Fainting (cont.)
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
- Introduction to fainting (syncope)
- What causes fainting (syncope)?
- Heart rhythm changes
- Heart structural conditions
- Heart valve conditions
- Sudden cardiac death
- Postural hypotension
- Vasovagal syncope
- Anemia
- Dehydration
- Orthostatic hypotension
- Vertebrobasilar system
- Electrolyte imbalance
- Other medications and drugs
- Pregnancy
- 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?
- Fainting (Syncope) At A Glance
What is the treatment for fainting (syncope)?
Fainting is not normal, although the cause may not be serious. When in doubt, calling 911, activating the emergency medical system, and seeking medical care is appropriate. It is always appropriate to seek medical care.
If the episode is short-lived and the person returns to normal function with no evidence of injury, it may be appropriate to contact the primary care practitioner to discuss care options.
If the person is not breathing and no pulse can be felt, 911 should be activated, an AED placed, and bystander CPR should be initiated.
In the ambulance, hospital, or doctor's office, because the potential life-threatening causes of syncope need to be initially considered; often a patient who complains of fainting (syncope) will be placed on a heart monitor, have an intravenous line placed, and oxygen supplied. A fingerstick blood sugar may be checked to look for hypoglycemia (low blood sugar).
Further treatment will be tailored to the specific cause of the fainting or syncope based upon the patient's evaluation.
Can fainting (syncope) be prevented?
Depending upon the cause, there may be opportunity to prevent fainting spells. For example:
- Patients who have had a vasovagal episode may be aware of the warning signs
and be able to sit or lie down before passing out and avert the fainting
episode.
- For older patients with orthostatic hypotension, waiting for a second after
changing positions may be all that is needed to allow the body's reflexes to
react.
- Medications may be adjusted if they are thought to be the potential
cause of fainting or syncope.
- Adequate fluid intake may be enough to prevent dehydration as the cause for
syncope.
- There is an increased awareness of syncope and sudden death in younger athletes due to hypertrophic cardiomyopathy. A variety of screening tests are available to assess potential risk for sudden death, but no consensus yet as to who and when to screen athletes has emerged.
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