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FaintingFainting Overview Fainting , which medical professionals call syncope is a temporary loss of consciousness. Unlike a seizure, the person who faints usually regains alertness soon after regaining consciousness. Fainting is caused by a temporary loss of the brain’s blood supply. Fainting can sometimes be a sign of a more serious condition. People of any age can faint, but elderly persons more often have a serious underlying cause. Three percent of adults aged 30-62 years have an episode of syncope but 6% of those older than 75 years faint. Syncope accounts for 1-3% of emergency department visits and 1-6% of hospital admissions. The biggest risk is in people with heart disease, especially those with congestive heart failure or coronary heart disease. Causes of Fainting Fainting has many different causes. Vasovagal syncope : Also known as the "common faint," this is the most frequent cause of syncope. It results from an abnormal circulatory reflex. The heart pumps more forcefully and the blood vessels relax, but the heart rate does not compensate fast enough to maintain blood flow. People older than 45 years rarely experience a first "common faint." Causes of vasovagal syncope include the following: Environmental factors - Most commonly in a hot, crowded setting Emotional factors - Stress or the sight or threat of injury Physical factors - Standing too long with locked knees Illness - Fatigue, hypoglycaemia (low blood sugar), dehydration, or other current illness Situational syncope : Susceptible people have episodes of syncope only in particular situations. Causes of situational syncope include the following: Cough syncope occurs in people with lung disease when coughing forcefully. Swallow syncope occurs upon swallowing in some people with disease in the throat or oesophagus. Micturition syncope occurs when a susceptible person empties an overfilled bladder. It is most common in males who are intoxicated with alcohol. Carotid sinus hypersensitivity occurs in some elderly people when turning the neck, shaving, or wearing a tight collar. Postprandial fainting can occur in elderly people when their blood pressure falls about an hour after eating. Postural syncope : This occurs when a person lying down, who feels perfectly well and alert, sudden faints upon standing up. The brain's blood flow decreases when they stand owing to a drop in blood pressure. This sometimes occurs in people who have recently started or changed certain cardiovascular medications. This type of fainting results from either or both of the following causes: Low circulating blood volume, caused by blood loss (external or internal), dehydration, or heat exhaustion Impaired circulatory reflexes, caused by many medications, disorders of the nervous system, or congenital problems Cardiac syncope: Heart disease causes a person to faint by a variety of mechanisms. Cardiac causes of fainting are generally life threatening. They include the following: Cardiac rhythm abnormality: Electrical problems of the heart impair its pumping ability. This causes a decrease in blood flow. The heart rate may be either too fast or too slow to pump blood well. This condition usually causes fainting without any warning symptoms. Cardiac obstruction: Blood flow can be obstructed within the blood vessels in the chest. Cardiac obstruction can cause fainting during physical exertion. A variety of diseases cause obstruction, including heart attacks, diseased heart valves, pulmonary embolism, Cardiomyopathy, pulmonary hypertension, cardiac tamponade, and aortic dissection. Heart failure: The heart's pumping ability is impaired. This lowers the force with which blood circulates through the body and may decrease blood flow in the brain. Neurologic syncope: Neurologic problems cause fainting (or loss of consciousness) by various mechanisms. Seizures are a cause of unconsciousness but are different from fainting. With seizures, the blood flow to the brain does not decrease. Unconsciousness results from disordered electrical discharges within the brain. Seizure typically causes prolonged (longer than 8 seconds) shaking of the arms and legs followed by confusion and disorientation after awakening. Stroke (bleeding in the brain) can cause syncope associated with headache. Transient ischemic attack (TIA or mini-stroke) can cause fainting, usually preceded by double vision, loss of balance, slurred speech, or vertigo (a spinning sensation). Other rare causes include certain tongue problems and migraines. Psychogenic syncope: Hyperventilation from an anxiety disorder can cause fainting. Rarely, people pretend to faint to minimize stress or for Fainting Symptoms Unconsciousness is an obvious sign of fainting. Vasovagal syncope Before fainting, you may feel light-headed and shaky and experience blurred vision. You may "see spots in front of your eyes." During this time, observers note paleness, dilated pupils, and sweating. While unconscious, you may have low pulse rate (less than 60 beats/minute). Consciousness returns when the situation is over, usually very quickly. Postural syncope You may have noted a blood loss (black stools, heavy menstrual periods) or fluid loss (vomiting, diarrhoea, fever). You may have experienced light-headedness when sitting or standing. Observers may note paleness, sweating, or signs of dehydration (dry lips and tongue). Cardiac syncope You may report palpitations (awareness of pounding, fast, or abnormal heartbeat), chest pain, or shortness of breath. Observers may note a weak, abnormal pulse, paleness, or sweating. Syncope often occurs without warning or following exertion. Neurologic syncope You may have headache, loss of balance, slurred speech, double vision, or vertigo (a feeling that the room is spinning). Observers note a strong pulse during the unconscious period and normal skin colour. Seizures People experiencing a seizure may report strange sensations that precede the unconscious period. (This is referred to as an aura.) Incontinence (inability to hold urine or stool) is common. If observers are present during the seizure, they note sustained convulsions (lasting longer than 8 seconds). A prolonged period of confusion, lasting several minutes, follows the seizure. During a seizure, people often scrape themselves or bite their tongues. When to Seek Medical Care Because fainting can be caused by a serious condition, you should be transported to a hospital emergency department in an ambulance. Calling your health care provider may waste time. The only exceptions are people who meet certain conditions. If all of these conditions apply, and you have a primary health care provider who is familiar with your medical condition, you may not have to go to the hospital. Have a family member or companion call your health care provider and ask if you should be taken to the hospital. If your health care provider is not available within 15 minutes, you should go to the hospital. Do not attempt to drive yourself; call 999 for emergency transport. Self-Care at Home If possible, help the person who has fainted to the ground to minimize injury. Stimulate the person vigorously (yelling, briskly tapping). Call 999 immediately if the person does not respond. Check for the pulse in the neck and begin CPR, if needed. After the person recovers, encourage him or her to lie down until medical help arrives. Even if you believe the cause of the fainting is harmless, have the person lie down for 15-20 minutes before attempting to get up again. Ask about any persistent symptoms, such as headache, back pain, chest pain, shortness of breath, abdominal pain, weakness, or loss of function, because these may indicate a life-threatening cause of the fainting. Essential oils can be helpful for a state of shock or for feeling faint. Neroli and Peppermint are the best to use but if these are not available then Lavender or Rosemary can be used. Simply hold the opened bottle under the nose of a person who feels faint or to aid recovery after the faint. Alternatively put a few drops on a handkerchief and hold under the nose of the person. |
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