Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Fainting (syncope) Facts
- Introduction to fainting (syncope)
- What causes fainting (syncope)?
- Heart rhythm changes
- Heart structural conditions
- Heart valve conditions
- Sudden cardiac death
- Postural hypotension
- Vasovagal syncope
- Orthostatic hypotension
- Vertebrobasilar artery disease
- Electrolyte imbalance
- Other medications and drugs
- What are the signs and symptoms of fainting (syncope)?
- How is fainting (syncope) diagnosed?
- What is the treatment for fainting (syncope)?
- Can fainting (syncope) be prevented?
Vasovagal syncope is one of the most common causes of fainting. In this situation, the balance between the chemicals adrenaline and acetylcholine is disrupted. Adrenaline stimulates the body, including making the heart beat faster and blood vessels narrower, thereby increasing blood pressure. Acetylcholine does the opposite. When the vagus nerve is stimulated, excess acetylcholine is released, the heart rate slows and the blood vessels dilate, making it harder for blood to defeat gravity and be pumped to the brain. This temporary decrease in blood flow to the brain causes the syncopal (fainting) episode.
Pain can stimulate the vagus nerve and is a common cause of vasovagal syncope. Other noxious stimuli can do the same thing, including situational stressors. It is common for medical and nursing students to faint when observing their first operation or autopsy. Some people pass out when they hear bad news; others pass out when they experience the sight of blood or needles. In the Victorian age this was known as a "swoon."
Other situations commonly cause the heart rate to temporarily slow and cause a faint. Straining with urination, bowel movement, or coughing can cause a vagal response, increase acetylcholine levels and decrease blood flow to the brain.
Anemia (low red blood cell count), whether it occurs acutely from bleeding or gradually for a variety of reasons, can cause fainting because there aren't enough red blood cells to deliver oxygen to the brain.
Dehydration, or lack of water in the body can similarly cause fainting or syncope. This can be caused by excessive loss of water from vomiting, diarrhea, sweating, or by inadequate fluid intake. Some illnesses like diabetes can cause dehydration by excess loss of water in the urine.
Next: Orthostatic hypotension
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