Fainting: New assessment may help identify health risks

July 7, 2016 Providence Health Team

Losing consciousness is a sign that something is wrong, but there’s a big difference between a brief fainting spell and a suggestion of a looming heart attack. Unfortunately, a person who has fainted may not know how seriously to take the episode.

A recent study out of Canada says health care providers can determine the seriousness of a patient’s condition after fainting by assessing nine factors.

"Fainting is a big problem," said Venkatesh Thiruganasambandamoorthy, emergency physician and scientist at The Ottawa Hospital, and an assistant professor at the University of Ottawa, 

in a prepared statement. "The way fainting patients are examined in emergency rooms varies greatly between physicians and hospitals. We hope that this screening tool will make the process more consistent and improve the detection of serious conditions related to fainting."

The study, published in the Canadian Medical Association Journal, examines a set of factors that can contribute to a person losing consciousness, including whether the patient had experienced a sudden fright, has a history of heart disease, abnormal blood pressure or other factors.

The Canadian Syncope Risk Score

The researchers from the University of Ottawa and The Ottawa Hospital examined the records of more than 4,000 patients who visited six emergency departments after fainting. The scientists reported that “serious adverse events,” including death, occurred within 30 days for 147, or 3.6 percent of the patients.

The researchers analyzed the factors that contributed to the fainting episodes, distilled them down to nine key indicators and created a scoring scale they call the Canadian Syncope (or fainting) Risk Score. By asking questions of patients and conducting their own examinations, health care providers can place patients on a risk scale that suggests whether they should be discharged or admitted to a hospital.

The result, said Professor Thiruganasambandamoorthy, could spare patients who don’t need to be in an emergency room from excess worry and wasting time, and help free up hospital resources.

The key factors

Issues for a health care provider to consider when assessing a patient who has fainted include:

  • What triggered the fainting episode? Was the patient in warm or crowded place, on his feet for a long time, or dealing with intense emotion, fear or pain?
  • Does the patient have a history of heart disease?
  • Are the electrocardiogram results normal?
  • Does the patient have abnormal blood pressure?
  • Does the patient have high levels of troponin, a protein that can indicate a damaged heart?

What should you do if you faint?

The Canadian survey focused on patients who went to emergency rooms after fainting, so was conducted with health care providers in mind. But in an email to Providence, Professor Thiruganasambandamoorthy suggested three choices for treatment if you have fainted:

  1. After a fainting episode, if you feel unwell or suffer symptoms (headache, chest pain, difficulty breathing, belly pain, repeated fainting, dizzy on standing or any other new symptoms), go to the emergency department.
  2. If you faint for the first time and have heart disease, ongoing symptoms as listed above, irregular heart rhythm or a family member who has died from unknown causes, seek immediate care in the emergency department. If none of the above are present, see your health care provider within three to four days.
  3. If you faint repeatedly, but don’t have any of the symptoms or conditions listed above, see your health care provider.

More reading and resources

The Canadian Medical Association Journal article can be found here.

If you have fainted or have a history of fainting, discuss this with your health care provider. You can find a Providence provider here.

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