Have you ever suddenly fainted and hit the ground? Here is what syncope means for your health.

Have you ever seen someone suddenly lose consciousness and fall to the ground? Or has it ever happened to you while standing in a long line or getting up too quickly?

This scary experience is known in medicine as syncope, which simply means fainting or passing out. Let us take a close look at why this happens and what you can do about it.

Syncope occurs when your brain temporarily does not get enough blood flow. While it can be frightening, many episodes are short-lived and not dangerous, but understanding the underlying cause is essential for your long-term health.

What Is Syncope?

Simply put, syncope happens when your brain experiences a sudden, temporary drop in blood supply. This lack of blood flow causes you to faint or pass out.

Most of the time, this occurs due to a short-term and non-life-threatening reason. You might experience this if your blood pressure drops suddenly.

It can also happen if your heart rate slows down too much. Changes in blood distribution throughout your body can also trigger an episode.

When you faint, you usually regain consciousness within seconds or a few minutes. However, you might feel confused, tired, or washed out for a short while afterward.

Within minutes or hours, you usually return completely to your normal self. Yet, syncope can sometimes be a warning sign of an underlying medical problem.

Therefore, if you faint, seeing a doctor to find the exact cause and get proper treatment is very important. Many people can manage this condition well with a clear diagnosis and proper medical care.

Types of Syncope.

Yes, syncope comes in several different forms. Let us look at the main types so you can understand how they differ:

• Vasovagal syncope: Also called neurocardiogenic syncope, this is the most common type. It accounts for about half of all fainting cases.
• Situational syncope: This is a specific subtype of vasovagal syncope that happens only during certain specific triggers or activities.
• Postural or orthostatic syncope: Also known as postural hypotension, this happens when you change your body position quickly, such as standing up from a lying position.
• Cardiac syncope: This happens when a heart or blood vessel problem reduces blood flow to your brain.
• Neurologic syncope: A condition related to your nervous system can trigger this type of fainting.
• Postural orthostatic tachycardia syndrome (POTS): In this condition, your heart rate speeds up greatly right after you stand up.
• Syncope with an unknown cause: Sometimes, doctors cannot pinpoint an exact reason for the fainting spell despite thorough testing.

How Common Is Syncope?

Syncope is actually a very common medical condition. Over the course of a lifetime, about 3 percent of men and 3.5 percent of women experience it.

It becomes more common as you age, affecting about 6 percent of adults over age 75. This condition can happen at any age, to people with or without other health problems.

What Warning Signs Happen Before Fainting?

Most of the time, you will notice certain warning signs right before you faint. These symptoms can include:

• Blacking out or feeling like your vision is fading to black.
• Feeling lightheaded, dizzy, or unsteady on your feet.
• Falling down suddenly without any clear reason.
• Feeling drowsy, groggy, or unusually tired.
• Fainting especially after eating a large meal or exercising.
• Feeling weak or unsteady while standing or walking.
• Changes in vision, such as seeing spots or having tunnel vision where your peripheral vision darkens.
• Having a mild headache.

Important: If you experience these warning signs often, make sure to schedule an appointment with your doctor right away.

Why Does Fainting Happen? (Causes).

The primary cause of fainting is a lack of enough blood flow to your brain. This can happen for many different reasons depending on the specific type of syncope you experience.

Many people have an underlying medical condition affecting their nervous system or heart without realizing it. Alternatively, issues that lower your blood pressure when you change positions can restrict blood circulation.

Causes of Vasovagal Syncope.

This happens when your blood pressure drops suddenly, reducing the flow of blood to your brain. It often happens after standing for a long time or during intense emotional stress, grief, or fear.

Imagine standing in a hot school assembly hall for a long time; you might suddenly feel dizzy and faint. When you stand up, gravity naturally pulls blood down into the lower parts of your body below your diaphragm.

Normally, your heart and your autonomic nervous system work together to keep your blood pressure stable. However, during vasovagal syncope, your heart rate and blood pressure drop suddenly and inappropriately.

This reduces blood flow to your brain and causes you to faint. Fortunately, this type is usually not dangerous.

Causes of Situational Syncope.

This type happens only during specific situations that affect your nervous system. Common triggers include:

• Dehydration from a lack of fluids.
• Intense emotional stress or anxiety.
• Severe fear.
• Intense pain.
• Hunger or low blood sugar.
• Alcohol or drug use.
• Hyperventilation. This breathing too fast and taking in too much oxygen while losing carbon dioxide too quickly.
• Coughing hard, turning your neck too far, or wearing a tight shirt collar, which is known as carotid sinus hypersensitivity.
• Urinating, known as micturition syncope.

Causes of Postural Syncope.

This is also called postural hypotension or orthostatic hypotension. It happens when your blood pressure drops abruptly as you change your body position, such as standing up too quickly from bed.

Certain medicines and dehydration can cause this problem. In people with this type of fainting, the systolic blood pressure drops by at least 20 mmHg, or the diastolic pressure drops by at least 10 mmHg within minutes of standing.

Causes of Cardiac Syncope.

If you have a problem with your heart structure or blood vessels that limits blood flow to your brain, you may experience cardiac syncope. These conditions include:

• Irregular heart rhythms, known as an arrhythmia.
• Heart muscle thickening that blocks blood flow, known as hypertrophic cardiomyopathy.
• Blocked blood vessels in the heart, known as myocardial ischemia.
• Heart valve diseases.
• Aortic stenosis. This narrowing of the main artery leaving the heart.
• A blood clot.
• Heart failure.

If you have cardiac syncope, seeing a cardiologist to get proper medical evaluation and treatment is extremely important because this type can be serious.

Causes of Neurologic Syncope.

You can experience this if you have a neurological condition such as a seizure, a stroke, or a Transient Ischemic Attack (TIA). Less common conditions like migraines and normal pressure hydrocephalus can also cause neurologic syncope.

Postural Orthostatic Tachycardia Syndrome (POTS).

If you have POTS, your heart rate increases dramatically when you move from a sitting or lying position to a standing position, a condition called tachycardia.

Your heart rate may jump by 30 beats per minute or more. This increase typically happens within 10 minutes of standing up.

Syncope with an Unknown Cause.

About 33 percent of people who faint never find an exact cause. Sometimes, side effects from certain medicines can increase your risk of fainting.

If you do not know why you are fainting, consulting a doctor is essential.

How Do Doctors Diagnose Syncope?

If you faint, you should always consult a doctor so they can refer you to a syncope specialist for a complete medical evaluation.

The specialist will perform a physical exam and review your medical history in detail. They will ask questions about your symptoms and when the fainting happened, such as what you felt beforehand and where you were.

They may also measure your heart rate and blood pressure while you are in different body positions, such as lying down, sitting, and standing.

Next, you may need one or more diagnostic tests. These tests examine:

• Your heart health and structure.
• Your heart rate and rhythm.
• Your total body fluid volume.
• How your blood circulation responds to position changes.

What Tests Are Used for Syncope?

Common tests used to find the cause of fainting include:

• Laboratory testing: Blood tests to check for conditions like anemia or metabolic changes.
• Electrocardiogram (EKG): A test that records the electrical signals in your heart.
• Exercise stress test: Tests that monitor your heart while you exercise or use medicine to make your heart work harder. Some stress tests use EKG changes, while others use an ultrasound of the heart or nuclear imaging.
• Ambulatory monitor: A portable device you wear to record your heart rate and rhythm continuously over time.
• Echocardiogram: An imaging test that uses sound waves to create pictures of your heart structure.
• Tilt table test (head-up tilt test): A test where you lie on a table that tilts to various angles while doctors monitor your blood pressure and heart rate minute by minute or beat by beat. This test helps identify abnormal cardiovascular responses that cause fainting.
• Autonomic reflex testing: A series of tests that measure blood pressure, blood flow, heart rate, skin temperature, and sweating in response to various stimuli. These measurements help your doctor determine if your autonomic nervous system is working correctly or if you have nerve damage.

You might also need other tests, such as electrophysiology studies, an evaluation of your nervous system, or a Computed Tomography (CT scan). Doctors may also perform vestibular function testing to rule out inner ear problems.

Your doctor will explain any additional tests you might need and why they are necessary.

What Should You Do If Someone Faints?

If someone near you faints, follow these basic steps:

1. Check if they are breathing normally.

2. Lay them flat on their back, or have them sit with their head down between their knees, for at least 10 to 15 minutes.

3. Offer them a small sip of cool water once they regain full alertness.

What Treatments Are Available for Fainting?

Treatment options depend entirely on the underlying cause of your fainting and the results of your diagnostic tests. The main goal of treatment is to prevent future fainting spells.

Treatment choices for syncope include:

• Taking prescribed medicines or adjusting current medicines.
• Wearing supportive garments or compression stockings to improve blood circulation.
• Making changes to your diet. Your doctor may recommend eating smaller, more frequent meals, increasing salt (sodium) intake slightly, drinking more water, increasing potassium, and avoiding caffeine and alcohol.
• Taking extra care when standing up.
• Elevating the head of your bed while sleeping by using extra bed pillows or placing risers under the bed legs at the head end.
• Avoiding triggers that cause fainting, such as prolonged standing, heat, or stressful situations.
• Biofeedback training to help control fast heart rates.
• Treating underlying heart structure diseases.
• Getting a pacemaker implanted to regulate heart rate for specific medical conditions.
• Getting an Implantable Cardioverter Defibrillator (ICD), a device that constantly monitors your heart rate and rhythm and corrects fast, dangerous rhythms automatically in specific high-risk conditions.

Your medical team will create a treatment plan tailored to you and discuss these options with you.

Are There medicines for Fainting?

medicines sometimes prescribed for fainting include:

• Midodrine.
• Fludrocortisone (available under brand names like Astonin® or Florinef®).

These medicines can cause side effects such as heartburn, nausea, dizziness, urination difficulties, stomach pain, or feeling chilled. Therefore, taking these medicines exactly as directed by your doctor is important.

Can You Prevent or Reduce Fainting?

To reduce your risk of fainting, you must first know the cause. For example, if dehydration is the issue, drinking plenty of fluids and staying hydrated can greatly lower your risk.

If a heart condition caused your fainting, treating irregular heart rhythms with medicines or medical devices is necessary.

Often, you will feel a fainting spell coming on with warning signs such as dizziness, nausea, or heart palpitations (a fast or pounding heartbeat). You may be able to prevent fainting if you:

• Sit or lie down quickly and elevate your legs.
• Clench your fists tightly.
• Tension your arm muscles.
• Cross your legs or squeeze your thighs together.

What Happens After You Faint? Should You Worry?

With an accurate diagnosis and proper treatment, you can successfully manage syncope. If you have fainted once, you have about a 30 percent chance of fainting again.

Your risk of future fainting depends on several factors, including the cause, your age, your biological sex, and any other medical conditions you have. Talk to your doctor if you have questions about your personal risk.

If you have been diagnosed with syncope, check the driving laws in your local area. Some regions require drivers who experience fainting to report it to the driver licensing agency.

Your doctor will advise you on whether you need to wait and treat the cause before driving again.

Most of the time, fainting is not dangerous. However, if an abnormal heart rhythm or neurological disorder causes your fainting, it can be life-threatening.

People with known heart or neurological conditions must always seek medical treatment from a doctor.

Important Questions to Ask Your Doctor.

You can ask your doctor these questions during your visit:

• Do you know what caused my fainting episode?
• What steps should I take to prevent this type of syncope from happening again?
• Do I need any further tests or follow-up appointments?

Sources & References:
1. Cleveland Clinic. Syncope (Fainting): Causes, Types, and Treatment. Available at: Cleveland Clinic Health Library.
2. Mayo Clinic. Fainting - Symptoms and Causes. Available at: Mayo Clinic Patient Care.
3. NHS UK. Fainting: Causes, Treatment, and When to Get Help. Available at: NHS Health A-Z.
4. Centers for Disease Control and Prevention (CDC). Fainting and Syncope Guidelines. Available at: CDC Public Health Guidance.
5. National Institutes of Health (NIH) / MedlinePlus. Syncope Overview. Available at: MedlinePlus Medical Encyclopedia.