When we see someone faint, we often worry about injuries from the fall, such as brain trauma or broken bones, especially in the elderly. However, we might forget to ask the most important question: "Why did they faint?"
This is the most common cause, often occurring in younger people in crowded places like train stations, public transport, markets, or in hot outdoor environments.
Often found in elderly patients taking blood pressure medication without proper adjustment. Fainting typically occurs when standing for long periods or changing positions too quickly.
An arrhythmia is a condition where the heart beats too slow or too fast, resulting in insufficient blood flow to the brain. This can happen to anyone regardless of age or gender and often occurs in individuals with pre-existing heart disease (whether diagnosed or not). This is the most dangerous cause of fainting as it can lead to Sudden Cardiac Death (SCD).
In most cases of fainting, the patient loses consciousness for a short period and wakes up on their own. However, if the fainting is caused by severe cardiac arrhythmia , the patient may not regain consciousness naturally and will require immediate resuscitation. Failure to do so results in Sudden Cardiac Death.
Sudden Cardiac Death (SCD) can happen to people of all ages, from children to the elderly. Most cases involve patients with underlying heart conditions that may or may not have been previously known. The survival rate for SCD is extremely low (less than 1%) because it can happen anywhere and anytime without warning, making timely medical intervention difficult.
"While there are three main causes of fainting, they all share one symptom: temporary loss of consciousness."
Patients with a history of fainting should undergo a medical evaluation to determine the cause, with a focus on whether the episode was triggered by an arrhythmia. Diagnostic tests include:
By the time a patient regains consciousness, tests may show signs of potential causes, but they cannot definitively confirm if the fainting was due to an arrhythmia. An accurate diagnosis requires recording the heart's rhythm at the exact moment the fainting occurs.
In cases where a doctor strongly suspects that fainting is caused by an arrhythmia, they may recommend an Implantable Loop Recorder (ILR). This tiny device has a battery life of 2-3 years. The procedure involves a local anesthetic and placing the ILR under the skin near the left side of the breastbone. The process takes less than an hour, and the patient can return home immediately.
If a patient faints in the future—no matter when or where—the device will record the heart rhythm during the episode. This allows doctors to determine if an arrhythmia was the cause, enabling them to create an effective treatment plan and prevent life-threatening Sudden Cardiac Death.
"An ILR is suitable for individuals who have experienced unexplained fainting and have pre-existing heart disease or suspected heart conditions."
