fainting spell

Education

Fainting: When to Go to the ER or Urgent Care

Baptist Health Miami Cardiac & Vascular Institute

Fainting, also known by the medical term syncope, is a sudden and temporary loss of consciousness that can happen to anyone, even without a clear underlying health issue. Passing out occurs when there isn’t enough blood flowing to the brain.

A fainting episode most often lasts less than a couple of minutes, and one can usually recover from it quickly. It’s a relatively common occurrence, but it often leaves people uncertain about whether they should seek medical attention. When is it necessary to visit the emergency room (ER) or an urgent care center after fainting -- and what underlying health issues could be at play?

In some cases , there are obvious causes of fainting. For example, you could pass out from dehydration or heat exhaustion from working or exercising excessively outdoors. If you’re a diabetic and your blood sugar level drops very low, you could faint from a hypoglycemic attack. But if you fainted and have know idea of the cause, you should consult with your doctor as soon as possible.

Fainting can be one of several signs of a serious condition, including heart disease, explains Marcus St. John, M.D., an interventional cardiologist, the medical director of the Cath Lab at Baptist Health Miami Cardiac & Vascular Institute.

Marcus St. John, M.D., interventional cardiologist and medical director of the Cardiac Catheterization Lab (Cath Lab) at Baptist Health Miami Cardiac & Vascular Institute‘s.

 

Usually, two types of cases make their way to the Cath Lab, said Dr. St. John. Many involve urgent cases where patients are transported from the ER with potentially life-threatening, cardiac-related events.

Dr. St. John emphasizes that no one should ignore telltale symptoms of a heart attack, such as chest pain or pressure, shortness of breath, nausea or vomiting, profuse sweating, dizziness, or fainting.

“It’s not that every time you get a discomfort in your chest you need to run to the emergency department,” said Dr. St. John. “But discomforts that are severe, that are associated with shortness of breath, nausea, vomiting, sweatiness, or fainting -- and that don't go away quickly – then they really do warrant urgent attention. And if you are in doubt about whether this could be a heart attack, going to the emergency room is really the best strategy.”

When to Go to the ER vs. Urgent Care

For many, a brief fainting spell may not warrant a trip to the ER. However, several factors should guide your decision:

  • Duration of Fainting: If the episode lasts more than a minute, or if the person does not quickly regain consciousness, it’s crucial to seek immediate medical help. Prolonged fainting could indicate a more serious underlying condition.
  • Age: Age plays a significant role in evaluating fainting episodes. Older adults (especially those over 65) are at a higher risk for serious health issues that could cause fainting. If an older adult faints, it’s essential to get evaluated promptly.
  • Underlying Health Issues: If the individual has pre-existing medical conditions, particularly heart disease, diabetes, or neurological disorders, err on the side of caution and seek medical attention.

Common Underlying Health Issues

Fainting can stem from a variety of underlying health issues, including:

  • Cardiovascular Issues: Conditions like arrhythmias, heart attacks, or structural heart problems can lead to fainting spells. An undiagnosed heart issue is often a serious concern.
  • Metabolic Issues: Diabetics may experience low blood sugar, which can cause fainting. Dehydration and electrolyte imbalances are also common culprits.
  • Neurological Conditions: Seizures, transient ischemic attacks (TIAs), or other neurological disorders can manifest as fainting episodes.
  • Other Causes: Situational factors like heat exhaustion, prolonged standing, or stress-induced vasovagal syncope can trigger fainting but may not require emergency intervention unless symptoms persist or worsen.

“Erratic blood pressure” is a medical condition marked by blood pressure fluctuations that are unpredictable or don’t have an obvious cause. Dizziness, lightheadedness, or fainting are possible symptoms of a sudden drop in blood pressure. They are extreme – unlike normal fluctuations, explains Adedapo Adeyinka Iluyomade, M.D., preventive cardiologist with Baptist Health Miami Cardiac and Vascular Institute.

“An individual with erratic blood pressure might have elevated blood pressure at one moment, but then have it drop to a considerably lower level within minutes or hours, without following any discernible pattern or having an apparent cause,” said Dr. Iluyomade.

Adedapo Iluyomade, M.D., preventive cardiologist at Baptist Health Miami Cardiac & Vascular Institute.

Recommended Testing for Patients

If a patient has fainted but appears otherwise healthy, a thorough assessment is vital:

  • Initial Assessment: The first step involves checking vital signs, obtaining a medical history, and conducting a physical exam.
  • Possible Tests:
    • ECG/EKG: This test helps evaluate heart rhythm and can identify arrhythmias or other heart-related issues.
    • Blood Tests: Testing blood sugar levels, electrolytes, and other metabolic markers provides insight into potential underlying problems.
    • Imaging: Depending on the case, an echocardiogram or brain imaging may be warranted to investigate further.
  • Follow-up: If no significant issues are found, monitoring and lifestyle adjustments may be recommended to prevent future episodes.

Fainting can be alarming, and understanding when to seek medical help is crucial. If you or someone you know experiences fainting, especially under concerning circumstances—such as prolonged loss of consciousness, advanced age, or pre-existing health conditions—don’t hesitate to seek medical attention. Always consult your healthcare provider for personalized advice and follow-up care.

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