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Experts say some consumers need extra monitoring after fainting

Passing out or losing consciousness may be a huge red flag for a bigger health concern

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For many consumers, fainting spells are common after spending hours in the heat or when they haven’t had enough water. Though fainting can be a bit nerve-wracking, it usually doesn’t cross consumers’ minds after the initial shock has worn off.

However, a new study conducted by researchers from The Ottawa Hospital found that fainting can sometimes be a sign of a more serious medical condition, and some patients need to be monitored longer than others after fainting as a precaution.

“Before this study, we didn’t know which fainting patients needed to be monitored in the Emergency Department, and how long they needed to be monitored,” said lead author Dr. Venkatesh Thiruganasambandamoorthy. “We didn't know who needed to be hospitalized in order to catch life-threatening conditions. Now we have answers to these questions that will help improve patient care, and potentially reduce ED wait times and hospital admissions.”

Knowing who is at risk

The researchers set out to classify patients as either low-, medium-, or high-risk post-fainting based on their likelihood of developing an arrhythmia.

Prior to the study, Dr. Thiruganasambandamoorthy and his team developed a tool that doctors can use in the emergency room to help them identify the patients who appear to be at a higher risk of having an irregular heartbeat -- which is common after fainting, but can often lead to other medical conditions.

The researchers evaluated over 5,500 participants, 74 percent of who were classified as low-risk, 19 percent as medium-risk, and seven percent as high-risk. Within 30 days of fainting, over 3.5 percent of patients experienced an arrythmia, though it happened at different times for the patients depending on their risk classification.

According to the researchers, low-risk patients are usually able to leave the hospital after two hours, and they typically don’t require a follow-up appointment. However, both medium- and high-risk patients should stay at the hospital for at least six hours after fainting, at which point the doctor should decide whether they can go home with additional monitoring or stay in the hospital for more up-close monitoring.

“We learned that irregular heartbeat called arrhythmias usually happen soon after fainting,” said Dr. Thiruganasambandamoorthy. “This means we can catch most of these events in those first few hours in the Emergency Department, where we can quickly give people the treatment they need. The types of arrhythmias that medium-risk patients suffer are more important, but not life-threatening, so these patients can be monitored from the comfort of their homes. A few days in the hospital can be considered for high-risk patients.”

Though the researchers note that the majority of patients that enter into emergency rooms after fainting are low-risk cases, it’s important for consumers to be aware of the potential risks that are associated with fainting.

Other risks

While the researchers from this study were most concerned with patients developing arrhythmias after fainting, a recent study conducted by researchers from the Johns Hopkins Bloomberg School of Public Health found that fainting or dizziness when standing up from a seated position is linked to an increase risk of dementia or stroke.

Researchers say the lightheaded feeling -- or fainting spell -- which is known as orthostatic hypertension comes from a drop in blood pressure, but it could also be a sign of dementia or stroke later in life.

The study found that those who experienced orthostatic hypertension at a young age were over 50 percent more likely to develop dementia as an older adult.

“Orthostatic hypertension has been linked to heart disease, fainting and falls, so we wanted to conduct a large study to determine if this form of low blood pressure was also linked to problems in the brain, specifically dementia,” said researcher Dr. Andrea Rawlings. “Measuring orthostatic hypertension in middle-age may be a new way to identify people who need to be carefully monitored for dementia and stroke.”

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