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Fainting


Fainting should be considered a medical emergency unless you know the cause.

If possible, help the person who has fainted to the ground to minimize injury.  Be careful not to injure your back when doing so.  The person should lie flat on their back.  Elevate the legs to help restore the person's blood pressure.

Stimulate the person vigorously (yelling, briskly tapping) taking care not to cause injury.  Call 911 immediately if the person does not respond.

Check for the pulse in the neck and begin CPR, if needed.

After the person recovers, encourage him or her to lie down until medical help arrives.  Even if you believe the cause of the fainting is harmless, have the person lie down for 15-20 minutes before attempting to get up again.

Ask about any persistent symptoms, such as headache, back pain, chest pain, shortness of breath, abdominal pain , weakness, or loss of function, because these may indicate a life-threatening cause of the fainting.

Medical Treatment for Fainting

The treatment of fainting depends on the diagnosis.

Vasovagal syncope (Situational)

  • Examples of vasovagal syncope include fainting in scary or embarrassing situations or during blood drawing, coughing, or urinating.
  • Lifestyle alterations: Drink plenty of water, increase salt intake (under medical supervision), and avoid prolonged standing.
  • Medications: Medication may be prescribed if episodes are frequent.

Postural syncope (Changing body position)

  • Lifestyle alterations: Sit up and flex calf muscles for a few minutes before getting out of bed.  Avoid dehydration.  Elderly people with low blood pressure after eating should avoid large meals or plan to lie down for a few hours after eating.
  • Medications: In most cases, drugs that cause fainting are withdrawn or changed.

Cardiac syncope

  • Medication and lifestyle alterations: These treatments are designed to optimize the heart's performance while limiting its demands.  Controlling high blood pressure, for example, would call for a medication and lifestyle change.  In some cases, specific anti-arrhythmic drugs may be prescribed.
  • Surgery: Bypass surgery or angioplasty is used to treat coronary heart disease.  For some valve problems, valves can be replaced.  Catheter ablation is available to treat some arrhythmias.
  • Pacemaker: A pacemaker may be implanted to slow the heart in certain types of fast arrhythmias.
  • Implanted defibrillators are used to control life-threatening fast arrhythmias.

Neurological Syncope

  • Seizures: If these are recurrent, medications will be used.
  • Stroke or transient ischemic attacks: A full evaluation will be performed to detect any significant blockages in the arteries to the brain.  Surgery and medications may be needed depending on the findings.

Other Causes of Syncope

  • There are many other causes of syncope including low blood sugar levels and lung disease such as emphysema and a pulmonary embolus.
  • Your doctor will do a complete history, physical, and various diagnostic tests to identify the cause of fainting.
  • Depending on the cause, appropriate therapy will be instituted.

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