Introduction:

Syncope, or fainting, happens when your brain doesn' t gets enough blood flow and you lose consciousness. Usually a slow heart rate causes a drop in blood pressure, which reduces the blood flow to the brain. In most cases, you recover within seconds or minutes. About 3 - 4% of people, mostly the elderly, have episodes of fainting. If you have slurred speech or have trouble moving an arm or a leg after fainting, call for emergency help immediately -- this may be a sign of stroke.

Signs and Symptoms:

You may have the following signs and symptoms before you faint:

• Lightheadedness
• Feeling warm
• Blurred vision
• Sweating
• Heaviness in your lower limbs
• Confusion
• Yawning
• Nausea, and sometimes vomiting

When you faint, in addition to loss of consciousness, you may have the following symptoms:

• Turning very pale
• Falling down or slumping
• Spasmodic jerks of your body
• Weak pulse
• Drop in blood pressure

What Causes It?:

Fainting often happens due to a simple, non-medical cause, including standing up for long periods of time, feeling emotional distress, or even the sight of blood. More rarely, it may be the result of a serious health condition, such as heart disease (decreased blood flow to the heart or irregular heart rhythm), low blood sugar (often from diabetes), seizures, panic attacks, and problems regulating blood pressure. Severe blood loss can also cause fainting.

Who's Most At Risk?:

People with the following conditions or characteristics are at risk for fainting:

• Over 65 years of age
• Already have heart disease, diabetes or high blood pressure
• Recreational drug use
• Taking certain medications such as blood pressure medication, insulin, oral diabetes medications, diuretics (water pills), antiarrhythmics, or blood thinners (anticoagulants)
• Pregnancy

What to Expect at Your Provider's Office:

If you have fainted, you should see your doctor. Your health care provider will ask questions about what you were doing before you fainted and how you felt afterward, do a physical examination, and perform diagnostic tests. Tests may include blood tests, electrocardiogram (ECG), and imaging of the brain, such as magnetic resonance imaging (MRI). Your doctor will focus on medications you take, preexisting medical conditions, and your description of any similar episodes you may have experienced in the past. This will help your health care provider pinpoint why you fainted and identify or rule out particular health conditions. If seizures are suspected, your doctor may also perform a test called an electroencephalogram (EEG).

Treatment Options:

Prevention

You may be able to avoid fainting, depending on the cause.

• Avoid fatigue, hunger, and stress. Don' t skip meals.
• Drink plenty of fluids.
• Avoid changing positions quickly, especially getting up from a sitting or lying-down position.
• Sleep with the foot of your bed raised.
• Avoid standing for long periods of time.
• Wearing elastic stockings may keep blood from pooling in your legs, which may reduce blood flow to the brain.
• Diuretics and other prescription and non-prescription medicines can contribute to the problem, so check with your health care provider.
• Avoid tight clothing around the neck.
• Turn your whole body and not just your head when looking around.
• To prevent injuries, cover floors with thick carpeting and avoid driving or operating mechanical equipment.
• Avoid caffeine and alcohol.

If you feel like you are going to faint, lie down and raise your legs (that helps keep blood flowing to your brain). If you can' t lie down, sit down and put your head between your knees. Or stand with your legs crossed and thighs pressed together -- this can also help keep blood from pooling in your legs.

Treatment Plan

Any serious underlying health condition should be treated. When someone faints, place him or her in a position that increases blood flow to the brain, such as with the legs raise. Loosen all tight clothing, apply cold water to the person's face, and turn the person's head to the side to prevent vomiting or choking. A pregnant woman should lie on her left side to relieve pressure on the heart.

Drug Therapies

When an irregular heartbeat causes fainting, your health care provider may prescribe medications such as beta-blockers or antiarrhythmics. Your health care provider may also prescribe mineralocorticoids (such as fludrocortisone) or salt tablets.

Surgical and Other Procedures

If fainting is caused by a heart condition, such as a slow or rapid heartbeat, you may need a pacemaker.

Complementary and Alternative Therapies

Although there are no specific treatments for fainting, a number of alternative therapies help protect the heart and blood vessels. Fainting may be caused by a serious underlying health condition, so check with your health care provider before taking any herbs or supplements. Always tell your health care provider about the herbs and supplements you are using or considering using.

You may have warning signs before fainting. Hypnosis, deep breathing, relaxation techniques, and biofeedback may help you avoid fainting. These techniques may also help you control fainting related to regulation of your blood pressure.

Nutrition and Supplements

These supplements may promote heart health:

• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily -- may help lower inflammation and improve heart health. Cold-water fish, such as salmon or halibut, are good sources. Omega-3 fatty acids may increase the risk of bleeding. If you take blood-thinning medications such as warfarin (Coumadin), talk to your doctor before taking fish oil.
• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, folic acid, zinc, and selenium.
• Coenzyme Q10, 100 - 200 mg at bedtime -- an antioxidant that may be good for heart health.
• Acetyl-L-carnitine, 500 mg daily -- an antioxidant that may be good for heart health.
• Alpha-lipoic acid, 25 - 50 mg twice daily -- an antioxidant that may be good for heart health.
• L-arginine, 1 - 2 grams one to two times daily -- an antioxidant that may help promote good circulation. Arginine may not be right for people with certain viral infections such as herpes.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, take herbs with care, under the supervision of a health care provider.

• Green tea (Camelia sinensis) standardized extract, 250 - 500 mg daily -- an antioxidant and anti-inflammatory that may be good for heart health. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Bilberry (Vaccinium myrtillus) standardized extract, 80 mg two to three times daily -- an antioxidant that helps promote good circulation. Bilberry may increase the risk of bleeding, so talk to your doctor before taking bilberry if you take blood-thinning medications such as aspirin or warfarin (Coumadin).
• Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily -- an antioxidant that may be good for heart health. Gingko may increase the risk of bleeding, so do not take gingko if you take blood-thinning medications such as aspirin or warfarin (Coumadin).

Sometimes, fainting may be due to drops in a hormone called cortisol that is made by adrenal glands. Ask your doctor about testing for low cortisol. Some doctors may prescribe cortisol hormone supplements or use nutrients and herbs to get cortisol levels back to normal.

Homeopathy

Before prescribing a remedy, homeopaths take into account a person' s constitutional type -- your physical, emotional, and intellectual makeup. An experienced and certified homeopath will assess your individual constitution and symptoms, and then recommend remedies. Below are common remedies used for fainting or pre-fainting symptoms:

• Carbo vegetabilis -- used for fainting or lightheadedness after rising in the morning, from loss of fluids, or from becoming overheated
• Opium -- used for fainting due to excitement or fright
• Sepia -- used for fainting following prolonged standing, exercise, or fluid loss due to fever

Acupuncture

Accupuncture may be help treat fainting. A clinical analysis of 102 serious cases of loss of consciousness reported that acupuncture helped in a large percentage of these cases.

Acupuncture does not often cause side effects or complications. However, some people may faint during acupuncture treatments, although it is not considered a serious complication.

Prognosis/Possible Complications:

In most people, simple fainting is not a sign of a life-threatening disease, particularly if it only happens once. The elderly have a higher risk of injury after a fainting episode, especially from fractures.

Following Up:

Many people who faint, especially the elderly and those who have heart disease, may be hospitalized to look for a cause. Continuous ECG monitoring can identify irregular heartbeat as a cause of fainting, especially in people who have recurring fainting problems.

Alternative Names:

Fainting