By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

FAINTING IN HEALTHY, YOUNG PERSON USUALLY NO CAUSE FOR CONCERN

Question: Why do people faint? A friend of mine fainted in school last week and another one the week before. They both seemed fine before they passed out.

Answer: Fainting, which is called syncope in the medical community, can be due to many different things. In over a third of all fainting episodes, no cause can be found, and we classify the disease as “idiopathic syncope.” The word idiopathic literally means a disease peculiar to an individual; thus, in the wonderfully convoluted syntax we doctors sometimes love, this word is used to refer to diseases that have no identifiable cause. Idiopathic syncope seldom has a serious or long-term health consequence. However, other types of syncope can signal very serious underlying disease.

Generally when a person faints, it is because the brain has not gotten enough blood and oxygen. This is frequently associated with a drop in blood pressure and a slowing of the heart rate. Once the person becomes unconscious from the faint, he or she usually falls into a prone position. This returns adequate blood flow to the head and the victim “comes to.” This “simple faint” is called vasovagal syncope. Things that can cause this are: • Standing for long periods of time without moving your legs, • Standing up too fast, • Getting upset or nervous, • Exhaustion, • Dehydration due to inadequate fluid intake or excessive fluid loss, • Coughing, usually very hard, and • Bodily functions like urinating or having a bowel movement. Sometimes no cause can be found for this vasovagal episode, and it falls into the idiopathic category I mentioned earlier.

There may be warning signs before you faint. Some of these are a feeling of being too warm, nausea, sweatiness, pallor and blurred vision. When these symptoms first appear, fainting can often be avoided if you lay down or sit down with your head bent forward.

Some people seem prone to fainting. These people should learn what causes them to faint and learn to avoid these triggers, or to notice the pre-fainting symptoms and use the avoidance techniques I just mentioned.

Now we need to take a look at the serious causes of syncope. Fainting episodes that initially appear to be a vasovagal syncope should be a cause for concern if they occur frequently or are associated with chest pain, an irregular heartbeat, slurred speech or severe mental confusion. In these circumstances you should seek immediate medical attention. Also, if you have a fainting episode and have an underlying health problem such as heart disease, high blood pressure or diabetes, you should consult your family doctor. This is especially true if you are getting up in years or are on regular medications.

In a nutshell: While most cases of fainting in young, healthy people are never explained, there can be serious, even life-threatening, causes of syncope that should be excluded when a person faints.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnosis and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.