Guest: Dr. J. Philip Saul - Pediatric Cardiology
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Dr. Philip Saul. Dr. Saul, we have been talking about fainting, let’s talk a little bit now about recurrent fainters or people who seem to faint a lot. It’s not due to a serious heart problem. What causes that and what can be done about it?
Dr. J. Philip Saul: Typically, that kind of fainting is due to low blood pressure. Now a lot of times people have been told it’s low blood sugar and that’s not usually correct, those are different symptoms. I rarely see anybody, who faints from low blood sugar, but low blood pressure is very common and if you think about it, there are a lot of animals who do the same kind of thing. It turns out possums; when they get scared, actually faint. They actually drop their blood pressure and so it may be kind of a leftover reflex that we as humans have where there are some advantages to the fainting or certainly advantages to having low blood pressure, but in most cases where it happens in humans, it’s something that you don’t want to happen. You don’t want to be falling down when you are trying to do things.
Dr. Linda Austin: So let’s take a typical situation, church, or you seated okay, standing and prayed or may be if you are watching an operation or something like that, are there any strategies you can use to prevent fainting?
Dr. J. Philip Saul: Yeah there are and there are preventive strategies and then treatment strategies. So, the best thing to prevent fainting is to stay what I call superhydrated. So, it doesn’t necessarily mean you are dehydrated, but sometimes your volume of fluid in your body is just a little low for what you need and the best way to do that is to drink beverages that contain salt or sugar, but no caffeine, so things like Powerade, Gatorade, Ginger Ale, even water is okay, but it’s better to have salt or sugar and drink enough that you fill your bladder up to the point that you pee clear urine and that you urinate at least twice in the morning and twice in the afternoon and those are kind of good measures to say that your body is full of fluid. You are just filling it up till it overflows through your kidneys and then it comes out in the urine.
Dr. Linda Austin: Are there any postural strategies that you can use to keep from fainting?
Dr. J. Philip Saul: So then the other half is not the long-term prevention like this staying hydrated, but actually what do you do when you feel dizzy, and there are few very simple things that can be done. The best one I know of is one I learned from a Dutch doctor named Dr. Walter Wheeling 02:30, who actually did a study on this and found that if you cross your legs and tense your thigh muscles, and tense your abdominal muscles, and now we have added, and clench your buttocks, then you can actually bring a lot of blood from the lower body that is pulled down in the legs and in the abdomen, and push it up towards the heart and raise the blood pressure. It’s very effective and one of the best times I saw it worked was my wife was standing in a religious service and got dizzy when she was pregnant and didn’t want to sit down and I said ?cross your legs? and she got a lot better and was able to stay standing. So, she almost had church fainting or church syncope as we call it that can be extremely effective. The other things that one can do are squat down, that’s even more effective because you really get the heart down near the legs and cut off the circulation to the legs just a little bit and then of course if you really feel dizzy and you feel like you are going to faint, the best thing is to lie down on your back and put your knees up a little, so it just sort of standard first aid. I think one of the things that parents forget sometimes with small children is that you don’t want to pick up somebody and make him stand or put him over your shoulder or that sort of thing. So, if an adult or a small child faints, keep him down low to the ground or on the ground, don’t try and make him stand up and walk it off, that’s probably not the right thing to do.
Dr. Linda Austin: Dr. Saul, thank you so much for talking to us.
Dr. J. Philip Saul: Sure, thank you.
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