What can make a person swoon

Sudden faint: not always harmless

Status: 14.05.2019 12:13 p.m. | archive

Every third person experiences fainting (syncope) in the course of their life. Often the cause is a harmless dysregulation of the circulatory system. But in every fifth case there is a serious illness behind it, for example a disorder of the heart function or a neurological disease such as a stroke or epilepsy. It is often difficult to tell whether a faint is harmless or dangerous. According to experts, many doctors do not take enough time to find out the causes.

The most common causes of fainting are:

  • Reflexes such as fear, pain or nerve reactions when emptying the bladder: harmless.
  • Fluctuations in blood pressure, for example when getting up: harmless.
  • Neurological causes such as cervical and cerebral vessels that are too narrow, which impede blood flow, or undetected epilepsy: to be taken seriously.
  • Heart problems such as valvular heart disease or cardiac arrhythmias: to be taken seriously.

Symptoms of fainting: circulation or heart?

Syncope is a diagnostic challenge for doctors. Because after a sudden faint, the EKG and blood values ​​are often completely in order. The different symptoms of cardiovascular and cardiac fainting:

  • A circulatory fainting can be associated with harbingers such as visual disturbances, a strange feeling in the stomach, tingling in the body, cracking and hissing in the ear, nausea and slight twitching. It is often mistaken for epilepsy. It comes quickly and lasts only a short time. Then the patients are fit again.
  • A cardiac fainting usually occurs without a harbinger. The blood pressure drops and the heart sometimes even stops for several seconds. A faint that turns into cardiac arrest is life-threatening.

Dysregulation of the circulatory system

The cause of circulatory fainting is usually low blood pressure (hypotension), especially in tall and slim people. This form of fainting is triggered, for example, by a violent shock, fluctuations in air pressure or the sight of blood. Doctors can use the so-called Schellong test to find out whether it is a circulatory-related fainting: The affected person lies on a tilting table that is suddenly raised. Before and after the change in position, the doctor measures blood pressure and pulse. If the pulse rises sharply, this is an indication of circulatory fainting.

Disturbance of the heart function

The causes of a disturbed heart function are, for example, cardiac arrhythmias, narrowing of the aortic valves, damage to the coronary vessels or the heart muscle. In the event of repeated fainting attacks, doctors use what is known as an event recorder: the device is pushed under the skin under the skin under local anesthesia and then records the heart's activity for three years. In the event of abnormalities, the device transmits the data to the treating physician. In this way, even rare heart damage can be discovered and treated.

Heartbeat that is too fast is more dangerous than too slow

If the heart beats more than 180 times a minute, it is life-threatening because the heart then does not have enough time to fill itself again. This can lead to syncope just as much as a heartbeat that is too slow, but it is far more dangerous. Such ventricular tachycardia is treated with medication, with cardioversion (restarting the heart with an electric shock) or with catheter ablation. In the case of slow cardiac arrhythmias, on the other hand, a pacemaker is usually used.

Prevent circulatory fainting

If damage to the heart is excluded as a cause, you can prevent cardiovascular fainting with these measures:

  • Regular Move - preferably once a day for 15 to 30 minutes in the fresh air. Going to the sauna and alternating hot and cold showers can also get the circulation going. If you have to stand for a long time, you can prevent the blood from sinking into your legs by putting on compression stockings.
  • Easy nutrition, for example with pick-me-ups such as water, juice spritzers and herbal teas. Drink at least 2 to 2.5 liters of this per day. A cup of coffee only stimulates the circulation temporarily. Avoid heavy or fatty foods. Eat enough salt - but no more than six grams per day.
  • If symptoms are common, special Medication (Alpha agonists) raise blood pressure.
  • Isometric Exercises serve for prevention, but can also often prevent an acute impending fainting: cross your legs while standing, tensing the leg, abdominal and buttock muscles. Then grab the other with one hand and pull in the opposite direction with both arms at chest height. Finally, take a rubber ball or other object in your hand and press firmly.

Experts on the subject

Prof. Dr. Joachim Weil, chief physician
Medical Clinic II - Cardiology and Angiology
Heart and vascular center
Sana Kliniken Lübeck
Kronsford Avenue 71-73
23560 Lübeck
Tel .: (0451) 585-16 81
Internet: www.sana-luebeck.de

Dr. Britta Goldmann, chief physician
Asklepios Clinic Harburg
Eissendorf Horse Trail 52
21075 Hamburg
Tel .: (040) 18 18-86 22 15
Internet: www.asklepios.de

Dr. Frauke Wehage, senior physician
Asklepios Clinic Harburg
Eissendorf Horse Trail 52
21075 Hamburg
Tel .: (040) 18 18-86 26 45
Internet: www.asklepios.com

Additional Information:
Pocket Guideline: Diagnosis and Management of Syncope (Version 2018)

German Heart Foundation
Bockenheimer Landstrasse 94-96, 60323 Frankfurt / Main
Tel. (069) 955 12 80, Fax (069) 955 12 83 13
Internet: www.herzstiftung.de

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