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When fainting becomes a serious problem

Dr. Jeffrey Banker is director of the Syncope Clinic at Sinai, part of the LifeBridge Health Cardiovascular Institute.
Dr. Jeffrey Banker is director of the Syncope Clinic at Sinai, part of the LifeBridge Health Cardiovascular Institute. (Courtesy of LifeBridge Health / HANDOUT)

Work out too hard and become overheated, or stand up too fast, and you might faint. In most cases, the body will revive itself. But fainting, also known as syncope, can be a sign of a more serious health problem. Dr. Jeffrey Banker, director of the Syncope Clinic at Sinai, part of the LifeBridge Health Cardiovascular Institute, says tests are sometimes needed to determine whether there is a larger problem.

What happens when one faints?

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Many of us are familiar with the dangers of high blood pressure and how it can cause heart attacks and strokes. However, low blood pressure can also pose serious health risks. Low blood pressure can cause fainting. This occurs when not enough blood and its nutrients are circulating around the body. When blood pressure drops below the level needed to get blood and oxygen to the brain, a person loses consciousness temporarily. Syncope can occur at any age.

What causes a person to faint?

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Among the causes are the dilation of blood vessels, which means blood is unable to sustain enough pressure to get blood to the brain; something is wrong with the structure of the heart so that it is unable to pump enough blood to the brain; or there is not enough blood in the body. All of these can slow the heart rate and cause syncope.

It can be difficult to make a diagnosis for syncope because the symptoms can mirror a variety of similar medical conditions. Much of the time, there is no serious irregular heartbeat or other mechanical problem with the heart, but it is important to rule out dangerous problems. There is a long list of reasons that someone might faint. The spectrum includes benign conditions such as dehydration, low blood sugar, emotional stress, becoming overheated and sweating, pain, standing up too fast and taking some medications. Unfortunately, syncope can also be an indicator of more malignant conditions such as heart, lung and brain diseases. That's why additional tests might be needed.

How do you revive someone who has fainted?

Most of the time, one revives on his or her own, but putting the person into a reclining position will help blood flow to the brain. Smelling salts, which are usually ammonia inhalants that do not contain salt, can be used with brief exposure. They trigger a reflex causing a person to inhale, which allows the body to get added oxygen. However, you should always approach a seemingly unconscious patient with some knowledge of CPR and assess whether the person can be awakened. If not, help must be called immediately.

How can you tell if you're at risk of fainting.

Watch for signs such as becoming lightheaded, dizziness, feeling like you have to vomit, having the room feel like it's closing in on you and fading vision.

When can fainting be dangerous?

The dangers of syncope are related to its causes. The event itself and the underlying condition have a danger spectrum. Once consciousness is restored, the imminent danger is usually over; however, there can be a resulting physical trauma, such as falling and hitting your head or injuring your body in other ways, and an emotional toll that comes with the uncertainty. It is also vital that the original cause of the episode be pursued and diagnosed because there could be a critical underlying condition causing the fainting.

To avoid syncope, make sure you drink plenty of fluids, not including alcohol. However, if you feel yourself getting dizzy or lightheaded, try to sit or lie down. Certain medicines can help with the situation.

Can fainting lead to death?

In some circumstances, syncope could be a symptom of a potentially lethal situation and must always be evaluated urgently. Usually this would mean a trip to the emergency department. A physical and a complete family history are indicated, and subsequent evaluations may be necessary by a cardiologist and/or neurologist depending on the findings at the initial assessment.

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