Causes of Fainting, Symptoms, Treatment


Fainting, syncope or “blacking out” is the loss of consciousness temporarily followed by a returning to complete wakefulness. The fainting or loss of consciousness might be complemented with loss of tone in the muscles that can cause slumping over or falling down. Perhaps to understand better fainting and why it happens, it will be helpful to understand why someone is awake.

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Brains have multiple sections including two (2) hemispheres – the cerebellum and the brain stem. The brain needs blood to provide glucose/sugar as well as oxygen to the cells in the brain to maintain life. For the body to be awake, a region in the brain stem known as the “reticular activating system” needs to be working. Read more about the functioning of the brain

When fainting occurs, either the “reticular activating system” will lose its blood source or both brain hemispheres will be receiving no oxygen, glucose or blood. When blood sugar/glucose levels are normal, blood flow might be interrupted momentarily to the entire brain or to the “reticular activating system”.

Fainting is not due to a head trauma, because loss of consciousness after an injury to the head is known as a concussion. But, fainting can itself cause injury if the individual falls and hurts themselves or if the fainting occurs when taking part in an activity such as driving a car.

Fainting symptoms

When an individual faints, they are unaware that they have fainted and fallen down. It is only after the fact that the individuals understand what occurred.

There can by signs or symptoms prior to the episode of fainting, and may include:

• Lightheaded

• Nauseated

• Sweating

• Weak

• Dizziness or vertigo

• Vision fade or blurred

• Muffled hearing

• Tingling sensations

In cases of near fainting, the exact symptoms will occur but the individual does not lose total consciousness.

With fainting episodes, when the individual is unconscious, there might be some twitching of the body which is sometimes confused with activity of having a seizure.

The individual might be confused after wakening but it should resolve within a few seconds.

In most fainting episodes, there will normally be a fast return to normal mental function, though there could be other symptoms and signs depending on the underlying cause of the fainting. For instance, when an individual is in the middle of a heart attack, they might complain of pressure or chest pain after recovering from fainting.

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What causes fainting? (Reasons for fainting)

A blood flow decrease to the brain usually occurs due to:

• Failure of heart to pump the blood

• Blood vessels lack tone to maintain blood pressure to bring the blood to the brain

• Not enough fluid or blood in the blood vessels

• Combination of the three above

The rhythm of the heart changing is the most common reason for passing out, syncope or fainting. This might sound ominous, but most of the time fainting is just due to a temporary alteration in body function that is normal.

Causes of this temporary body function alteration can be:

• Heart structural conditions

• Abnormalities with heart valves

• Sudden cardiac death

• Postural hypotension – often occurs when standing up too fast

• Loss of intravascular fluid – not enough water and blood in blood vessels

• Balance between adrenaline and acetylcholine is disrupted

Anemialow red blood cell count

• Dehydration

• Orthostatic hypotension – older adults when standing

• Narrowing of the vertebrobasilar system – arteries supplying the base of the brain

• Electrolytes and hormone abnormalities

• Some drugs and medications

• Pregnancy – compression of inferior vena cava

Treatment for fainting

Of course, fainting is not normal, but the cause is not always serious. If in doubt, call 911, which activates the emergency medical system and seek medical care.

When a fainting episode is short-lived and the individual returns to normal function with little evidence of injury – it could be appropriate to contact the primary care physician to see about options for care.

If the individual is not breathing and has no pulse, again 911 needs to be activated, an airway established and CPR initiated.

In the hospital, ambulance or the physician’s office, individuals who have fainted will be placed on a heart monitor, have an IV placed, and oxygen supplied all due to the fact that fainting can be possibly caused by a life-threatening problem. A blood sugar/glucose test will also be done to check for low blood sugar levels.

After the patient has been evaluated, further treatment will be personalized for the precise cause of the fainting.

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