Passed out; Lightheadedness - fainting; Syncope; Vasovagal episode
Fainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and you usually recover from it quickly. The medical name for fainting is syncope.
When you faint, you not only lose consciousness, you also lose muscle tone and the color in your face. Before fainting, you may feel weak and nauseated. You may have the sense that your vision is constricting (tunnel vision) or noises are fading into the background.
Fainting may occur while or after you:
- Cough very hard
- Have a bowel movement (especially if you are straining)
- Have been standing in one place for too long
Fainting can also be related to:
- Emotional distress
- Severe pain
Other causes of fainting:
- Certain medicines, including those used for anxiety, depression, and high blood pressure (these drugs may cause a drop in blood pressure)
- Drug or alcohol use
- Rapid and deep breathing (hyperventilation)
- Low blood sugar
- Sudden drop in blood pressure (such as from bleeding or being severely dehydrated)
- Standing up very suddenly from a lying position
Less common but more serious reasons for fainting include heart disease (such as abnormal heart rhythm or heart attack) and stroke. These conditions are more likely in people over age 65.
If you have a history of fainting, follow your health care provider's instructions for how to prevent fainting. For example, if you know the situations that cause you to faint, avoid or change them.
Get up from a lying or seated position slowly. If having blood drawn makes you faint, tell your provider before having a blood test. Make sure that you are lying down when the test is done.
You can take immediate treatment steps when someone has fainted:
- Check the person's airway and breathing. If necessary, call 911 and begin rescue breathing and CPR.
- Loosen tight clothing around the neck.
- Raise the person's feet above the level of the heart (about 12 inches or 30 centimeters).
- If the person has vomited, turn him or her onto their side to prevent choking.
- Keep the person lying down for at least 10 to 15 minutes, preferably in a cool and quiet space. If this is not possible, sit the person forward with the head between the knees.
When to Contact a Medical Professional
Call 911 if the person who fainted:
- Fell from a height, especially if injured or bleeding
- Does not become alert quickly (within a couple of minutes)
- Is pregnant
- Is over age 50
- Has diabetes (check for medical identification bracelets)
- Feels chest pain, pressure, or discomfort
- Has a pounding or irregular heartbeat
- Has a loss of speech, vision problems, or is unable to move one or more limbs
- Has convulsions, a tongue injury, or a loss of bladder or bowel control
Even if it is not an emergency situation, you should be seen by a provider if you have never fainted before, if you faint often, or if you have new symptoms with fainting. Call for an appointment to be seen as soon as possible.
What to Expect at Your Office Visit
Your provider will ask questions to determine whether you simply fainted, or if something else happened (such as a seizure or heart rhythm disturbance), and to figure out the cause of the fainting episode. If someone saw the fainting episode, their description of the event may be helpful.
The physical exam will focus on your heart, lungs, and nervous system. Your blood pressure may be checked while you are in different positions. People with a suspected arrhythmia may need to be admitted to a hospital for testing.
Tests that may be ordered include:
Treatment depends on the cause of fainting.
Calkins HG, Zipes DP. Hypotension and syncope. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 40.
De Lorenzo RA. Syncope. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 15.
Walsh K, Hoffmayer K, Hamdan MH. Syncope: diagnosis and management. Curr Probl Cardiol. 2015;40(2):51-86. PMID: 25686850 www.ncbi.nlm.nih.gov/pubmed/25686850.