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How are Fainting Spells Evaluated?

If you have episodes of fainting, your doctor will first want a complete description of the symptoms and events surrounding these episodes. For instance, your doctor may ask:

• Do these episodes come on suddenly or gradually?
• Are you standing, sitting, or lying down when you faint?
• Do you notice any other symptoms?
• How long does the episode last?
• Do you return to normal quickly after fainting, or are you momentarily confused?

Your doctor may attempt to reproduce your symptoms by simulating the situation during which you usually have a fainting episode. For example, if you tend to faint after coughing, you may be asked to bear down forcibly, in order to see if you this causes symptoms. You may have your pulse and blood pressure taken lying down, and then after quickly standing, in order to see what changes are provoked by these different positions.

This may be all the evaluation performed in an otherwise healthy child or young adult. But in some cases, your doctor may want to evaluate you further for a heart or brain problem.

The heart evaluation usually starts with an electrocardiogram (ECG), which measures the electrical activity of your heart to look for heart arrythmias. Other tests, such as exercise stress test, Holter monitor, or echocardiogram may be needed to rule out other cardiac causes of syncope.

If ECG and other heart tests are normal, and your doctor still suspects a heart abnormality, he may order what's called a tilt-table test. A tilt-table test is often used because some people have preliminary symptoms of fainting or actually do faint from having their heads and bodies tilted to about 60 or 70 degrees. Someone who has a vasovagal attack will usually faint during the tilt, due to the rapid drop in blood pressure and heart rate. As soon as the person is placed on his back again, blood flow and consciousness are restored.

If your doctor suspects that your fainting is due to a seizure, he may order an electroencephalogram (EEG), which records the activity of your brain waves.

What Are the Treatments?

If you are with someone who faints, there are a number of things you should do. If he or she is sitting, carefully support them in a bent position, with their head between their knees.

f he or she is lying down, position them on their back and raise their feet higher than their head. Turn their head to the side, so that their tongue does not accidentally block their breathing and so that any vomit will not cause choking. You may try reviving them by putting a cold, wet washcloth on their face or neck. If they feels cold to the touch, cover them with a blanket.

Once they regain consciousness, do not allow them to get up immediately. Elevate the person's feet. If he or she was lying down, wait several minutes before asking them to sit up. Ask them to sit for several minutes before standing. Then be prepared to support them in case they faint again when they stands.

If you suffer from episodes of fainting, the type of treatment your doctor offers will depend on the cause of your fainting spells and how often you experience them.

Infrequent non-heart related fainting may be not be treated.

You may be given certain medications to manage the underlying problem, or if you have an arrhythmia you may require a pacemaker.

In certain instances, you may be asked to wear certain types of support hose that help keep your blood pressure in balance or to increase your salt intake, which increases your blood volume.