What should you know about chronic syncope?

Fainting happens when the brain briefly receives too little blood flow. Some episodes follow standing for a long time, heat, pain, fear, dehydration, or a sudden drop in blood pressure. Other causes include an abnormal heart rhythm, anaemia, or low blood glucose. The warning pattern matters: nausea, sweating, warmth, or tunnel vision may precede some episodes, while fainting during exertion or without warning is more concerning. A clinician may ask about posture, palpitations, injury, medicines, family history, and recovery, then check blood pressure, heart rhythm, and other findings.

If you feel faint, lie down and raise your legs if possible, or sit with your head lowered until the feeling passes. Avoid driving, heights, swimming alone, and operating machinery until the cause has been reviewed. Record what happened before, during, and after the event, including food and fluid intake, illness, exertion, warning symptoms, and injuries. Do not stop prescribed medicines without advice. Arrange medical assessment for recurrent episodes, even when recovery is quick, because the treatment depends on the trigger.

Call emergency services if fainting occurs with chest pain, severe breathlessness, sustained palpitations, seizure-like movements, major injury, confusion that does not clear, or difficulty speaking or moving. Urgent assessment is also needed when an episode happens during exercise, while lying down, or without any warning, or when there is known heart disease. Keep the person lying down, check breathing, and do not give food or drink until they are fully alert.

What pattern does my episode suggest? Could dehydration, anaemia, blood glucose, blood pressure, or heart rhythm be involved? Do I need an electrocardiogram or monitoring? Which activities should I avoid for now? What should family or colleagues do if it happens again?