ANSWER: Fainting happens when your brain doesn’t get enough blood, and that causes you to briefly lose consciousness. In many cases, fainting is not a reason for concern. But, in some people — particularly in those with a history of heart problems or those who faint while exercising — fainting may be caused by a more serious underlying medical condition. In those cases, a health care provider should assess it as soon as possible.

One of the most common reasons people faint is in reaction to an emotional trigger. For example, the sight of blood, or extreme excitement, anxiety or fear, may cause some people to faint. This condition is called vasovagal syncope.

Vasovagal syncope happens when the part of your nervous system that controls your heart rate and blood pressure overreacts to an emotional trigger. Your heart rate slows, and your blood vessels widen. In turn, that causes your blood pressure to drop. When that happens, your body cannot deliver the blood your brain needs, and you lose consciousness.

This kind of fainting doesn’t require treatment. Because fainting is more likely when standing up, though, to prevent fainting, it can be useful for people prone to vasovagal syncope to lie down or sit down with their heads between their knees if they begin to feel lightheaded or dizzy.

Another kind of fainting can happen when you stand up from sitting or lying down, and your blood pressure drops quickly. This causes dizziness, lightheadedness or a brief loss of consciousness. This is called orthostatic hypotension. It’s typically not a serious condition. Orthostatic hypotension often is caused by something that’s easily resolved, such as dehydration or being overheated.

However, if orthostatic hypotension happens regularly, especially if you lose consciousness, see your health care provider. In that case, it could be a side effect of a medication or due to an underlying medical condition, such as a nervous system disorder.

Fainting becomes a more serious concern when it happens to people who have a prior history of a heart attack, people who have had heart surgery, or those who have heart disease or an irregular heart rhythm. In those situations, fainting could be a sign of a heart problem requiring treatment. For people who fall into those categories, discuss any episode of fainting with a health care provider to see if additional evaluation is needed.

It’s also highly uncommon for someone to faint for no reason while doing some type of physical activity or exercise. In particular, sudden fainting without any prior warning signs, such as lightheadedness, dizziness or nausea before a fainting episode, must be assessed by a health care provider. Although rare, young people without a prior history of heart disease may experience fainting as the first clinical symptom of an underlying congenital heart condition.

Finally, if you lose consciousness as a result of a fall or another type of accident, you should be evaluated promptly by a health care provider to ensure that you haven’t sustained a concussion or another head injury. — Dr. Win-Kuang Shen, Cardiovascular Disease, Mayo Clinic, Scottsdale, Arizona

The post Mayo Clinic Q and A: When does fainting require medical attention? appeared first on Mayo Clinic News Network.

ANSWER: Most people remember an occasion when they felt dizzy or light-headed after standing up too quickly. This happens because the pull of gravity causes your blood pressure to drop after you stand. For most people, this occasional phenomenon lasts only a few seconds and usually isn’t a serious problem.

On the other hand, if you frequently feel light-headed, experience dimming of your vision, ringing in your ears, weakness of your legs, or pain of the neck and shoulders when standing up, and your symptoms go away once you sit down, you may have orthostatic hypotension. This means that your blood pressure remains much lower than normal as long as you continue standing.

Orthostatic hypotension can limit activities that involve standing. Feeling unsteady when you stand can increase your risk of falling and fracturing a bone, which can be life-changing. Simple steps can help improve symptoms.

Normally, when you stand, gravity causes blood to be pulled into your legs and your blood pressure to drop slightly. Your body makes up for the increased blood pooling in your legs by constricting your blood vessels and increasing your heart rate. This reflexive response is carried out by your autonomic nervous system.

With aging, the autonomic nervous system may lose some of its ability to regulate blood flow in response to the pull of gravity. Occasionally certain diseases — such as Parkinson’s disease — can disrupt the chemical balance and structure of autonomic nerve cells, resulting in orthostatic hypotension. Orthostatic hypotension also can be a side effect of medications, such as those used to treat high blood pressure, an enlarged prostate or depression.

A sudden drop in blood pressure can mean there is less blood available to reach your brain. Symptoms of decreased blood flow to the brain may range from light-headedness, dizziness and fatigue to confusion, vision changes or fainting on standing. Less commonly, you might have nausea, trouble breathing, headache, or neck or chest pain when standing.

Some people get light-headed or dizzy every time they stand, while others do only when their bodies are stressed, such as from dehydration, heat or after illness. Others have hypotension after a large meal. Not everyone with low blood pressure has symptoms.

Your doctor may be able to make a diagnosis by monitoring your blood pressure while you transition from sitting to standing. A fall of more than 20 to 30 millimeters of mercury in your systolic blood pressure or 10 millimeters of mercury diastolic blood pressure, or both within three minutes of standing is considered orthostatic hypotension. Another way to diagnose orthostatic hypotension is by a tilt table test or an autonomic reflex screen.

Your health care provider may request blood and urine tests to rule out underlying problems, such as anemia or dehydration. He or she also may recommend monitoring your blood pressure over a 24-hour period or specific tests to check your autonomic function. 

The next goal is finding ways to improve your symptoms. First steps may include — with your health care provider’s advice — drinking more fluids, adding salt to your diet or adjusting medications. Waist-high compression stockings or an abdominal binder can help prevent symptoms by keeping blood from pooling in your abdomen and legs. You can learn to anticipate when you are likely to have symptoms and take measures to help keep your blood pressure steady. In general, always try to move from lying to sitting to standing in gradual stages. Start walking only after you feel steady.

Finally, orthostatic hypotension can occur as a medication side effect. When medicine that might cause hypotension can’t be stopped, other strategies or medications are available that can help address the symptoms of orthostatic hypotension. — Dr. Sarah Berini, Neurology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: Orthostatic hypotension is more than feeling dizzy every now and then appeared first on Mayo Clinic News Network.

For people with postural orthostatic tachycardia syndrome (POTS), everyday tasks can be daunting. Symptoms such as fatigue, dizziness and stomach problems greatly impact quality of life. Patients with POTS may look healthy, but they say they feel terrible, making it hard for other people to understand. POTS falls under the category of disease called dysautonomia, and October is Dysautonomia Awareness Month.

In this Mayo Clinic Minute, reporter Vivien Williams talks to Dr. Jeremy Cutsforth-Gregory about POTS. He explains how one simple test can diagnose the condition and how treatment can improve symptoms.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads. Read the script.

Related posts:

Living with POTS, Oct. 24, 2016

The post Mayo Clinic Minute: What is POTS? appeared first on Mayo Clinic News Network.

Christine Esposito has suffered with POTS for many years. Her symptoms include dizziness, extreme fatigue, stomach problems and more. When a medical team at Mayo Clinic led by Dr. Jeremy Cutsforth-Gregory diagnosed her symptoms as POTS, the news came as a relief. She wasn't just too lazy to get out of bed and head to school. There was a real condition preventing her from doing so. For the Mayo Clinic News Network, reporter Vivien Williams shares Christine's story.

Watch: Living with POTS.

Journalists: Broadcast-quality video pkg (3:19) is in the downloads. Read the script. 

POTS and other malfunctions of the autonomic nervous system are grouped under the umbrella term, dysautonomia. October is Dysautonomia Awareness Month, and experts hope to educate people about these conditions.

For more information about POTS, visit the Dysautonomia International website.

The post Living with POTS appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: What causes BPPV, and is there a treatment for it?

ANSWER: Benign paroxysmal positional vertigo, or BPPV, is one of the most common causes of vertigo (dizziness). BPPV is characterized by sudden bursts of vertigo that are caused by head movements, such as sitting up or tilting your head. What leads to the development of BPPV isn’t known, but it’s more common in older adults.

Once you develop BPPV, the bursts of dizziness typically occur after you change the position of your head, such as when you roll over in bed. BPPV also may cause nausea and possibly vomiting, with a feeling of lingering fatigue, queasiness or a feeling of imbalance. Without treatment, these symptoms may last for as little as one day to as long as weeks or months. Fortunately, with proper diagnosis, a simple procedure may be all it takes to treat BPPV.

Your sense of balance relies on a finely tuned system that coordinates sensory information (from nerves throughout your body) and visual information to help you determine the position of your body relative to your surroundings.

BPPV is a result of tiny crystals in your inner ear being out of place. The crystals make you sensitive to gravity and help you to keep your balance. Normally, a jelly-like membrane in your ear keeps the crystals where they belong. If the ear is damaged — often by a blow to the head — the crystals can shift to another part of the ear. When they are out of place, the crystals make you sensitive to movement and position changes that normally don’t affect you, sparking vertigo.

Since there are numerous causes of imbalance and dizziness — and more than one cause may occur at the same time — proper diagnosis is critical to effective treatment. With BPPV, the primary diagnostic test is called the Dix-Hallpike test. During the test, you are placed in the position that usually causes your vertigo. Then, your doctor checks for involuntary, jerking eye movements (nystagmus) that are associated with BPPV. The test may be done in different ways to determine which side is causing the problem.

Treatment for BPPV can be done in your doctor’s office, or with an audiologist or certain physical therapists. The treatment includes a series of body movements that reposition the crystals in your inner ear, where they no longer cause symptoms. Two procedures used are the canalith repositioning procedure and the Lempert roll. With canalith repositioning, just one time through the procedure is often enough to correct BPPV. However, it may be necessary to perform the procedure up to several times with brief breaks between before BPPV is eliminated. Your doctor will be able to detect treatment completion when there’s no sign of nystagmus in your eyes. After the treatment, you’ll likely be advised to keep your head upright for the rest of the day.

Although the canalith repositioning procedure is highly effective, BPPV can linger or return. This is more likely to happen in older adults. If this happens, you may be taught how to do the canalith repositioning procedure on your own at home.

If dizziness persistently lingers or continues to return, a visit to a specialist, such as an audiologist or vestibular therapist, may be warranted. A specialized evaluation can determine if BPPV is being treated properly or if other factors affecting balance may be in play.

Some people continue to have symptoms of impaired imbalance and dizziness after BPPV has been resolved. In these cases, working with a physical therapist specializing in vestibular and balance rehabilitation can help you decrease dizziness symptoms and regain balance. (adapted from Mayo Clinic Health Letter) — Dr. Neil Shepard, Audiology, Mayo Clinic, Rochester, Minnesota

The post Mayo Clinic Q and A: Dizziness Caused by Inner Ear Crystals appeared first on Mayo Clinic News Network.

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The post Housecall: Tips for Choosing Healthier Fast Food Options appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC:

ANSWER: Vertigo is a sensation that either you or your surroundings, or both, are spinning or moving when they are not. Some people confuse vertigo with dizziness, but there is a difference. Dizziness typically is a feeling of being lightheaded, or it may be a loss of balance that makes you unsteady on your feet. Dizziness usually does not involve the feeling that either you or something in your environment is moving.

A number of disorders can trigger vertigo. The most common is a condition called benign paroxysmal positional vertigo, or BPPV. If you have BPPV once, you are at an increased risk of getting it again. In many cases, BPPV can be successfully treated.

For many adults, BPPV is the underlying source of vertigo. With BPPV, vertigo happens when you move a certain way. Sitting up, tilting your head or lying down may all trigger vertigo if you have BPPV.

BPPV is a result of tiny crystals in your inner ear being out of place. The crystals make you sensitive to gravity and help you to keep your balance. Normally, a jelly-like membrane in your ear keeps the crystals where they belong. If the ear is damaged — often by a blow to the head — the crystals can shift to another part of the ear. When they are out of place, the crystals make you sensitive to movement and position changes that normally don’t affect you, sparking vertigo. Occasionally, especially in older adults, the specific cause of BPPV cannot be determined.

To diagnose BPPV, doctors use a technique called the Dix-Hallpike test. During this test, you are placed in the position that usually causes your vertigo to begin. When the symptoms start, your doctor checks to see if they are accompanied by a certain type of involuntary eye movement response. If so, that usually confirms BPPV. If the test does not yield clear results but you have a history of vertigo and your symptoms are intermittent, other tests may be used to detect involuntary eye movements or to test your ability to maintain your balance. Physical therapy and other diagnostic tests also may be necessary.

Treatment of BPPV involves your doctor guiding you slowly through a series of specific head movements that reposition the crystals in your inner ear where they no longer cause vertigo. For the majority of people with BPPV, vertigo goes away after just one repositioning treatment. For about 50 percent of people successfully treated for BPPV, however, the vertigo does come back within a year.

Your doctor will likely teach you how to perform the repositioning procedure by yourself so you can do it at home. If the problem is not resolved after trying the repositioning treatment for a couple of days, follow-up treatments with your doctor may be necessary.

Beyond BPPV, examples of other medical conditions that can cause vertigo include vestibular neuritis and labyrinthitis. Both involve inner ear damage that is usually the result of an infection. Meniere’s disease, a rare inner ear disorder, also can lead to vertigo. The underlying cause of Meniere’s disease is not clearly understood. These disorders can be harder to treat than BPPV. In many cases, though, the vertigo they cause can be effectively managed so it doesn’t interfere with a person’s daily activities.

Experiencing vertigo can be very unnerving, especially if you’ve never had it before. Although it is not a medical emergency, if you have an episode of vertigo, see your doctor as soon as possible to have your condition evaluated. It is important to find the underlying cause of vertigo so it can be effectively treated. — Neil Shepard, Ph.D., Audiology, Mayo Clinic, Rochester, Minn.

The post Mayo Clinic Q and A: Number of disorders can trigger vertigo appeared first on Mayo Clinic News Network.

Miss the show?  Here's the podcast: Mayo Clinic Radio PODCAST March 28 2015

Myth or Matter-of-Fact: Stretching as part of a workout is nice to do, but not critical for getting in shape.

To listen to the program at 9 a.m. Saturday, March 28, click here.

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeartRadio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

To find and listen to archived shows, click here.

The post Mayo Clinic Radio: Spring Training/Wearable Fitness Devices/Vertigo appeared first on Mayo Clinic News Network.

Are you feeling dizzy, disoriented, lightheaded and/or anxious?

On the next Mayo Clinic Radio Show, Saturday, August 2 at 9 a.m. CT, we'll discuss one of the most common reasons people visit a physician — dizziness. Chair of the Division of Audiology at Mayo Clinic and the Dizziness and Balance Disorders Program, Neil Shepard, Ph.D., will join us. Dr. Shepard will describe the different types of dizziness, plus the symptoms, causes, diagnoses and treatment. Tune in this Saturday!

Myth or Matter of Fact: Dizziness is just something that happens as we age.

Follow #MayoClinicRadio and tweet your questions.

To listen to the program on Saturday, click here. 

Mayo Clinic Radio is available on iHeart Radio.

Listen to this week’s Medical News Headlines: News Segment August 2, 2014 (right click MP3) 

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

For future topics, click on Upcoming Programs.
To listen to archived shows, click on Episodes.
If there is a topic you would like us to address, drop us a note. Click here to create a guest account.

The post MAYO CLINIC RADIO appeared first on Mayo Clinic News Network.

Are you feeling dizzy, disoriented, lightheaded and/or anxious?

On the next Mayo Clinic Radio, Saturday, August 2 at 9 A.M. CT, we'll discuss one of the most common reasons people visit a physician — dizziness.  Chair of the Division of Audiology at Mayo Clinic and the Dizziness and Balance Disorders Program, Neil Shepard, Ph.D., will join us.  Dr. Shepard will describe the different types of dizziness, plus the symptoms, causes, diagnoses and treatment.  Tune in this Saturday!

Myth or Matter of Fact:  Dizziness is just something that happens as we age.

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeart Radio.

To listen to Mayo Clinic Radio live, go to our flagship station, KROC AM.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

The post Mayo Clinic Radio: Dizziness appeared first on Mayo Clinic News Network.