Overview

Some people feel lightheaded, weak, dizzy, or nauseous as signs before fainting happens. Other people experience “fading away” of noises and sensations, which can be described as “whiting out” or “blacking out.”

A person who fainted, usually recover after a few minutes, and if there are no underlying medical conditions that cause fainting, there is no need for treatment. Fainting is often no cause for concern. But it can be a symptom of a severe health condition. If you have no history of passing out yet you experienced fainting more than once in the current month, you should consult your doctor about the problem. 

Symptoms

A visible sign of fainting is unconsciousness, but there are several notable symptoms. 

For Vasovagal Syncope

Lightheadedness, shaky and blurred vision

Seeing spots in front of the eyes

Paleness, sweating and dilated pupils

Low-pulse rate when unconscious

Regains consciousness quickly

For Situational Syncope

No warning signs and consciousness returns when the situation is over

For Postural Syncope

Before fainting spells, one may experience blood loss like heavy menstruation, black stool or fluid loss due to vomiting or diarrhea

Light-headedness when standing or sitting

Sweating, paleness, and signs of dehydration

For Cardiac Syncope

Palpitations, abnormal heartbeat, shortness of breath and chest pain

Paleness and sweating

Fainting usually happens without warning or after exertion

For Neurologic Syncope

Headache, slurred speech, vertigo, double vision and loss of balance

Steady pulse during unconsciousness and normal skin color  

Causes of Fainting

Different conditions can cause a fainting spell. It includes heart conditions like irregular heartbeats, low blood sugar, anemia problem, and issues with how the nervous system regulates blood pressure. Some kinds of syncope also run in the family.

Fainting may also indicate a specific medical condition; however, it can happen to any healthy individual. For the elderly, passing out is a cause for concern as they may suffer severe injuries from falls if they faint. Fainting spells are usually brief, and those who experience it regain full consciousness in a matter of minutes. 

Vasovagal Syncope – is the most common and usual cause of passing out. It happens when a person has a circulatory reflex that is abnormal. When it happens, the heart pumps more forcefully while the vessels relax. However, the heart rate doesn’t compensate quickly enough to sustain blood flow to the brain. Those who are older than 45 years rarely experience this type of fainting for the first time. Some common causes of this type of fainting are:

• Environmental factors like a hot and crowded place
• Emotional factors like a threat or sight of an injury or stress
• Physical factors such as standing or sitting too long
• Dehydration, fatigue or illness

Situational Syncope- a kind of fainting that happens in specific situations. Some causes of this include:

• Cough syncope happens when one has forceful coughing
• Swallow syncope happens when people with a disease in the esophagus or throat swallows
• Micronutrition syncope happens when susceptible individual empties their bladder than has been overfilled
• Postprandial syncope may arise with the elderly when their blood pressure level falls after consuming food

Postural Syncope – happens when one is perfectly healthy and alert, yet feels faint when he suddenly stands up from lying down position. Blood flow to the brain declines when the person suddenly stands up because of a momentary drop in blood pressure. It usually happens to people who recently started their cardiovascular medication. fainting may be due to the following: 

• Impaired circulatory reflexes due to nervous system disorder, congenital problems, drugs or diabetes
• Low blood circulation volume due to blood loss, heat exhaustion or dehydration 

Cardiac Syncope – if a person has heart disease, he is susceptible to fainting due to several mechanisms. Fainting due to cardiac issues are fatal, and it includes the following situations:

• Cardiac rhythm abnormality – otherwise known as arrhythmia, it is the impairment of the heart’s pumping abilities due to electrical problems. It the blood flow to significantly decrease. The heart rate can be too fast or too slow to pump blood efficiently; thus, this condition can happen without any signs. 
• Cardiac Obstruction – is the obstruction of the blood flow within the chest blood vessels. It can cause fainting when a person is tired from exertion. More so, this condition may be due to diseased heart valves, cardiomyopathy, aortic dissection, or cardiac tamponade. 
• Heart Failure – is the impairment of the heart’s pumping abilities. It decreases the force of the blood that circulates throughout the brain and body.

Neurologic Syncope – fainting due to neurologic conditions as listed: 

• Stroke can cause fainting with associated with a headache 
• Transient ischemic attack or what is known as mini-stroke can cause fainting with symptoms including loss of balance, double vision, vertigo, and slurred speech 
• On rare cases, fainting may be due to migraines

Psychogenic Syncope – is when hyperventilation from mental disorders causes fainting. Likewise, some pretend to faint to lessen stress. This condition should be deliberated after all other causes were ruled out.  

Diagnosis and Treatment

People who have no history of fainting and have fainted several times recently will have to undergo tests to determine any underlying conditions which might have caused it. 

Even if you are physically well and healthy and you passed out once, you should get at least an electrocardiogram (EKG or ECG) to see the electrical activity of your heart.

You will be asked to tell your doctor about the circumstances of your fainting, like what you were doing and the symptoms that you felt before you passed out. Likewise, expect to provide your complete medical history, including details about previously diagnosed conditions, prescription and over the counter medications that you are taking.

Depending on the results of your physical exam, the doctor may still require additional tests starting with the EKG. Other tests that they may use are: 

Echocardiogram – uses sound waves for a moving picture of the heart

Holter monitor – a portable heart-monitor that patients need to wear for 24 hours.

Electroencephalogram (EEG) – a device used to measure the electrical activity of the brain to check whether you had a seizure. 

CT Scan – In rare cases, a patient may be required to get a CT scan to check for bleeding in the brain, especially if there is a recent injury that would call for concern. 

Treatment and Outlook 

Treatment for fainting depends on the doctor’s diagnosis. If there are no underlying conditions that caused you to faint, there are no treatment plans needed, and long-term outlook is fine.

A person with an underlying medical problem who experience fainting will need treatment to prevent future episodes. However, further treatment is not necessary. Generally, people should avoid triggers to prevent new fainting episodes like standing still for long periods, staying in hot environments, and dehydration.

If getting injections or the sight of blood makes you faint, you should inform the nurse or doctor before going through such medical procedures. You should be in a safe position like lying down before going through any medical process that involves injections and blood. 

Beta-blockers used for controlling high blood pressure may also be changed if it causes neurocardiogenic fainting that interferes with the person’s daily life. Some adverse effects of beta-blockers are slow heartbeat and pulse, diarrhea, nausea, fatigue, and clammy hands and feet. 

What are Normal Conditions?

Patients taken to a hospital when they fainted will usually be subjected to blood pressure checks and diagnosed for any underlying conditions. Doctors may perform tests, including an electrocardiogram to monitor for an irregular heartbeat. The cause of fainting spells may be seen immediately, but there will be instances when more tests will be required. 

Young adults with symptoms that are associated with the most common type of fainting or the vasovagal syncope are soon discharged from the hospital. Patients who are 50 years or older are usually admitted for further tests. However, despite testing and hospitalization, the real cause of fainting is not determined. 

Risks of Fainting

Usually, fainting is caused by a brief drop in blood pressure when the brain does not get sufficient blood flow. It causes loss of consciousness. One serious cause of fainting is bleeding in the stomach or intestines, or a rupture in the body’s main artery.

Likewise, different heart conditions temporarily lowers blood pressure. With this condition, the heart beats too slowly to pump sufficient blood. Irregular movement of the heart’s pumping chambers will also cause the heart to pump less efficiently. These abnormalities, including the stiffening of the aortic valve, can lead to temporary pressure loss.  

Other symptoms observed for these heart conditions include palpitations, angina chest tightness, and experiencing shortness of breath. These symptoms indicate that you need immediate medical attention. 

Another risk of fainting that you should look out for is a seizure. It is an abnormality of the brain and is not related to blood pressure. Some seizures will cause shaking and loss of consciousness that is longer than the usual fainting spell.

When to Seek Medical Attention?    

An underlying medical condition can cause fainting, thus it should be taken seriously. A person with the first episode of fainting requires evaluation of a healthcare professional immediately. If the person has previous episodes of fainting and has a diagnosis for his fainting spells, he should let his doctors know of the current event.  

Health care professionals will decide whether a patient needs further tests and hospitalization after a thorough evaluation. Although most cases of fainting do not need to be admitted, people who passed out need to be examined by a doctor as soon as possible.