Passing Out the Facts on the Causes of Fainting
In her youth, my sister (who is not exactly a delicate flower) would sometimes faint. It was never quite clear why, and the episodes eventually passed. I was impressed. I couldn’t even faint when I tried, and I did try once, in my teens. A pal devised a kind of “fainting recipe” that involved antics like rapid inhaling and exhaling. The antics didn’t work.
To learn more about fainting, I peppered some local doctors with questions about my sister, a woman I know who passed out in church, smelling salts, Victorian ladies and whether “fainting” is the same as “swooning” and “passing out.”
Dr. William K. Averill, a Torrance cardiologist, and Dr. Marshall Morgan, chief of emergency medicine at UCLA Medical Center, explained that the technical term for a faint is “syncope” from the Greek for “cutting off.” (You pronounce the “e” on the end.) Syncopal episodes happen when the brain is transiently deprived of blood, and they don’t last long: When people faint they tend to fall over, and in that new position sufficient blood easily gets into the brain again. (It’s not a good idea, say the doctors, to prop someone up when they’re about to faint. Let them lie down.)
Sometimes people faint because they have a serious heart problem, such as an arrhythmia that leads to a temporary lack of brain blood. So alert your doctor about any unexplained fainting episodes. Sometimes they faint because they suddenly exert themselves when they don’t have enough blood coursing through their system--say, after they’ve just donated blood. Or they’ve been standing too long, like a co-worker who passed out in church. Gravity is working against getting enough blood to the brain.
Sometimes people faint because they’re overstimulated: by the sight of blood, distressing news, an emotional moment. The same co-worker who passed out in church also fainted after becoming overwhelmed with sympathy while watching a movie about a man with a terrible disfigurement. The mind does indeed affect the body.
Our body has a nifty system for making sure we get the right amount of blood flow no matter what we’re doing. When someone’s lolling in bed, his heart, arteries and veins have an easier job. When someone gets up and lumbers toward the bathroom or fridge, his circulation is suddenly fighting gravity. The body senses this change in pressure: The heart rate quickens and blood vessels narrow so that blood goes to the head instead of ballooning up the ankles.
“There’s this tremendous balancing act so when we get out of bed in the morning we don’t drop to the floor and pass out,” Averill says. “It’s really cool. You don’t think about it, you just get up and go.”
The system’s even more impressive in a giraffe, adds Averill. Consider how much higher the beast’s brain is--and thus what a tougher job its heart and circulation have.
But sometimes things go awry--and a key nerve in this balancing act, called the vagus, gets overstimulated. Other nerves quiet down. The result: Heart rate drops and blood vessels dilate, and down to the floor we go.
Some folks are more prone to this kind of a faint than others; no one quite knows why. And some people will pass out while they’re urinating (it’s called micturition syncope), coughing or stimulating a nerve while swallowing. (Either of the last two could lead to someone fainting while eating ... maybe a pretzel, say the doctors, though neither was willing to diagnose the cause of President Bush’s recent tumble.)
Did fluttery Victorian ladies really faint more than today’s sturdier stock? Neither doctor knew of data pertaining to that matter; it is possible that the National Institutes of Health do not see that as a high research priority. But UCLA’s Morgan says his favorite faint-prone patient is a “former cop, jet pilot, carouser, drinker and good-time tough guy.”
And was there any rationale at all for the silly fainting recipe my pal had gotten from who knows where--inhaling and exhaling rapidly and then pinching the nose and straining hard against that pinched nose?
Actually, yes. Inhaling and exhaling very rapidly causes the amount of carbon dioxide in the blood to fall--causing blood vessels to constrict.
And the business of bearing down hard against a pinched-shut nose even has a special name. “It’s a classic Valsalva maneuver,” Averill says. Just as a cough can constrict the chest and potentially diminish blood flow, so too can such a strain.
Finally, should one really whip out smelling salts and waft them under the fainted party’s nose to bring them round? “People wake up pretty quickly anyway,” Morgan says. “All the smelling salts do is make the normal, fairly rapid process of waking up a lot more unpleasant.”
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Write or e-mail Rosie Mestel at the Los Angeles Times, 202 W. 1st. St., Los Angeles, CA 90012, rosie.mes tel@latimes.com.
