Fainting
(Syncope)
Definition
Causes
| Blood Flow to the Brain |
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- During medical procedures
- During times of high stress, trauma, or fright
- After standing still for a long period of time
- Orthostatic hypotension, low blood pressure when standing
- Dehydration
- Anemia
- Hypoglycemia, which is low blood sugar
- Seizure
- Stroke or transient ischemic attack
- Abnormal heart rhythms
- Heart conditions
- Blood loss
- Blood pressure medications
- Medications to regulate heart rhythms
- Diuretics
- Certain antidepressants
Symptoms
- Sudden loss of consciousness
- Inability to remain standing or sitting
- Consciousness regained without any need for intervention
- Dizziness or lightheadedness before losing consciousness
When Should I Call My Doctor?
- Have a heart condition
- Have a job where you or others may be at risk if you faint. Examples include airline pilot, bus driver,or machinist.
When Should I Call for Medical Help Immediately?
- Weakness or numbness of face, arm, or leg, especially on the left side of the body
- Confusion
- Loss of balance, coordination problems
- Vision problems
- Severe headache
- Rapid, irregular heartbeat; chest pain
Diagnosis
- Blood tests
- Electrocardiogram (EKG)
- Holter monitoring
- CT scan
- Electroencephalogram (EEG)
- MRI
- Echocardiogram
- Tilt table testing
- MR angiogram and CT angiogram
Treatment
Prevention
- Know the warning signs. If you feel that you are going to faint, sit or lie down right away.
- Get up slowly and carefully from lying down. Start by sitting up for a minute and then stand up.
- Drink plenty of fluids.
- Discuss dietary changes with your doctor.
- Avoid using alcohol or other drugs.
- Crossing your legs while tensing the muscles of legs, abdomen, and buttocks.
- Forcefully squeezing a rubber ball or other object as hard as possible. Try to use your dominant hand.
- Gripping one hand with the other while tensing both arms and raising the elbows slightly.
RESOURCES
American Academy of Family Physicians http://www.aafp.org
American Heart Association http://www.heart.org
References
Benditt D, Goldstein M. Fainting. American Heart Association, Circulation website. Available at: http://circ.ahajournals.org/content/106/9/1048.full. Published 2002. Accessed April 25, 2013.
Chen LY, Benditt DG, et al. Management of syncope in adults: an update. Mayo Clin Proc. 2008;83(11):1280-1293.
Fainting. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/fainting.html. Updated July 2010. Accessed April 25, 2013.
Miller TH, Kruse JE. Evaluation of syncope. Am Fam Physician. 2005;72(8):1492-1500.
Syncope evaluation. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 5, 2013. Accessed April 25, 2013.
2/6/2007 DynaMed's Systematic Literature Surveillance. Available at: http://dynamed.ebscohost.com/about/about-us: van Dijk N, Quartieri F, Blanc JJ, et al. Effectiveness of physical counterpressure maneuvers in preventing vasovagal syncope: the Physical Counterpressure Manoeuvres Trial (PC-Trial). J Am Coll Cardiol. 2006;48(8):1652-1657.

