Common Sense Health: Fainting can be frightening, but it’s usually benign

By DR. GIFFORD-JONES & DIANA GIFFORD-JONES on July 22, 2022.

People have been swooning for joy since at least the 13th Century when the earliest recorded use of the word can be found. By the 20th century, losing consciousness for love and rapture was a necessary attribute of a Southern belle. Even today, swooning has a positive connotation, defined as, “a few steps beyond being happy, but not so over the top that you scare children.”

But change the language describing the same loss of consciousness and “blacking out like a light” is not so glamourous. Parents fainting with a thud on the floor most certainly gives the kids a fright.

But how dangerous is fainting? And how common a problem is it?

There have been some famous faints. Most recently, the 74-year-old America guitarist, Carlos Santana, passed out temporarily on stage in Michigan. Hillary Clinton had an episode during her Presidential campaign in 2016. In presidential circles, POTUS14, Franklin Pierce, was known as “Fainting Frank.” Both Bush Sr. and Jr. had unglamourous occasions. And Obama and Trump interrupted speeches to help nearby fainters.

Fainting, otherwise known medically as syncope, is defined as a loss of consciousness followed by spontaneous recovery. It’s caused by a decreased flow of blood to the brain. People may feel nauseous or dizzy. Being in the hot sun or not being hydrated are risk factors.

Doing something as simple as standing up can cause a faint. Blood pressure drops, reducing circulation to the brain. For the elderly, it becomes harder for their bodies to regulate blood pressure when moving from a lying or sitting position to standing. Among even the young and healthy, fainting might be caused by hunger, anxiety, emotional swings, or alcohol and drug use.

According to various estimates, about 20-30% of the population has fainted at some point in life.

In most cases, getting some rest is the easy prescription. But as with most things medical, prevention is the most prudent course.

While the short loss of consciousness itself may not cause harm, seniors are prone to bad injuries when they fall from a faint. It can be disastrous if a faint occurs while driving.

To understand whether a fainting episode is a one-time event from a missed cue to slow down or a more serious problem involving heart trouble, doctors need to evaluate the patient. An important clue is the speed of recovery. If recovery is not swift, it’s essential to get quick medical care.

Doctors will want a full patient history. An important set of considerations will be the list of medications.

People taking beta-blockers and ACE inhibitors which lower blood pressure may be more susceptible to trouble on hot days or when exerting themselves.

Antihistamines are powerful allergy medications, but they can also be a factor in fainting episodes. These drugs interact with the nervous system and therefore have many side effects. A change in dose should always be discussed with a doctor, and people who self-medicate by boosting their dosage are playing games with their health.

Other considerations will be recent bouts with ill health, including COVID, pneumonia, or any other common respiratory infection. Getting back to good health is job number one before pushing the pace at work or in leisure.

It’s not easy to predict a faint or even to see it coming in the moments before it happens. But if you detect a person turning pale and their eyes glazing over, or if you notice someone’s speech slowing down or difficulty in collecting their thoughts, get to their side and sit them down safely. Lower their head and raise their feet to restore blood flow.

If recovery is slow, get medical help.