Dizziness or lightheadedness can happen to anyone, even children. While some people may experience some dizziness or “room spinning” as a sign of vertigo or an inner ear disturbance, in other cases, the dizziness can come on before a person faints or passes out. This is known as syncope. Learn more about the conditions that may cause syncope, what to look for, and how to treat it.
What is syncope?
Syncope is the medical term for fainting or passing out related to a sudden drop in blood pressure or heart rate. There are other terms that are used to describe fainting such as vasovagal syncope, neurally-mediated syncope (also called reflex syncope), and vasodepressor syncope.
Vasovagal syncope or “fainting” refers to a sudden loss of consciousness, followed by a rapid and complete recovery. This type of syncope is common—up to 15 percent of children experience an episode of syncope prior to the end of adolescence, and there’s a one-in-three chance of having a vasovagal syncope episode in everyone’s life.
Neurally-mediated and vasodepressor syncope are much less common. In general, syncope is usually harmless and requires no medical treatment.
What symptoms are associated with syncope?
Prior to an episode of syncope, patients typically describe one or more of the following symptoms or warning signs:
- lightheadedness
- dizziness
- visual changes (blurry vision, tunnel vision or double vision)
- voices becoming distant (tunnel hearing)
- dry mouth
- nausea
- a feeling of warmth or cold clammy sweat
Often the person looks pale and sweaty to others.
What causes syncope?
Fainting occurs when the part of your nervous system that regulates heart rate and blood pressure has a maladaptive response to a trigger. These triggers can include:
- the sight of blood
- stress (physical or emotional – being scared or a gory scene)
- sitting or standing for a prolonged period of time
- standing up quickly after sitting, lying down or crouching for a long period of time
- being in a warm environment (hot weather, hot crowded room, shower or bath)
- immediately following exercise
When an individual stands up, blood pools in the legs through the effect of gravity. To compensate for the lower amount of blood returning to the heart immediately after standing, the body has a surge of adrenaline (epinephrine). This adrenaline surge leads to a faster heart rate and to more vigorous heart beats. The faster heart rate and more vigorous heart contractions allow the reduced amount of blood returning to the heart to be pumped more efficiently to vital organs (the brain).
In individuals with fainting, there is a “miscommunication” between the heart and the brain. Just when the heart needs to beat fast to pump blood to the brain and prevent fainting, the brain sends out the message that the heart rate should be slowed down, and that the blood vessels in the arms and legs should dilate. These actions take even more blood away from the central part of the circulation where it is needed.
In response, the person feels lightheaded or may faint because there is not enough blood getting to the brain. Fainting is helpful, as it restores the person to a flat position, removing the pooling effect of gravity on the blood, and allows more blood to return to the heart and to be pumped to the brain.
Immediately after fainting most individuals feel tired and their mental abilities may be somewhat foggy, but they quickly return to normal.
How is syncope treated?
Syncope is treated most often with a combination of increased salt and water intake. Salt helps us to retain or “hold” fluid in the blood vessels and helps to maintain blood pressure. Along with extra salt intake (salty snacks and prepared foods), one must also increase water/gatorade/powerade intake and other non-caffeinated beverage consumption to a MINIMUM of two liters of fluid a day (approximately 64 ounces). Avoiding caffeine loading is essential, as caffeine acts as a diuretic and a stimulant, which can worsen symptoms.
Treatment is aimed at controlling the symptoms. Most people do respond to these suggested supportive measures. Typically, episodes of fainting resolve by the end of the teenage years.
Other supportive measures include:
- Avoid circumstances which might bring on symptoms. Take shorter baths/showers.
- Avoid standing still for prolonged periods in hot environments or on hot days. Flex your leg muscles and shift your weight when you are standing still.
- Avoid caffeine.
- Incorporate “cool down” periods after exercise.
- Recognize symptoms to stop/prevent episodes from progressing, i.e. immediately sit or lie down.
If you observe someone fainting, they should be kept in the lying position until they regain consciousness. Elevating their legs is also helpful.
Dizziness and fainting can be scary at any age. Fortunately, most dizziness and fainting is innocent. If you or your child experience an episode of “red flag” fainting—fainting with no “warning” or fainting mid-exercise—seek medical attention immediately.
Find a Doctor
