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Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Unconsciousness is an obvious sign of fainting.

Vasovagal syncope

• Before fainting, the person may feel light-headed and shaky and experience blurred vision.
• The person may "see spots in front of their eyes."
• During this time, observers note paleness, dilated pupils, and sweating.
• While unconscious, the person may have low pulse rate (less than 60 beats/minute).
• The person should quickly regain consciousness.
• Many people have no warning signs before a syncopal episode.

Situational syncope

• Consciousness returns when the situation is over, usually very quickly.

Postural syncope

• The person may have noted a blood loss (black stools, heavy menstrual periods) or fluid loss (vomiting, diarrhea, fever).
• The person may have experienced light-headedness when sitting or standing.
• Observers may note paleness, sweating, or signs of dehydration (dry lips and tongue).

Cardiac syncope

• The person may report palpitations (awareness of pounding, fast, or abnormal heartbeat), chest pain, or shortness of breath.
• Observers may note a weak, abnormal pulse, paleness, or sweating.
• Syncope often occurs without warning or following exertion.

Neurologic syncope

• The person may have a headache, loss of balance, slurred speech, double vision, or vertigo (a feeling that the room is spinning).
• Observers note a strong pulse during the unconscious period and normal skin color.

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