Syncope, or fainting, is a sudden loss of consciousness caused by decreased blood flow to the brain. Usually a slow heart rate causes a drop in blood pressure, which reduces the blood flow to the brain. In most cases, you recover within seconds or minutes. About 3 - 4% of people, mostly the elderly, experience episodes of fainting. If you have slurred speech or have trouble moving an arm or a leg after fainting, call for emergency help immediately; this may be a sign of stroke.

You may havethe following signs and symptoms before you faint:

• Lightheadedness
• Feeling warm
• Blurred vision
• Sweating
• Heaviness in your lower limbs
• Confusion
• Yawning
• Nausea, and sometimes vomiting

When you faint, in addition to loss of consciousness, you may have the following symptoms:

• Abnormal paleness
• Falling down or slumping
• Spasmodic jerks of your body
• Weak pulse
• Drop in blood pressure

Fainting often occurs from a simple, non-medical cause, including standing up for along periods of time, experiencing emotional distress, or even the sight of blood. More rarely, it may be the result of a serious health condition, such as heart disease (decreased blood flow to the heart or irregular heart rhythm), low blood sugar (often related to diabetes), seizures, panic attacks, and problems regulating blood pressure. Severe blood loss can also cause fainting.

People with the following conditions or characteristics are at risk for fainting:

• Over 65 years of age
• Preexisting heart disease, diabetes or high blood pressure
• Recreational drug use
• Taking certain medications such as antihypertensives (blood pressure medication), insulin, oral hypoglycemics (diabetes medications), diuretics (water pills), antiarrhythmics, or anticoagulants (blood thinners)
• Pregnancy

If you have fainted, you should see your health care provider. Your health care provider will ask questions about what you were doing before you fainted and how you felt afterward, do a physical examination, and perform diagnostic tests. Tests may include blood tests, electrocardiogram (ECG), and imaging of the brain, such as magnetic resonance imaging (MRI). Your provider will focus on symptoms associated with the current fainting episode, medications you take, preexisting medical conditions, and your description of any similar episodes you may have experienced in the past. This will help your health care provider pinpoint the cause of the fainting episodes and identify or rule out particular health conditions. If seizures are suspected, your health care provider may also perform a test called an electroencephalogram (EEG).

Prevention

Some cases of fainting may be preventable, depending on the cause.

• Avoid fatigue, hunger, and stress. Don’t skip meals.
• Drink plenty of fluids.
• Avoid changing positions quickly, especially rising from a sitting or lying-down position.
• Sleep with the head of your bed elevated.
• Avoid standing for long periods of time.
• Wearing elastic stockings may keep blood from pooling in your legs (which may reduce blood flow to the brain).
• Diuretics and other prescription and non-prescription medicines can contribute to the problem, so check with your health care provider.
• Avoid tight clothing around the neck.
• Turn your whole body and not just the head when looking around.
• To prevent injuries, cover floors with thick carpeting and avoid driving or operating mechanical equipment.
• Avoid caffeine and alcohol.

If you feel like you are going to faint, lie down and elevate your legs (that helps keep blood flowing to your brain). If lying down is impossible, sit down and put your head between your knees. Or stand with your legs crossed and thighs pressed together -- this can also help keep blood from pooling in your legs.

Treatment Plan

Any serious underlying health condition must be treated. When someone faints, place him or her in a position that increases blood flow to the brain, such as with the legs elevated. Loosen all tight clothing, apply cold water to the person's face, and turn the person's head to the side to prevent vomiting or choking. A pregnant woman should lie on her left side to relieve pressure on the heart.

Drug Therapies

When irregular heart rhythm causes fainting, your health care provider may prescribe medications such as beta-blockers or antiarrhythmics. Your health care provider may also prescribe Mineralocorticoids (such as fludrocortisone) or salt tablets.

Surgical and Other Procedures

A cardiac pacemaker may be necessary in some cases where fainting is caused by an underlying heart condition, such as a slow or rapid heartbeat.

Complementary and Alternative Therapies

Although there are no specific treatments for fainting, a wide variety of alternative therapies help protect the heart and vascular systems. Taking these supplements may help decrease episodes of fainting. Fainting may be caused by a serious underlying health condition, so check with your health care provider before taking any herbs or supplements. Always tell your health care provider about the herbs and supplements you are using or considering using.

You may have warning signs before fainting. Hypnosis, deep breathing, relaxation techniques, and biofeedback may help you avoid fainting. These techniques may also help you control fainting related to nervous system regulation of your blood pressure.

Nutrition and Supplements

These nutritional tips are designed to improve general health and heart health:

• Eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
• Eat more high fiber foods, including beans, oats, root vegetables (such as potatoes and yams), and psyllium seed.
• Avoid refined foods such as white breads, white pastas, and especially sugar.
• Eat lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, excess sugar, alcohol, and tobacco.
• Drink 6 - 8 glasses of filtered water daily.
• Exercise at least 30 minutes daily, 5 days a week.

These supplements may promote heart health:

• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil one to two times daily, to help decrease inflammation and improve heart health. Cold-water fish, such as salmon or halibut, are good sources. If you take blood-thinning medications such as warfarin (Coumadin), talk to your doctor before taking fish oil. Fish oil may increase the effects of certain blood thinning medications; talk to your doctor.
• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, folic acid, zinc, and selenium.
• Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant, heart, and muscular support.
• Acetyl-L-carnitine, 500 mg daily, for antioxidant and heart protective activity.
• Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
• L-arginine, 1 - 2 grams one to two times daily, for vascular support.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, take herbs with care, under the supervision of a health care provider.

• Green tea (Camelia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
• Bilberry (Vaccinium myrtillus) standardized extract, 80 mg two to three times daily, for antioxidant and vascular system support.
• Ginkgo (Ginkgo biloba) standardized extract, 40 - 80 mg three times daily, for antioxidant and heart health support.

Homeopathy

Before prescribing a remedy, homeopaths take into account a person’s constitutional type -- your physical, emotional, and intellectual makeup. An experienced and certified homeopath will assess your individual constitution and symptoms, and then recommend remedies. Below are common remedies used for fainting or pre-fainting symptoms:

• Carbo vegetabilis --used for fainting or lightheadedness after rising in the morning, from loss of fluids, or from becoming overheated
• Opium -- used for fainting due to excitement or fright
• Sepia -- used for fainting following prolonged standing, exercise, or fluid loss due to fever

Acupuncture

Acupuncture may be helpful in treating syncope. A clinical analysis of 102 serious cases of loss of consciousness reported that acupuncture helped in a large percentage of these cases.

Acupuncture is known for rarely causing side effects or complications. However, some patients faint during acupuncture treatments, although it is not considered a serious complication.

In most people, simple fainting is not a sign of a life-threatening disease, particularly if it only happens once. The elderly are at increased risk for injury after a fainting episode, especially from fractures.

Many people with syncope, especially the elderly and those with preexisting heart disease, may be hospitalized to look for a cause. Continuous ECG monitoring can identify irregular heartbeat as a cause of fainting, especially in people who have recurring fainting problems.

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