When Worlds Blur: Understanding the Causes and Coping with Sudden Fainting Episodes

When Worlds Blur: Understanding the Causes and Coping with Sudden Fainting Episodes

Fainting and losing control for a moment is disconcerting. The causes of unconsciousness are usually completely harmless, such as low blood pressureSymptoms such as dizziness, sweating or nausea often appear shortly before you faint. In the case of other causes, such as cardiac arrhythmias, the fainting does not announce itself beforehand but occurs very suddenly. We reveal the possible causes behind fainting and how you should behave in an emergency.

causes of fainting

A brief fainting spell is called syncope, usually lasting just a few seconds. If the unconsciousness lasts longer, it is called a coma. A temporary circulatory disturbance in the brain causes syncope. The causes of this circulatory disorder are varied and cannot always be determined with certainty afterwards. In addition to harmless triggers such as low blood pressure, serious illnesses can also be the cause.

In general, the causes of fainting can be divided into four groups:

  • Orthostatic Syncope
  • Vasovagal Syncope
  • cardiac syncope
  • Cerebrovascular syncope


Orthostatic and vasovagal syncope

Fainting is often caused by a breakdown in the circulatory system – a circulatory collapse. Various factors, such as low blood pressure, favour this. However, a lack of fluids and varicose veins are also considered risk factors. Typically, fainting in such a case occurs when changing from lying or sitting to standing too quickly. The blood pools in the leg vessels, and the brain is no longer supplied with enough oxygen.

An excessive reflex response from the body causes vasovagal syncope. When certain stimuli occur, the vagus nerve automatically ensures that the blood vessels expand and the heart rate decreases. As a result, the blood sinks and the brain is no longer supplied with sufficient blood – fainting occurs. Triggers can include psychological stress, cold, pain, fear, bad news or a happy event.

Cardiac and cerebrovascular syncope

A malfunction in the heart function causes cardiac syncope and is, therefore, particularly dangerous. It is primarily cardiac arrhythmias that affect blood circulation. But structural changes in heart tissue can also trigger fainting. The dangerous thing is that the heart stops without warning in cardiac syncope. As a result, fainting occurs suddenly and without any prior symptoms. If the heart continues to beat, the affected person wakes up again. However, this is not always the case – sometimes sudden cardiac death (short-term death) occurs.

In cerebrovascular syncope, fainting is triggered by what is known as a tap phenomenon. A tapping phenomenon manifests as follows: A vascular occlusion in the body leads to an undersupply of the area behind it. This area, therefore, taps into the blood supply of another area via another vessel. If blood is drawn from a vessel that supplies the brain, it can lead to an undersupply in the brain and, consequently, fainting.


fainting in pregnancy

Pregnant women can occasionally experience fainting spells, especially toward the end of pregnancy. The cause is the so-called vena cava compression syndrome. The pressure exerted by the child on the inferior vena cava impairs blood flow to the heart. If the heart no longer fills with enough blood, it can cause fainting.

The syndrome usually occurs in the last trimester of pregnancy, when the child is already of an appropriate weight. Because the vena cava is located behind the uterus, prolonged lying in a supine position causes unconsciousness. Pregnant women should prefer to lie on their side when lying down.

Symptoms include nausea and dizziness.

Just before fainting, symptoms may appear that indicate impending syncope. Typical alarm signs are paleness, tiredness, ringing in the ears, sweating, dizziness, blurred vision and nausea. However, fainting can occur without any prior symptoms—this is most common in fainting episodes that occur due to heart disease.

At the first symptoms of fainting, you should sit down immediately, or even better, lie down. Elevate your legs so blood flows back toward your head faster. If there is no place to sit or lie down nearby, it also helps to tense the muscles. This squeezes the blood vessels and forces blood toward the heart.

For example, you can do the following exercises:

  1. While standing, cross your legs and then tighten the muscles of your abdomen, legs and buttocks.
  2. Place your hands in front of your chest, interlace your fingers, and pull both arms outward as firmly as possible.
  3. Take a rubber ball or another object and knead it vigorously.

Fainting: what to do?

You should always consult a doctor after fainting. He can ensure that it is a syncope and not a vascular circulatory disorder in the brain. The classic clinical picture in such a case is a stroke. The doctor can also check whether a heart disease – for example, cardiac arrhythmias – is the cause. If this is the case, the disease must be treated accordingly. A pacemaker or defibrillator may need to be used.

Don’t take a fainting spell lightly, even if it has a harmless trigger. Because the loss of consciousness is always associated with risks – a fall can result in head injuries, broken bones and bruises. You should, therefore, seek advice from your doctor on how to prevent another fainting attack.

You can prevent fainting, especially if it is an orthostatic syncope. On the one hand, the doctor can prescribe medicines that strengthen the circulation. On the other hand, you can also do something yourself to make your circulation more stable: Regular exercise, alternating showers and drinking a lot, for example, is helpful.


react correctly

When you see a person faint, responding quickly and correctly is essential. First, check whether the person concerned is unconscious. The best way to do this is to pat her on the cheeks or gently shake her shoulders. Also, make sure she gets some fresh air.

If there is only a slight fainting, the person concerned will wake up quickly. If the person does not wake up immediately after breathing independently, they should be placed in the stable side position. If the person does not respond to the shaking and you cannot detect breathing, call an ambulance and start CPR immediately.

Caution: When administering first aid to an unconscious person, remember that there are other types of unconsciousness besides syncope. In people with diabetes, fainting can also be triggered by hypoglycemia, for example.

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