June 18, 2008 at 10:33 PM ET
By Diane Mapes
You might not think President George W. Bush and Amy Winehouse have much in common, but they’ve both succumbed to episodes of syncope, a medical term derived from an ancient Greek word that means “to interrupt.”
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Bush passed out while eating pretzels and watching TV on his couch back in 2002; Winehouse lost consciousness last Monday after signing autographs for a group of fans outside her home.
According to the experts, fainting isn’t as freakish as you might think. Caused by a decrease in the flow of blood (and oxygen) to the brain, syncope is actually fairly common, says Dr. Blair P. Grubb, professor of cardiovascular medicine and pediatrics at The University of Toledo Medical Center. About 19 percent of all adults will experience at least one episode of it in their life. The tricky part is figuring out why.
“Syncope may be benign and it may be the warning sign of something more serious,” says Grubb, author of “The Fainting Phenomenon: Understanding Why People Faint and What to do About It.” “One of the difficulties is that there are many things that can cause it.”
On the serious end of the scale is cardiovascular syncope, which is often the only warning sign before a sudden death due to some form of heart complication or congenital anomaly. Basketball player Reggie Lewis experienced an episode of cardiovascular syncope before he collapsed and died of hypertrophic cardiomyopathy in 1993.
“You may only have one warning before a tragedy,” says Grubb. “If you faint, it could be due to a serious problem. Whenever there’s a question, it’s best to go ask your doctor.”
Non-cardiac syncope is far more prevalent and far less indicative of a serious illness. But its causes are legion.
Alcohol and certain drugs can cause blood pressure to drop which can then trigger an episode of syncope; starving yourself or becoming dehydrated can have the same effect. High gravitational forces can also cause fainting, which is why the Air Force commonly screens people for the condition. A hot, crowded setting such as a political rally or rock concert can also bring on a black out.
Historically, constraining corsets may have been responsible for fainting spells in women, although Grubb says the practice known as swooning might also be attributed to bad health (tuberculosis and other common diseases of the day), toxic make-up (arsenic and mercury were popular ingredients) or good old-fashioned deceit.
“In those days it was a learned behavior,” he says. “Some people would do it as a put-on; it became the social norm.”
Most people who faint don’t need to fake it, though; they’re predisposed to the condition thanks to their off-kilter autonomic nervous system (ANS), the set-up that controls the body’s involuntary functions -- i.e., the regulation of blood pressure, body temperature, sweating, digestion, etc.
“About 10 percent of the population has poor autonomic tone,” says Grubb. “If given the right set of stresses and strains, they’ll pass out.”
The ANS can short circuit in a variety of ways. In neurocardiogenic or vasovagal syncope (also known as the “common faint”), the heart mistakenly sends a signal to the brain that the body is experiencing an episode of hypertension, even though the blood pressure may be quite low. The brain responds by causing the blood pressure and heart rate to plummet, which then results in a lack of blood to the brain.
Boom. You’re on the floor.
Some folks will pass out when they stand for too long in the same lock-kneed position.
Others will faint at the sight of blood (or even the thought of it).
“People will pass out laughing, coughing, sneezing, and having orgasms,” says Grubb. "If you have an enlarged prostate and you have to strain to urinate, you can pass out from that. If you’re really constipated and you strain really hard, you can faint on the toilet. That’s called defecation syncope.”
While most people are able to take evasive action (i.e., get flat) when they feel a faint coming on (symptoms usually include light-headedness, blurred vision, shakiness, and “spots before your eyes”), those who suffer from refractory recurrent syncope aren’t as fortunate.
“These people have no warning whatsoever,” says Grubb. “They’ll wake up on the floor in a pool of blood with a broken jaw. Their lives are ruined by this.”
According to Grubb, syncope accounts for 3 percent of all emergency room visits and up to 6 percent of all hospital admissions.
The famously bee-hived British singer Amy Winehouse is one of them, although her fainting spell seems connected to a more serious problem. Doctors have determined that she has early stage emphysema and an irregular heartbeat caused by smoking crack cocaine and cigarettes.
Given her love of back-combing, though, it's surprising she hasn't fainted before.
“Some people will pass out when getting their hair done,” says Grubb. “It’s called hair grooming syncope. If you yank on the hair of people who are predisposed to this, they can pass out.”