People who suffer from a fainting condition need to prevent injury, and those few who faint because of a serious cardiac condition need to be protected from dying suddenly. Luckily, most faints are preceded by a warning. Patients can learn to recognize what it feels like just before they pass out, so they can try to keep from fainting. Immediately lying down and elevating the feet (by placing them on a wall, a chair, or even a spouse!) will almost always prevent vasovagal fainting. This position preserves blood flow to the brain while at the same time allowing blood trapped in the legs to return to the heart. If a person feels lightheaded but not close to fainting, quickly drinking a large volume (at least 16 ounces) of liquid can bring up the blood pressure. Squatting or tensing the leg muscles can buy time when symptoms are mild, but patients should always be ready to “hit the deck.” It’s always better to lie down than to fall down!
In order to prevent fainting, people must drink plenty of fluids during the day. At least 8-10 glasses per day is necessary to prevent an inadequate blood volume. Aerobic exercise can also help prevent fainting, and strengthening the leg muscles can improve the circulation and helps avoid pooling of blood in the lower part of the body. It is important to avoid medications that will drop the blood pressure excessively, so all your prescriptions should be reviewed with your doctor at each visit.
Patients who have fainting spells need to be sure that they are not suffering from a life-threatening condition. A thorough evaluation is essential to determine the likely causes of syncope. Serious problems can be addressed appropriately, and treatment is available for nearly all types of fainting.
Treatment of vasovagal syncope involves increasing water and salt intake and avoiding “triggers” than can precipitate a faint. In cases where faints occur unpredictably, medical therapy can reduce the chance of recurrence. Medications can help in a number of ways. Some work by expanding the blood volume by enhancing fluid retention, while other medications can increase the blood pressure by constricting the arteries and veins. Certain medications can rebalance the blood pressure control systems in the brain to prevent syncope. Medical therapy does not always work, however, so patients still need to be on guard for any warning symptoms. Luckily, if fainting occurs at a young age (teenage years into the 20s), it may stop on its own.
More serious causes of fainting are also treatable. Medications can be effective in patients who have heart rhythm problems. Often, serious arrhythmias are treated with a device such as a pacemaker or an implantable defibrillator. Some rapid heart arrhythmias can be eliminated with a procedure known as Catheter Ablation. With other cardiovascular causes for syncope, the reason for the faint needs to be identified and corrected. A fainting specialist can work together with your primary care doctor and other specialists to offer you whatever options may be available to diagnose and treat your condition.