Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 18, 2015

Fainting, often referred to as “passing out” in many cases will be a onetime occurrence. When the brain is deprived of oxygen it suffers a momentary loss of blood flow, which results in a “black out”.


Definition & Facts

Syncope (pronounced SIN-ko-pee) is the medical term to describe fainting. Some report feeling dizzy, weak or lightheaded before losing consciousness. Many people feel nauseated when waking from a fainting spell. An individual may appear pale or sweaty. A low pulse rate may be noted. Many people report having little or no warning signs before fainting. Generally, it only lasts a brief moment and shouldn’t be considered cause for concern.


The most common causes of fainting include:

  • Vasovagal syncope occurs when the blood pressure or heart rate abruptly drop. This is often associated with standing for an extended amount of time, rising quickly, suffering stress, fear or emotional trauma or even at the sight of blood. This is the most common type of fainting, most often occurring with children and young adults.
  • Situational syncope can happen in specific situations of straining, such as a bowel movement, emptying the bladder or violently coughing. Gastrointestinal issues can also be a cause.
  • Carotid sinus syncope can occur when blood flow to the carotid artery is restricted. Typically in these situations fainting occurs when the head is turned to one side which would indicate the blood vessel is being constricted.
  • Cardiac syncope refers to fainting caused by several types of heart disease. When the hearts ability to function is weakened, the blood flow to the brain becomes limited. This is generally considered to be the most life-threatening syncope.

Other common factors that are associated with syncope include:

When to see a doctor

If a fainting spell is a onetime occurrence, referred to as a vasovagal attack, you probably won’t need to seek the help of a medical professional. In other instances, if the fainting occurs more than once during a short period of time, it is definitely advised to speak with a doctor to rule out any other causes or factors. Be prepared with a full medical history. Initially, a doctor will want to know specific symptoms that may have contributed to the fainting:

  • Did it occur abruptly and without warning?
  • Did the fainting happen while standing or sitting down?
  • Shortly before fainting was a heavy menstrual cycle present?
  • Has the patient been ill with fever, diarrhea or vomiting?
  • Did the fainting result in confusion or was there a return to normal activity shortly after?

A simple blood test may be ordered to rule out any anemia or chemical imbalances. If the doctor is unable to make a diagnosis at this point, further tests may be ordered to rule out any problems with the heart or the brain. Several different tests may be administered during a heart evaluation to establish how healthy the heart is. For instance, an electrocardiogram (ECG) will test the heart’s electrical activity to determine an arrhythmia.

A stress test is used to verify that adequate blood is flowing to the heart. An echocardiogram may determine any cardiac disease. In some cases, the patient may be asked to carry a Holter monitor. Worn for 24 hours or more, it also monitors the hearts activity. To test brain wave activity, a doctor may order an electroencephalogram (EEG). This is normally requested if the fainting spells are triggered by seizures.

Treatment & Therapy

Treating fainting spells will be determined by a doctor based on the health evaluation. If there are no medical causes found, a doctor may not require any form of treatment. However, sometimes medications are given to control the main cause of the fainting. A pacemaker may be required if an irregular heartbeat is the cause.

Specific treatment plans are available depending on the type of syncope diagnosed. For vasovagal syncope:

  • Drink sufficient amounts of water
  • Increase salt intake
  • Avoid standing for long periods of time

Treatments for postural syncope include:

  • To control low blood pressure in the elderly, consume smaller meals in a sitting
  • Stay hydrated
  • Before getting out of bed, sit up and stretch the calf muscles to increase blood flow

Treatments for cardiac syncope include:

  • Medication or changes to daily routine to manage high blood pressure
  • A specific diet may be recommended
  • If heart disease is determined some form of surgery or angioplasty may be required

These are the best methods in treating a person who has fainted:

  • Raise the feet above heart level to increase the flow of blood.
  • Apply a cold washcloth to the forehead or in cases of the chills offer a warm blanket.
  • Loosen any clothing that may be restricting blood flow.
  • Have the person remain with elevated feet for several minutes before allowing to sit or stand up.
  • Offer water to rehydrate the body.

If someone has fainted and exhibits these symptoms, 911 should be called immediately:

  • Stops breathing or hasn’t woken up within a few minutes
  • Wakes up confused, disoriented or struggles with speech
  • Is diabetic or suffers chest pains
  • Loses control of bladder or bowels
  • Unable to move or suffers an injury

Prevention & Prophylaxis

In a case where a doctor has determined a specific cause of the syncope, preventative measures can be taken to lessen the chance of a fainting spell. For instance, if fainting occurs on an empty stomach or during warm weather, eat before leaving the house, carry extra supplies of food and always have plenty of water.

Wear loose clothing to avoid overheating. Don’t rise up quickly from a seated position. Understand the signs of fainting, such as feeling lightheaded or dizzy. If theses sensations are present, sit or lie down placing the head between the knees until the feeling passes. Understanding the warning signs may help lessen the possibility of a fainting spell and the chance for injury.

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