Having fainting spells?

While some cases of unexplained fainting could be harmless, others can be serious and signal a heart problem. Frequent or unnexplained fainting does warrant a trip to the doctor, cautions Dr C N Manjunath.

Have you ever experienced lightheadedness out of the blue? Fading of your vision for a fraction of a second, before getting back to normal? Warm and sweaty palms in spite of sitting calmly in the ease of your living room? Or a fainting episode while driving?

Fainting, "blacking out," or syncope is the temporary loss of consciousness
followed by the return to full wakefulness. This loss of consciousness may be
accompanied by loss of muscle tone that can result in falling or slumping over. It occurs when the blood pressure drops and not enough oxygen reaches the brain. Fainting is usually preceded by symptoms such as light-headedness, dizziness, sweaty palms, nausea and fading vision.

Fainting is common and can happen for many reasons – after a scare or due of low blood sugar, anaemia, improper blood circulation or metabolic disorders, to name a few. While some causes of unexplained fainting are harmless and can be addressed by simple lifestyle changes, others can be more serious and signal a heart problem.

Heart-related causes, including abnormal heart rhythms, are among the most serious causes of fainting. Also, if you do not have any warning signs before you faint, there are high chances of injury. So, frequent or unexplained fainting certainly warrants a trip to the doctor.

Common causes

Low blood pressure
Very low or fast heart rate
Acute blood loss
Acute volume loss (severe diarrhoea)
Anaemia
Structural Heart Disease
Coronary Heart Disease
Metabolic and lung disorders
Emotional stress, pain, anxiety
Some medications (diuretics, anti-hypertensives)

It’s serious if

It happens often in a short period of time
It happens during exercise or a rigorous activity
It happens without warning
It happens when you are already lying down
You are losing a lot of blood - this could include internal bleeding that you can't see
You feel short of breath
You have chest pain
You feel like your heart is racing or beating unevenly (palpitations)
It happens along with numbness or tingling on one side of the face or body.

Diagnosis

If your doctor suspects a heart condition is causing your fainting, diagnostic tests may be run to gather information or he may wish to monitor your heart’s rhythm for typically one day to one week (based on the frequency of the symptom) to
establish the cause of the problem.

A heart rhythm problem - like when the heart beats too slowly, too fast, or stops
altogether - can cause fainting. Since fainting episodes may not occur regularly, the cause can be, often, very challenging to detect. Long-term heart rhythm monitoring allows your doctor to quickly and effectively discover if a heart rhythm disorder is causing your fainting spells and determine the right treatment or further diagnostic pathway.

Once the cause has been determined, the patient may need to go in for an
implantable device (such as a pacemaker or implantable defibrillator). Your doctor will decide on the best treatment based on your diagnosis.

(The writer is HOD, Cardiology, Sri Jaydeva Institute of Cardiology, Bangalore)