1. Fainting is sudden
2. Fainting is not associated with upright posture or harmful stimulus; occurs with rest or sleep
3. Fainting or seizures during exertion, excitement, startle
4. Fainting while swimming
5. Fainting caused by noise
6. Fainting occurs with sudden awakening from sleep (alarm clock sounding, telephone ringing, thunder, etc.)
7. Fainting associated with strong emotion, anger, fear, etc.
8. Fainting associated with palpitations or chest pain
9. Fainting associated with "seizure"
10. Fainting associated with menses or portpartum
11. Incontinence occurs with fainting
12. Injury occurs with fainting
13. Family history of sudden death exists
14. Any abnormalities on an electrocardiogram
If any of these criteria exist, the advice of a cardiac electrophysiologist should be sought immediately. |
With a cardiac event fainting (syncope) is sudden, precipitated by a cardiac arrhythmia or another heart abnormality, causing diminished blood flow to the brain. If any criteria listed in the information above exist, an immediate referral to a cardiologist for testing and treatment is strongly recommended. With a cardiac event there are usually neither preceding symptoms nor disorientation afterwards. Fainting spell can last 30 to 60 seconds or more. Breathing may be impaired. If the heart does not regain its normal rhythm sudden death will result.
With any unexplained syncopal or near syncopal episode of a child or young adult an electrocardiogram needs to be done and read by a cardiologist as soon as possible. A second opinion from a cardiac electrophysiologist is strongly recommended.
A common fainting spell (neurocardiogenic syncope or vasovagal syndrome) primarily results from a fall in blood pressure and usually a slowing heart rate. It is usually triggered by pain, injury, nausea, or a stressful experience and preceded by dizziness, nausea, blurring or blackening of vision, and/or tingling or sweating. Generally, neither respiratory problems nor sudden cardiac death result. Loss of consciousness is brief, with no disorientation afterwards.
A seizure may cause loss of consciousness due to abnormal electrical discharges in the brain. Blood flow to the brain remains normal. A strange feeling followed by muscle stiffening and/or body shaking can last up to a minute or more, often with tongue biting and loss of urine or bowel control. Usually there are no precipitating factors. Upon recovery there is usually a period of confusion, disorientation, and lethargy. Cardiac events are often misdiagnosed as seizures.
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