Fainting: Treatment, symptoms, advice and help
Fainting implies loss of consciousness which can be transient or prolonged. It can occur because of a variety of causes and can cause serious consequences in terms of damage to brain or heart, and even injury due to fall. A systematic evaluation is necessary to identify the contributing cause and institute appropriate treatment.
Fainting: Incidence, age and sex
Fainting can occur at any age; however, elderly individuals are especially prone to it.
Signs and symptoms of fainting: Diagnosis
The exact sequence of events leading to fainting depends upon the underlying cause. In case of fainting due to blood loss, dehydration or heart disorder, the person may have dizziness (prior to fainting), chest pain, breathlessness or palpitations. There may be history of blood loss from respiratory tract, gastrointestinal tract or due to trauma. There may also be a history of excessive fluid loss in the form of vomiting or diarrhea. In case of disorders of the nervous system, fainting may be very sudden and there may be abnormal movements of limbs suggestive of an epileptic fit.
The diagnosis is arrived at by a careful history and physical examination and appropriate investigations. Cardiac evaluation by an electrocardiogram (ECG), echocardiogram, holter monitoring may be required. Neurological evaluation may require computed tomography scan (CT) or magnetic resonance imaging (MRI) of brain.
Causes and prevention of fainting
Fainting can occur because of a number of causes which can be neurological, cardiac or reduced blood pressure resulting from loss of blood/fluids from the body. Neurological causes include an epileptic fit, stroke as a result of brain hemorrhage or infarct, brain tumour or infections. Cardiac causes include heart attack and disturbances in heart rhythm. There may be loss of fluid from the body in the form of diarrhea or vomiting. Moreover blood loss due to any cause may also result in fainting. Sometimes, there is fall of blood pressure when the person suddenly stands up from reclining position and this may cause fainting. This is especially seen in elderly people and those with diabetes. Diabetics on medications may also have fainting episodes due to fall in blood sugar to very low levels (hypoglycemia). Finally certain drugs like antihypertensive agents may cause fall in blood pressure and fainting.
Prevention of fainting rests on the control of the underlying condition of heart or nervous system. Elderly individuals should ensure adequate fluid intake. Thos who are prone to drop in blood pressure on standing should get up gradually from the bed. Those having a cardiac rhythm disturbance may benefit from placement of a pacemaker or implantable defibrillator. Diabetics should take care to avoid hypoglycemia by optimization of the anti-diabetic therapy and careful attention to meals.
Fainting is a potentially life-threatening condition and can be fatal if the underlying cause is serious and not treated in time. The person may have a fall and sustain injury. Also, there may be some compromise to the blood supply to brain resulting in brain damage. There may be aspiration of vomitus in the respiratory passages resulting in pneumonia.
Treatment of fainting depends on the underlying cause. The contributing cardiac or neurological conditions should be appropriately treated. Some people may need fluid or blood replacement intravenously. If hypoglycemia is detected, prompt administration of intravenous glucose or glucagon may be needed.