Fainting (Syncope)

Sudden loss of consciousnessInability to remain standing or sittingConsciousness regained without any need for interventionDizziness or lightheadedness before losing consciousness DiagnosisThe doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include (in order of importance): Blood teststo look for anemia, hypoglycemia, low potassium, and low magnesiumElectrocardiogram (EKG) a test that records the heart's activity by measuring electrical currents through the heart muscle Holter monitoring a mobile EKG test that is performed over 24 hours while you go about your usual daily activities Head CT scan a type of x-ray that uses a computer to make pictures of the brain Electroencephalogram (EEG) a test that records the brain's activity by measuring electrical currents through the brain MRI scan of the braina test that uses magnetic waves to make pictures of the brain Echocardiogram a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart Tilt table testinga tilted table that is used to provoke syncopal symptoms (medication may be used)Cardiac catheterization a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply Treatment Treatment will depend on the underlying condition that has caused fainting. For example:

Abnormal heart rhythms can be treated with medications or by implanting a pacemaker.If a medication is causing syncope, it may need to be changed or discontinued.Anemia or other blood abnormalities should be treated. PreventionIf you feel any warning signs, such as dizziness or lightheadedness, sit or lie down immediately so that you don't get hurt falling during a fainting spell. In a recent randomized trial involving 223 patients with vasovagal syncope, training to perform certain maneuvers during warning signs of an impending spell reduced the risk of recurrent symptoms. These physical counterpressure maneuvers, designed to rapidly raise blood pressure and increase blood flow to the brain, included: *Crossing the legs while tensing the muscles of the legs, abdomen, and buttocksForcefully squeezing a rubber ball or any other available object as hard as possible in the dominant handGripping one hand with the other while tensing both arms and raising the elbows slightly If you are prone to fainting: Get up slowly and carefully from lying down. Start by sitting up. Don't ever jump to a standing position.Ask your doctor if you should be on a high-salt diet.Drink lots of fluids. RESOURCES: American Heart Association

http://www.americanheart.org Columbia University Medical Centerhttp://hora.cpmc.columbia.edu/ CANADIAN RESOURCES: Alberta Health and Wellnesshttp://www.health.gov.ab.ca/ BC Health Guidehttp://www.bchealthguide.org/ References: Cecil Textbook of Medicine . 21st ed. WB Saunders Company; 2000. Griffith's 5-Minute Clinical Consult . Lippincott, Williams, and Wilkins; 2001. TH Miller and JE Kruse. Evaluation of syncope. Am Fam Physician. 2005;72:1492-1500. Updated Treatment section on 2/6/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : van Dijk N, Quartieri F, Blanc JJ, et al.Effectiveness of physical counterpressure maneuvers in preventing vasovagal syncope: the Physical Counterpressure Manoeuvres Trial (PC-Trial). J Am Coll Cardiol. 2006;48:1652-1657. Last reviewed November 2007 by Kari L. Kassir, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.