By: Alex Ryzhikov, MD, FACC, Cardiovascular Disease and Internal Medicine
Fainting is a brief loss of consciousness due to a temporary inadequate blood supply to the brain. Fainting spells, known as “syncope,” are extremely common. In fact, approximately one-third of us will experience a fainting spell at some point in our life. A person who faints will typically regain consciousness quickly and without assistance. Such fainting spells occur often in younger people and are typically benign. In older patients, however, fainting spells can often signal underlying heart disease.
Causes of Fainting
Fainting has several causes, including “vasovagal syncope,” which refers to a sudden drop in blood pressure and heart rate that can occur when an individual is laughing, coughing, using the bathroom, exposed to warm or hot temperatures, suddenly frightened or experiences sudden pain. Dehydration, caffeine use and alcohol use can lead to such fainting spells, which are often preceded by nausea, a feeling of doom and “tunnel vision,” clamminess and profuse sweating. After regaining consciousness, the person often feels extremely tired. Other causes of fainting include blood pressure drops caused by a change in position (such as standing up); this occurs more commonly in people with low blood pressure or those take diuretic medications for blood pressure or water retention.
More worrisome causes of fainting spells are problems with the electricity of the heart, in which the heartbeat becomes unusually slow, momentarily stops or accelerates rapidly. An overly muscular heart or a problem with one of the heart valves can lead to a fainting spell without any warning signs. Fainting that occurs without warning, often called a “drop attack,” or fainting that occurs with exertion, is likely due to a problem with the heart and should be evaluated by a primary care doctor and possibly a cardiologist as soon as possible.
Diagnosis
To check for a heart problem, the doctor will likely start with an electrocardiogram (EKG). Patients are often asked to wear a 24-hour heart monitor to look for electrical problems with the heart. Sometimes a two- to four-week event monitor is used. In addition, the doctor may order an echocardiogram and a stress test to check for any problems with the blood flow in the heart. Implantable recorders under the skin, tilt-table testing and occasionally electrophysiology studies are sometimes necessary to precisely determine the cause of fainting spells. These tests are performed by a cardiologist.
Treatment
Treatment of fainting spells focuses on the underlying cause, which varies from one person to the next. If you experience a fainting spell, please seek medical attention. The cardiologists at MedStar Southern Maryland Hospital Center are experts at diagnosing and treating syncope. Simple lifestyle changes can often prevent future fainting spells: minimizing caffeine and alcohol, increasing the amount of water you drink, changing your medications and wearing compression stockings. In other cases, your cardiologist may recommend a pacemaker or defibrillator to treat an underlying heart condition.
Learn more about Heart Care at MedStar Southern Maryland Hospital Center.