KIMS Hospital in Maidstone offers outstanding expertise in cardiology and neurology, and is now running a special one-stop clinic to help those who suffer with unexplained faints, falls and fits. KIMS Consultant Dr Edward Petzer looks at some of the common medical conditions that can cause these episodes …
Older people may be more likely to shrug off or put down a fit, fall or fainting episode to their age. However if you have fainted and any of the following apply you should go and see your GP (whatever your date of birth) as there could be a serious underlying medical condition which needs monitoring and treatment:
- you have no previous history of fainting
- you have injured yourself when you have fainted
- you have diabetes or another lifelong condition affecting blood glucose levels
- are pregnant
- you have a history of heart disease where the heart’s blood supply is blocked or interrupted chest pains or an irregular heartbeat
- you have suffered a loss of bladder or bowel control
- it takes you longer than a couple of minutes to recover from fainting
Fainting is caused by a short term reduction in blood pressure to your brain. Sometimes the term syncope will be used when referring to fainting to distinguish it from other causes of temporary unconsciousness, such as a fit or seizure. In the majority of cases when a person faints, they will regain consciousness in a couple of minutes, however there are less common types of fainting which can be medical emergencies and if someone doesn’t regain consciousness within a couple of minutes you should call an ambulance.
The nervous system
Fainting is usually related to a temporary malfunction in the autonomic nervous system. This is the part of the nervous system which regulates the body’s automatic functions including heartbeat and blood pressure. This type of fainting is called neurally mediated syncope. This can be caused by sudden emotional stress, heat, pain or prolonged standing.
Situational syncope is when a sudden strain is placed on the autonomic nervous system which can be caused by coughing, sneezing or laughing.
Postural tachycardia syndrome, the response of the autonomic nervous system to sitting or standing up, is another cause of fainting, dizziness, nausea, sweating and palpitations.
Low blood pressure
Orthostatic hypotension is fainting caused by a fall in blood pressure when you stand up and tends to affect older people, usually aged 65 and over. This is also a common cause of falls in older people. This is caused by gravity pulling blood down into your legs which reduces blood pressure. The nervous system should make your heart beat faster to stabilise your blood pressure but this doesn’t happen. This can be caused by dehydration, uncontrolled diabetes, medication for high blood pressure or antidepressants. There are also neurological conditions such as Parkinson’s disease which cause orthostatic hypotension.
Cardiac syncope is fainting caused by a heart problem which interrupts the brain’s blood supply. Incidence of cardiac syncope does increase with age and also if you have narrowed or blocked blood vessels to the heart, chest pain, have had a heart attack in the past, weakened heart chambers, structural problems with the muscles of the heart (cardiomyopathy), an abnormal electrocardiogram or any repeated episode of fainting which comes on without warning. You should consult your GP if you suspect your fainting could be linked to a heart problem and they will refer you to a specialist for further tests.
Finally reflex anoxic seizures is a type of fainting which occurs when the heart pauses due to excessive activity of the vagus nerve. This is one of 12 nerves in your head and runs down the side of your head, through the neck and into the chest and abdomen. This tends to be more common in children, especially if they are upset.