality of life,” says Marta Bavolarova, a cardiologist at Louis Pasteur University in Slovakia, who suggested her way of dealing with fainting at the European Society of Cardiology conference in October 2015.

She examined vasovagal syncope in two female patients aged 56 and 62 years, deliberately plunging them into a light-headed state on an orthostatic table and measuring their blood pressure.At the moment when it began to decrease, the doctor asked the patients to sniff twice or to inhale the air forcefully, leaving the mouth closed, and then exhale.

These simple actions, in her opinion, do not allow the parasympathetic system to increase its activity uncontrollably and help to overcome the light-headed state. True, 90,027 results from are worth checking on more patients.

What should be done if it was not possible to prevent fainting? As we remember, fainting occurs due to the fact that the brain does not have enough oxygen, and when the blood supply returns to normal, the person should recover.Therefore (if the victim is breathing and his pulse can be felt), he should be laid on his back, raising his legs and unbuttoning a tight belt or collar, which can restrict breathing. In this case, it is better to turn the head to one side so that a relaxed tongue or possible vomiting does not block the airways. Being in a stuffy room, it is necessary to ensure the flow of oxygen – open the window, take it out into the street (or, on the contrary, bring it into a cool room if it is stuffy and hot outside).

In order to speed up the return of consciousness, you can moisten a towel with cold water and apply it to the victim’s head, sprinkle it with cold water, bring a piece of cotton wool soaked in vinegar or ammonia to the nose.

When a person has come to his senses, there is no need to immediately try to raise him to his feet. If the syncope is orthostatic, he will pass out again. It is better to let him lie down a little more so that his head stops spinning, then let him slowly put his feet on the floor and only then carefully stand up.

If the person does not come to their senses for more than five minutes, call a doctor immediately. Perhaps you are not dealing with fainting, but with a coma: at the stage of first aid, the differences are minimal, and further sluggishness with prolonged oxygen starvation of the brain is very dangerous.

Fainting in cardiology practice

Loss of consciousness is a syndrome that is widespread in clinical practice. Up to 40% of people have fainted at least once in their lives. At the same time, doctors distinguish between fainting (syncope, syncope) and impaired consciousness. The diagnosis and treatment of the causes of syncope are mainly carried out by cardiologists; patients with impaired consciousness (epilepsy, strokes, coma) are examined and treated by neurologists.

At the Institute of Clinical Cardiology. A.L. Myasnikov National Medical Research Center of Cardiology, patients with fainting are examined and treated in the laboratory of syncope, created on the basis of the Department of Clinical Electrophysiology and X-ray Surgical Methods for the Treatment of Cardiac Arrhythmias. Specialists have accumulated a unique experience of working with such patients, developed algorithms for their diagnosis and treatment. In 2011, a patent of the Russian Federation was received for an original method for determining the cause of fainting of various origins.Up to 300 patients with attacks of loss of consciousness of various origins are examined annually at the Institute.

Patent of the Russian Federation for an invention “Method for determining the cause of fainting of various origins”, 2011

The unit meets all modern requirements for centers for examining patients with attacks of loss of consciousness. Special questionnaires have been developed for interviewing patients, which make it possible, with a high degree of probability, to suspect the cause of loss of consciousness already at the stage of primary examination.Directly employees of the Department carry out all the necessary examination methods (ECG, Holter ECG monitoring, telemetric monitoring of ECG, ECHOKG, daily monitoring of blood pressure, non-invasive topical diagnosis of arrhythmias, standard and modified stress tests, transesophageal electrophysiological tests, vagal and other) orthostatic orthostatic tests. On the basis of the Department, in the conditions of the X-ray operating room, complex invasive methods of examination are performed: intracardiac electrophysiological examination (experience since 1977), as well as implantation of monitors for long-term ECG recording.If necessary, it is possible to use other examination methods available in the arsenal of the National Medical Research Center of Cardiology, including angiographic studies (coronary angiography, angiography of the brachiocephalic arteries, etc.), magnetic resonance imaging and computed tomography, consultations of a neurologist, EEG registration, etc.

The laboratory’s specialists are leaders in the country in terms of their experience in conducting a long-term passive orthostatic test (performed at the Institute since 1990), the “gold standard” in diagnosing the causes of syncope.Also, a special protocol for conducting a test on a bicycle ergometer has been developed and introduced into clinical practice in order to determine the causes of fainting.

Room for orthostatic and stress tests

After establishing the cause of the loss of consciousness, an individual treatment plan is developed. The complexity of the methods of therapy used depends on the identified disorders. For patients with orthostatic fainting, educational materials have been developed, recommendations for modifying lifestyle and nutrition, “training” (specific physical exercises to prevent the development of fainting) are used, indications for drug therapy and non-drug methods of treatment are determined.Patients with cardiac arrhythmias undergo radiofrequency and cryoablation of arrhythmia sources. In the diagnosis of cardiac conduction disorders that act as causes of fainting, the implantation of pacemakers. In a special category of patients with serious heart disease, a high risk of developing malignant arrhythmias, implantation of cardioverter-defibrillators and resynchronization devices is performed.

X-ray operating room of the Department of Clinical Electrophysiology

Unique long-term experience in managing patients with attacks of loss of consciousness, developed own methods of diagnosis and treatment, allow us to establish the cause of fainting and choose an effective therapy in more than 95% of cases, which is more effective than many world centers.

Causes of syncope:

The immediate cause of fainting is a decrease in blood flow in the brain against the background of a decrease in blood pressure. Various conditions can lead to this, for example, disturbances in the rhythm or conduction of the heart, heart defects and tumors, the consequences of a previous myocardial infarction or inflammation of the heart muscle (heart failure), in which there is a decrease in the output of blood from the heart. Such patients require examination in a specialized cardiology department.

Syncope is often caused by a reflex decrease in blood pressure in response to medical manipulations (blood sampling, visit to the dentist), pain, emotional excitement, severe cough, tension during urination or defecation. But most often, staying in a stuffy room, standing for a long time (in transport, in a queue), abrupt cessation of physical activity (quickly climbing stairs, ending an intense workout, stopping after running) leads to fainting of this type.Because of the mechanism of development of this type of syncope, they are called vasovagal (neurogenic, neuroreflex). In such cases, a complete examination may not reveal any heart disease, and a long-term passive orthostatic test, a special type of exercise test and so-called vagal tests are used to confirm the cause of loss of consciousness. In the elderly, orthostatic hypotension, a decrease in blood pressure when standing up, is a common cause of fainting.In some cases, these symptoms can appear at a young age, and can also be so severe that the patient loses the ability to stay upright for a long time. It must be remembered that the appearance of such symptoms can serve as a sign of a number of neurological diseases and requires the obligatory consultation of both a cardiologist and a neurologist. Fainting, proceeding according to the type of orthostatic hypotension, can also develop with varicose veins of the lower extremities, with blood loss, in pregnant women, etc.

Syncope conditions are less common in the presence of carotid sinus syndrome. In such patients, loss of consciousness can occur with any manipulations, pressure in the neck area – shaving, tying a scarf, wearing clothes with a tight collar. This is due to the increased sensitivity of receptors located in the region of the carotid arteries (vessels that feed the brain). Fainting is often the result of uncontrolled use of drugs or incorrectly selected dosages, the frequency of their intake.This is especially true for the use of nitrates, diuretics, antiarrhythmics, blood pressure lowering agents. Prescribing drugs must be carried out by a doctor and must be justified. If you suspect a connection between syncope and medication being taken, you should consult your doctor to change the medication regimen.

Clinical picture:

Before losing consciousness, the patient may experience harbingers of fainting: palpitations, dizziness, darkening of the eyes, lightheadedness, nausea, flashing “flies” before the eyes, sweating or vice versa, cold extremities.Most often, these symptoms occur in an upright position of the body, but they can also be observed while sitting and even lying down. In some cases, loss of consciousness develops suddenly, when the patient does not even have time to understand what happened. This type of fainting is the most dangerous in terms of the risk of injury from a fall. In the unconscious period, there is a pallor of the skin, loss of muscle tone. The patient does not answer questions. There may be a “bending” of the body, twitching of the limbs and even seizures, which in itself is not a criterion for the diagnosis of epilepsy.The blood pressure level is low or even undetectable. When trying to determine the pulse, there may be a significant decrease in its frequency up to a pause in the work of the heart, or the pulse may be so fast that it is difficult to count it.

A distinctive feature of the syncope is its short duration (fainting rarely lasts more than 5 minutes) and complete reversibility (after the return of consciousness, the patient remembers everything, recognizes those around him, answers questions). The pallor of the skin and their moisture may persist.Patients often experience weakness, general ill health. Blood pressure and pulse rate depend on the cause of the fainting, and may be normal or remain low or high.

Diagnosis of the causes of loss of consciousness:

If syncope occurs, see your doctor to find the cause of fainting. It is important to describe in detail the circumstances of the loss of consciousness – in what conditions it happened, what the patient experienced before and after syncope.Also valuable are eyewitness accounts of fainting. The more information the doctor receives, the more accurately he will be able to choose the necessary examination methods. Their number and severity depend on the suspected cause of the syncope. The doctor may limit himself to taking blood tests, taking an electrocardiogram and performing an echocardiography, or he may expand the examination using long-term monitoring of an electrocardiogram, conducting a transesophageal or intracardiac electrophysiological study, a long-term passive orthostatic test, tests with physical exertion, tomographic studies, etc.It is correct to first visit a doctor with the development of an examination plan for the fastest and most accurate diagnosis of the cause of fainting.

Syncope Treatment:

Treatment for syncope can be divided into immediate care at the time of loss of consciousness and treatment of an established cause of fainting.

It is important for the patient to recognize the precursors of loss of consciousness in order to take timely measures aimed at preventing injury as a result of a fall.When precursors appear (nausea, dizziness, palpitations, etc.), you should immediately sit down or (better) lie down, preferably with your legs raised on a dais (headboard, bag, folded clothes). Also, if the cause of fainting is not established or there is a suspicion of the development of life-threatening conditions, it is necessary to call an ambulance team. The use of medicines, if not previously discussed with a specialist, can be dangerous and aggravate the course of fainting. If you witness the development of fainting, lay the victim on his back, turning his head to one side and, if possible, raise his legs.Make sure the patient’s airway is clear. In the presence of seizures, do not forcibly hold the patient’s head or limbs; it is enough to protect them from injury (for example, put something soft under the head). It is important to try to determine the pulse – its presence and characteristics (frequent or infrequent, correct or irregular) may be important later in determining the cause of syncope.

The success of the treatment of syncope directly depends on the accuracy of establishing the cause that caused it.Reflex fainting often does not require drug treatment, but such patients need to go through a stage of special education, in which patients learn to apply measures to subsequently avoid the recurrence of loss of consciousness, receive recommendations for changing lifestyle, degree of physical activity, etc. Patients with cardiac causes of fainting need specialized treatment – the appointment of antiarrhythmic therapy or surgical treatment of arrhythmias, implantation of a pacemaker in patients with impaired cardiac conduction, removal of the obstruction to blood flow in the presence of a heart defect, medical or invasive treatment of heart failure.For patients with orthostatic hypotension, recommendations and treatment regimens have also been developed, depending on the presence of chronic diseases, signs of diseases of the nervous system. At the visit, a detailed analysis of drug therapy, which the patient takes constantly or occasionally, is carried out in order to exclude or minimize the effect of drugs on the frequency of fainting.

It must be remembered that loss of consciousness is a reason for contacting a specialist to establish the cause of syncope, determine the prognosis for life and develop an optimal treatment regimen for the identified disease.

It is (not) necessary to see a doctor. 9 most common causes of fainting and dizziness

Many people lose consciousness, but in 90% of cases, this does not indicate any systemic health problems. But in the remaining 10% … it is worth considering and, perhaps, seeking medical attention. To know when to sound the alarm, you need to know when fainting is not a problem, but when you need to be on your guard.

At the heart of “blackout” is always a simple fact – for a short time, the brain received less oxygen than it needed.But why did this happen? Here are nine of the most common causes of loss of consciousness. Some of them are relatively “normal”, others require the attention of a doctor, as they are symptoms of life-threatening diseases.

Dehydration

Elevated air temperature and lack of fluid in the body in some people lead to a sharp drop in pressure, as a result – a decrease in the “dose” of blood for the brain, and with it oxygen. You need to drink a lot, and if you feel dizzy – sit down or lie down.In public transport, open a window or ask the driver to turn on the air conditioner.

Surprise or fear

Contrary to popular belief, you can faint not only from bad news, but also from good news and surprises. The nervous system briefly falls into a stupor and “drops” blood pressure. The result – you are on the floor, alas.

A sharp rise

Medicine even knows the correct name for a situation when a person loses consciousness with a sharp rise – orthostatic hypotension.A single case does not mean anything, but if this happens often, make an appointment with a doctor.

Disturbed heart rhythm

Arrhythmia has a lot of symptoms and manifestations, and one of them is a short-term loss of consciousness. In fact, arrhythmia is quite dangerous, as it dramatically increases the risk of sudden cardiac arrest with subsequent death. It is worth seeing a doctor.

Poorly working heart valve

Foto: Shutterstock

Most often it is a congenital ailment and almost certainly the person suffering from it is well aware of it.The “mechanics” of loss of consciousness in this case is that the flapping valve prevents normal blood flow, and at some point among those who are “underdone” is the brain.

Stroke

Dizziness, muscle weakness, difficulty speaking, numbness in the limbs – all this is at the same time a sign of a stroke. Contrary to popular belief, a young person can also survive a stroke, so you do not need to brush it off, but you should always bear in mind the risk of its occurrence. Remember that the sooner the stroke survivor receives medical care, the more likely the person to get out of this mess is the better.Don’t wait, call 112!

Hunger

Low blood sugar in some cases can lead to fainting, although this is still rare in a healthy person. But diabetics are well aware of this danger. If you often faint on an empty stomach, this is a reason to make an appointment with a doctor.

Influenza

One of the symptoms of influenza, which often makes it possible to distinguish it from the “common cold”, is frequent dizziness, which is simultaneously caused by low blood sugar and dehydration against a background of fever.Do not self-medicate!

Fainting – ProMedicine Ufa

Fainting (syncope)

is a short-term loss of consciousness and a fall against the background of a sudden decrease in metabolism in the brain. Most often, such a decrease occurs as a result of a short-term disruption of cerebral blood flow and, consequently, a lack of oxygen to the brain. This leads to dizziness or loss of consciousness. A temporary deterioration in the blood supply to the brain can be caused by heart disease or other causes that do not directly affect the heart.

Fainting is always accompanied by a fainting state

– a person experiences a feeling of faintness, circles before the eyes, palpitations, pounding in the temples, sweating, hot flashes, nausea, a feeling of an impending fall.

Causes

Sources of insufficient blood flow in the brain can be:

– disorders of the functioning of the autonomic nervous system;
– heart defects; a sharp increase in intracranial pressure;
– intoxications caused by gas poisoning, nicotine, alcoholic beverages, household chemicals, plant care products, etc.NS.;
– strong emotional swings;
– a sudden drop in blood pressure;
– lack of glucose in the body;
– insufficient amount of hemoglobin;
– air pollution;
– change in body position.

Loss of consciousness occurs with a sharp rise to his feet from a lying or sitting position; specific effects on the human body, including prolonged exposure to hot temperatures or high atmospheric pressure; age category – in adults, fainting can occur when urinating or diarrhea, in adolescents, in particular in girls, fainting occurs during menstruation, and in older people, loss of consciousness can occur during sleep.

According to statistics, it is women who often faint, since they are most susceptible to changes in temperature or atmospheric pressure. Very often they have hungry faints due to diets.

Symptoms

Typical signs of fainting:

– profuse sweating;
– dizziness;
– ringing in the ears;
– nausea;
– flickering or darkening in the eyes;
– cardiopalmus;
– hot flashes;
– pallor of the skin.

Light-headedness is manifested by accelerated breathing and increased yawning, thus, the body is trying to make up for the lack of oxygen to nourish the brain. Further, drops of sweat appear on the forehead, the skin turns pale.

When fainting, blood pressure decreases, weakness appears, breathing becomes shallow. The time spent in an unconscious state can last from one moment to several minutes. In some cases, fainting may be accompanied by seizures.

Diagnostics

From laboratory methods in the diagnosis of the genesis of syncope, a general analysis of urine and blood, a study of the gas composition of the blood, determination of blood sugar, a glucose-tolerance test, a biochemical blood test help. The plan for the examination of patients with syncope usually includes: ECG, EEG, REG, Echo-EG, ultrasound of extracranial vessels.

If a cardiogenic nature of fainting is suspected, ultrasound of the heart, phonocardiography, daily ECG monitoring, stress tests are additionally prescribed.If organic brain damage is suspected, then an MRI of the brain, duplex scanning or X-ray of the spine in the cervical spine are performed.

Treatment

First aid should be to position the unconscious person in a position that will maximize blood flow to the brain. So, for example, if a person is in a sitting position, then he should be laid on a flat surface, lowering his head between his knees and raising his lower limbs.Fainting may be accompanied by vomiting, so the patient’s head should be tilted to the side to prevent aspiration.

It is important to ensure that during unconsciousness, the tongue does not sink in and does not block the airways. It is necessary to provide additional air access, for this you need to stretch the clothing that is constraining the body (collar, belt, etc.). If fainting occurs indoors, the windows should be opened.

To bring a person to consciousness, irritants are often used – ammonia is brought to the patient’s nose, cold water is sprinkled on the neck and face.After the patient has come to his senses, you need to observe him for some time – until the feeling of weakness disappears completely.

If within five minutes it is not possible to bring a person to consciousness, an ambulance must be called. Deep fainting is a very dangerous phenomenon, especially if the syncope is accompanied by cyanosis of the facial skin, in most cases, patients do not survive.

Medical practice in the treatment of syncope is the administration of subcutaneous drugs.If, after the measures taken, the effect is not achieved, doctors perform such actions as artificial respiration, accompanied by indirect heart massage.

Prevention of fainting consists in avoiding circumstances in which loss of consciousness can occur, that is, stressful situations, hunger, excessive fatigue, etc. Increased physical activity can provoke fainting, so a young guy who works in the gym for several hours in a row runs the risk of losing consciousness from physical overwork.

Preventive measures include moderate exercise, hardening, normal work, sleep and rest.

Paroxysmal conditions. Fainting | Polyclinic IVTE UB RAS

Paroxysmal conditions. Fainting

Fainting (syncope) is an attack of short-term loss of consciousness and impaired muscle tone of the body (fall) due to disorders of cardiovascular and respiratory activity. Syncope conditions can be neurogenic in nature, develop against the background of somatic pathology, and occur under extreme influences.

The immediate cause of loss of consciousness is transient ischemia of the entire brain.

Syncope states, despite their short duration, represent a process unfolded in time, in which successive stages can be distinguished:

– harbingers (presyncopal state),

– peak (syncopal state proper),

– recovery (post-syncopal state).

The severity of clinical manifestations and the duration of each of these stages are very diverse and depend mainly on the pathogenetic mechanisms of syncope.

The most common are reflex and orthostatic syncope – 50% of cases.

Orthostatic fainting is provoked by a transition from a horizontal position of the body to a vertical one, due to a significant change in blood pressure, the cause of which is a violation of autonomic nervous regulation. These fainting spells can be caused by some drugs that have a vasodilating effect, as well as blood loss of various origins.

Reflex fainting can be triggered by stuffiness, various stressful situations (bad news, taking blood), sudden acute pain.

In some cases, fainting occurs for no apparent reason. Fainting can occur from once a year to several times a month.

Clinical manifestations. Immediately after a provoking situation, a presyncopal state develops, lasting from several seconds to several minutes. At this stage, there is a sharp general weakness, non-systemic dizziness, nausea, flashing “flies”, “veil” before the eyes. These symptoms are rapidly increasing, there is a premonition of possible loss of consciousness, noise or ringing in the ears.Objectively, at this stage, there is a pallor of the skin, local or general hyperhidrosis, a decrease in blood pressure, pulse instability, respiratory arrhythmia, coordination of movements is impaired, and muscle tone decreases.

Fainting can end at this stage, or it can go to the next – the syncope itself, in which all the described symptoms increase, the patient falls, consciousness is disturbed. The depth of the loss of consciousness varies from a slight darkening of it to a deep disturbance, lasting several minutes.In this period, there is a further decrease in blood pressure, shallow breathing, muscles are completely relaxed, pupils are dilated, their response to light is slowed down, tendon reflexes are preserved. With a deep loss of consciousness, it is possible to develop short-term seizures, often tonic, and involuntary urination.

In the post-syncopal period, the restoration of consciousness occurs quickly and completely, patients immediately orient themselves in the environment and what happened, remember the circumstances preceding the loss of consciousness.The duration of the post-syncopal period is from several minutes to several hours. During this period of time, general weakness, non-systemic dizziness, dry mouth are noted, pallor of the skin remains, hyperhidrosis, a decrease in blood pressure, uncertainty of movements.

The diagnosis is made on the basis of a carefully collected history, examination of the somatic and neurological status.

90,000 Fainting: Causes, Symptoms, Treatment | First and urgent aid for fainting

A short-term loss of consciousness is called fainting.This symptom is also called syncope. Before this, a person may experience a lack of air, he has dark spots in front of his eyes, dizziness. After fainting, he feels weak, hypotension is possible.

Causes of symptom

The reasons for short-term loss of consciousness are as follows:

• heat. One person can withstand 40 ° C, while for another 38 ° C is already a big problem, especially if the room is not ventilated. Fainting is most common in overcrowded vehicles;
• severe thirst or hunger.This is especially true for people who are trying to rapidly lose weight. Also, the causes of fainting can be diarrhea, severe vomiting, sweating, frequent urination, due to which the body suffers from fluid loss. This also applies to food poisoning;
• Abrupt transition from a supine position to a sitting or standing position. Many people describe why they fainted like this: stood up abruptly, and swam before their eyes;
• alarm. Because of it, breathing can become very frequent;
• shock and severe pain;
• nervous shock, as well as phobias (for example, the sight of blood can cause fainting).Possible narrowing of cerebral vessels of hypocapnia. Carbon dioxide decreases, while oxygen consumption increases. This state of the body is characteristic of stress, panic, fear;
• Rapid and severe blood loss. Fainting is not associated with the fact that a lot of fluid has been lost, but with the fact that the body did not have time to activate its defense mechanisms;
• a decrease in the volume of circulating blood (this phenomenon is called hypovolemia) due to the fact that a person fainted, took many vasodilators or diuretics;
• A sharp drop in blood pressure.Fainting is common in hypotonic patients. Also, loss of consciousness is possible with vegetative-vascular dystonia;
• A sharp decrease in the level of concentration of sugar in the blood. This phenomenon is called hypoglycemia. By the way, this is not always associated with an overdose of insulin in patients with diabetes. Also, the drug can be used to increase weight (especially bodybuilding fans sin with this), which carries a danger to the body;
• anemia. It is also known as anemia;
• Swallowing food, if the patient has diseases of the esophagus, for example, it may be a reflex reaction, which is caused by irritation of the vagus nerve;
• side effects after taking certain medications.Also, this group of reasons includes an overdose of antihypertensive drugs;
• cough and urination. Due to the fact that the intrathoracic pressure increases, the venous return decreases, which means a limitation of the volume of cardiac output and a decrease in the blood pressure reading;
• Reduction of blood supply to certain parts of the brain due to various disorders. It may be a microstroke;
• cardiovascular diseases. For example, this symptom causes myocardial infarction;
• some endocrine diseases that cause severe disruptions in the hormonal system, which negatively affects the work of all organs and systems;
• neoplasms in the brain.This includes benign and malignant tumors, hematomas.

The causes of fainting can be both commonplace and quite serious. Do not ignore this symptom. In children, frequent fainting spells can be a sign of cardiac arrhythmias, which is difficult to recognize in young children (especially at an early age). But most often in people, fainting is caused by changes in blood flow, a decrease in blood pressure. The body simply cannot adapt to drastic changes.

What to do with a symptom

First aid rules for fainting should be known. First of all, it is required to restore hemodynamics by giving the body a horizontal position. In this case, you need to raise your legs a little.

First of all, it is necessary to create conditions for the oxygenation of the brain. For this, the patient needs to be laid down, loosened his belt, tie, unbuttoned jacket or shirt. You should also open a window or door to provide fresh air.It is recommended to sprinkle cold water on the face of a person in a faint or bring a cotton swab with ammonia to the nose. These actions in case of fainting will cause reflex excitement of the vessels and respiratory centers.

When you need to urgently call an ambulance

Calling an ambulance is required when one of the following symptoms appears:

• fainting lasts more than a minute;
• the victim’s face began to turn blue, especially the lips;
• the victim cannot feel the pulse, there is no breathing;
• the victim woke up, but his heart rhythm is too slow or irregular;
• after fainting, chest pains, difficulty breathing;
• after fainting, the victim immediately falls asleep, it is impossible to wake him up;
• with or after fainting, convulsions begin;
• after fainting, the victim says that his vision has deteriorated, everything is cloudy before his eyes, it is difficult for him to speak, and his consciousness is confused;
• when a person fainted, when he fell, he was injured.

In severe cases, with a significant decrease in blood pressure, if standard measures of relief for fainting did not help, then sympathicotonics are administered. If the patient has arrhythmia, then antiarrhythmics are used, and in case of cardiac arrest, atropine is administered and an indirect cardiac massage is performed.

You can call the ambulance team of JSC “Medicine” (clinic of Academician Roitberg) by phone +7 (495) 229-00-03. This is best done as soon as signs of fainting appear.

When you need a doctor’s appointment

If fainting begins to appear frequently or is of a protracted nature, then it is necessary to visit a neurologist for consultation.You should also go to the hospital if you suffer from the symptoms described above.

Symptom treatment

General and biochemical analyzes, ECG, EEG are carried out as diagnostics. Differential diagnosis is required for patients with syncope.

In some cases, no specific treatment is required. For the rest, the doctor selects therapy depending on the primary ailment that caused the loss of consciousness.

Symptom during pregnancy

Pregnant women can also lose consciousness, which is considered a common occurrence.This is due to the fact that blood flow is completely redistributed in their body. By the way, it is the loss of consciousness that is considered one of the very first symptoms of pregnancy. The situation is aggravated by emotional instability, hormonal changes, heat outside and at home. This causes a decrease in blood pressure, which leads to fainting.

Home treatment

Treatment depends on the cause of fainting, that is, the diseases that cause it. At home, it is required to strictly follow all the doctor’s recommendations.It is recommended to stay in bed, perform therapeutic exercises, take vitamin and mineral complexes to strengthen the body.

Prevention of symptom

A correct and balanced diet and a healthy lifestyle are recommended. We’ll have to give up bad habits (smoking, drinking). It is important to walk in the fresh air every day, play sports. You should also undergo a routine examination by a doctor at least once a year, and, if necessary, treat all diseases in a timely manner.

Which doctor should I contact with a symptom

You can make an appointment with a neurologist at Medicina JSC (Academician Roitberg’s clinic) using the registration form on the website or by phone +7 (495) 775-73-60. Our clinic is located in the central district of Moscow at the address: 2nd Tverskoy-Yamskaya per. 10.

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