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Fainting (Syncope)

Fainting is a brief loss of consciousness caused by a short drop in blood flow to the brain. Most fainting is harmless, but a first faint should always be checked — and fainting during exercise, while lying down or with chest pain can be a sign of a heart problem.

Call 911 if someone faints and:

If the person is not breathing, call 911 and start CPR. Keep going until help arrives or the person starts breathing (Mayo Clinic, MedlinePlus). Until the cause is known, Mayo Clinic advises treating a loss of consciousness as a medical emergency (Mayo Clinic).

What is fainting?

Fainting is a brief loss of consciousness caused by a drop in blood flow to the brain. It usually lasts less than a couple of minutes, recovery is usually quick, and the medical name is syncope (SING-kuh-pee) (MedlinePlus). It is a symptom, not a disease: most fainting comes from a temporary drop in blood pressure and is not serious, but less often a heart rhythm problem or another condition is to blame (NINDS).

How common is it?

Estimates differ. The CDC says about 3% of men and 3.5% of women report fainting at least once in their lives (CDC), while Cedars-Sinai puts it at about one-third of all people (Cedars-Sinai). Anyone can faint, but it is more common in older adults (NINDS), and the most common type — reflex fainting — is more common in children and young adults (American Heart Association).

Warning signs before a faint

Many people first notice dizziness or lightheadedness, nausea, blurred or blacked-out vision, or cold, clammy skin (NINDS); some feel sweaty or warm, or notice tunnel vision (MedlinePlus, Mayo Clinic). Knowing these signs gives you time to sit or lie down and can prevent a fall (NINDS). Lightheadedness without fainting is covered in our Dizziness & Vertigo guide.

Types of fainting

Reflex (vasovagal) fainting — the most common kind

Reflex syncope, often called vasovagal syncope, is the most common cause of fainting (NINDS). The nervous system overreacts to a trigger: the heart slows, blood pools in the legs, and blood pressure falls (Mayo Clinic). Common triggers are standing for a long time, heat, the sight of blood, having blood drawn, fear of injury and straining (Mayo Clinic), as well as pain, fear, dehydration and donating blood (NINDS). Needles are a classic trigger: the CDC has received reports of fainting after nearly all vaccines, and scientists think the vaccination process, not the vaccines themselves, is the likely cause (CDC).

Reflex fainting is a brief, automatic reflex and doesn’t mean the heart or brain is damaged (NINDS); it is usually harmless, though you can be hurt if you fall (Mayo Clinic). If fear, panic or rapid breathing seem to set off your spells, see our Anxiety guide — hyperventilation is one cause of fainting (MedlinePlus).

Situational fainting

Situational syncope is a type of reflex fainting tied to certain body functions, such as violent coughing, laughing, swallowing or urinating (American Heart Association). Fainting can also happen while or after you have a bowel movement, especially when straining, or urinate at night or after lying down for a long time (MedlinePlus). Pressure on the neck can set it off too (NINDS).

Orthostatic fainting: blood pressure drops when you stand

Orthostatic (postural) hypotension is a drop in blood pressure when you stand up after sitting or lying down, which can cause dizziness and sometimes fainting (Mayo Clinic). Standing up suddenly is a common cause (MedlinePlus), along with dehydration from fever, vomiting, diarrhea or heavy sweating, heat, alcohol, and medicines such as those for high blood pressure, heart disease, depression and Parkinson’s disease (Mayo Clinic). Some people, more often older adults, get low blood pressure after meals (MedlinePlus). See our Blood Pressure guide, and our Balance guide for preventing falls — a common complication (Mayo Clinic).

Heart-related (cardiac) fainting — the dangerous kind

Cardiac syncope accounts for only about 1 in 10 cases of fainting, but it can reflect a serious heart condition such as an unusual heart rhythm or damage to the heart, and it needs immediate medical care (NINDS). Causes include heart rhythms that are too slow or too fast (arrhythmias) and blockages to blood flow, such as severe narrowing of the aortic valve; cardiac syncope can signal a higher risk of sudden cardiac death (American Heart Association). The American Heart Association lists these as warning signs:

  • fainting during exercise or exertion, or while lying flat on your back;
  • palpitations (a racing, pounding or irregular heartbeat) or a sudden loss of consciousness;
  • known heart disease — coronary (ischemic) heart disease, structural heart disease, past arrhythmias, a weakly pumping heart or congenital heart disease — or an abnormal heart exam;
  • a family history of inherited heart conditions or sudden cardiac death before age 50;
  • being male or over age 60 (American Heart Association).

Chest pain or sudden changes in heart rate are also warning signs (NINDS). Separate MBHA guides to Heart conditions and Rapid Heartbeat are on the way.

POTS and other causes

Postural orthostatic tachycardia syndrome (POTS) makes the heart race on standing — a rise of more than 30 beats a minute (40 in teenagers) within 10 minutes — with lightheadedness, fainting and palpitations. It mainly affects people aged 15 to 50, more often women, and often begins after pregnancy, surgery, puberty, an injury or a viral illness (NINDS). Low blood sugar can also cause fainting (MedlinePlus), and people with diabetes may not notice low blood sugar until they faint (MedlinePlus) — see our Diabetes guide.

Why a first faint should be checked

See a provider if you have never fainted before, if you faint often, or if you have new symptoms with fainting (MedlinePlus). Fainting can be a sign of a heart or brain condition (Mayo Clinic), and the American Heart Association recommends that anyone who faints gets an initial check by a health professional (American Heart Association).

How fainting is evaluated

Fainting or seizure?

Fainting comes from a brief drop in blood flow to the brain; a seizure comes from abnormal electrical activity in the brain. Nausea or a cold sweat just before, passing out on standing, and thinking clearly soon after waking point to fainting; confusion afterward, tongue biting and loss of bladder or bowel control point to a seizure (Cedars-Sinai). Brief jerking can happen in an ordinary faint (Mayo Clinic), but in a video study people who fainted had far fewer jerks than people having convulsive seizures, and went limp, which never happened in the seizures (Shmuely et al., 2018). A clinician tells them apart from a careful account of what happened and from tests (Cedars-Sinai, MedlinePlus). See our Epilepsy guide.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) A careful history, exam, blood pressure lying and standing, and an ECG; heart monitors or a tilt-table test when needed. For reflex fainting: learning your triggers, counter-pressure moves, and extra fluids and salt only if your doctor advises. Reviewing medicines; for some people, medicines such as fludrocortisone or midodrine; a pacemaker for certain causes; and treating any heart cause. With Medicare Part B, EKGs and other diagnostic tests cost 20% of the approved amount after the deductible. A Holter monitor runs about $200–$800 without insurance ($50–$200 with). Tilt-table tests and specialist visits: cost estimate being researched. Most reflex fainting needs no treatment beyond understanding and avoiding triggers. Counter-pressure moves cut repeat faints in a trial. Heart-related fainting needs prompt specialist care.
Chiropractic No role in treating fainting. Not applicable. Fainting needs a medical check, not spinal care. Neck manipulation carries a rare risk of artery tears and stroke, and pressure on the neck can itself trigger a faint.
Acupuncture Not an established treatment for fainting; we found little research. Not applicable. Only a single case report and a small case series turned up. Fainting during acupuncture is itself a known side effect — tell your acupuncturist if you faint with needles.
Herbal medicine No herb is proven to prevent fainting. Not applicable. Licorice raises blood pressure but lowers potassium and can cause dangerous heart rhythms — a risk, not a treatment. Some herbs and supplements lower blood pressure or interact with heart medicines. We don’t list doses.
Massage therapy No role in treating fainting. Not applicable. If you are prone to fainting, tell your therapist, ask for gentle work around the neck, and sit for a while before getting up from the table.
MBHA Wellness Coach Drinking enough, rising slowly, knowing your warning signs and sitting or lying down at once, leg-crossing and handgrip moves, managing heat, alcohol and meals, lying down for shots and blood draws, and a symptom diary to take to your doctor. MBHA coaching cost estimate being researched. Supports — but doesn’t replace — a medical evaluation. These habits can help prevent reflex and standing-up faints and the falls they cause.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on the cause (MedlinePlus), so the first step is the evaluation described above.

1. Reflex fainting: understanding and avoiding triggers

Most vasovagal fainting needs no treatment beyond learning your triggers and how to avoid them (Mayo Clinic) — for example, long standing in hot, crowded places (Mayo Clinic).

2. Fluids and salt — only if your doctor advises

More fluids and salt are sometimes suggested, but talk to your provider before trying them (MedlinePlus); Mayo Clinic notes extra salt is for people who don’t usually have high blood pressure (Mayo Clinic). The American Heart Association says they can help people who are dehydrated and most children, but results are unclear for vasovagal fainting in general (American Heart Association).

3. Physical counter-pressure moves

Crossing your legs, squeezing your thighs, making a fist or tightening your arms when a faint is coming can help prevent it (NINDS); in a trial, people trained in these moves fainted again less often (PC-Trial, 2006). See Counter-pressure moves for warning signs below. Compression stockings may also help (Mayo Clinic).

4. Reviewing your medicines

If a medicine is the cause, your provider may reduce or stop blood pressure medicines or diuretics when that is safe (American Heart Association), or change the dose or switch medicines. Don’t stop any medicine before talking to your provider (MedlinePlus).

5. Medicines for some people

Some people need medicine to help control fainting (American Heart Association):

  • Fludrocortisone may help prevent vasovagal fainting that affects quality of life; SSRIs (a type of antidepressant) may also be used (Mayo Clinic).
  • Midodrine treats orthostatic hypotension by tightening blood vessels. Because it can push blood pressure too high when you lie flat, it is meant for people whose low blood pressure severely limits daily life despite other treatments (MedlinePlus).
  • For POTS, fludrocortisone and midodrine can give short-term relief, and beta-blockers help some people (NINDS).

We don’t list doses; these are prescription medicines chosen and monitored by your doctor.

6. Pacemakers for specific causes

A pacemaker is a small device that sends electrical pulses to keep the heart beating at a normal rate and rhythm (NHLBI). A person with cardiac syncope may receive one (NINDS). For vasovagal fainting a pacemaker is used only very rarely, in some people not helped by other treatments (Mayo Clinic).

7. Treating heart causes

Fainting from abnormal heart rhythms, coronary artery disease, severe aortic stenosis or a blood clot in the lungs may need hospital evaluation and treatment (American Heart Association). Arrhythmia treatments include medicines, catheter ablation, pacemakers and implantable defibrillators (ICDs), which can prevent sudden death in people at high risk (NHLBI). Athletes who faint should have a heart check before returning to competitive sports (American Heart Association).

8. Driving after fainting

The American Heart Association says there are no driving restrictions for people with vasovagal syncope and no faints in the previous year, and suggests health professionals discuss local driving laws with all patients (American Heart Association). Rules differ by place: in the UK, people who faint regularly must tell the licensing agency and must not drive while waiting for a specialist assessment (NHS). Ask your provider when it is safe for you to drive.

What it costs

  • ECGs and other diagnostic tests with Medicare: Part B covers diagnostic tests, including EKGs, when your provider orders them; after the deductible you pay 20% of the Medicare-approved amount, and a hospital outpatient copayment may be higher (Medicare.gov).
  • Holter monitor: about $200–$800 without insurance, or $50–$200 with it; a 30-day event monitor about $400–$800 without insurance (MedicalCostInfo, a consumer cost guide).
  • Tilt-table testing, echocardiograms, specialist visits and medicines: cost estimate being researched.

How well it works — what to expect

Most people recover within minutes to hours of a faint (NINDS), and reflex fainting rarely needs medical treatment (American Heart Association). Repeated fainting can lower quality of life (American Heart Association), so it is worth making a plan with your provider. Heart-related fainting needs prompt specialist care (NINDS).

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating fainting. Fainting needs a medical evaluation — including an ECG (American Heart Association) — to rule out a heart cause.

A caution about the neck. Neck manipulation has been linked to rare tears in the neck arteries that can lead to a stroke, and serious side effects may be more likely in people with underlying health problems (NCCIH). Pressure on the neck can also trigger reflex fainting in some people (NINDS). If you are prone to fainting, tell any practitioner who works on your neck.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is not an established treatment for fainting, and we found little research: a single case report, in which the patient was still sent to the emergency room (case report, PubMed), and a Chinese case series with no abstract to read. That is not enough to know whether it helps.

Fainting during acupuncture

Fainting is a known side effect of acupuncture itself. Vasovagal reactions happen in an estimated 0.02% to 7% of treatments and can cause dizziness, nausea, sweating, a slow heartbeat, low blood pressure and sometimes fainting (Christensen et al., 2017). If needles or blood make you faint, tell your acupuncturist, ask to be treated lying down, and get up slowly. Needles should be sterile and single-use, and most states license acupuncturists (NCCIH).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb has been shown to prevent fainting, and some can make things worse.

Licorice: a risk, not a treatment

Regularly eating licorice raises blood pressure and lowers blood potassium, even in modest amounts, which matters most for people with heart disease (meta-analysis, PubMed). Its component glycyrrhizin can cause irregular heartbeat and even cardiac arrest, especially in large amounts or long-term use (NCCIH) — and heart rhythm problems are themselves a cause of fainting.

Herbs that lower blood pressure or interact with heart medicines

  • Garlic supplements may lower blood pressure a little in people with high blood pressure (NCCIH).
  • St. John’s wort has documented interactions with medicines including the heart drug digoxin and the blood thinner warfarin; ginseng might interact with blood pressure medicines; green tea in high amounts can reduce the effect of the beta-blocker nadolol (NCCIH).
  • Some “tejocote root” (Mexican hawthorn) supplements actually contained yellow oleander, a toxic plant that can harm the heart (NCCIH).

If you take any medicine, talk with your provider before using herbal products, because some herbs and medicines interact in harmful ways (NCCIH). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage has no role in treating fainting. If you are prone to fainting:

  • Get up slowly. After lying on the table, sit up for a moment before you stand — standing up suddenly from lying down can cause fainting (MedlinePlus). This is MBHA’s own advice.
  • Ask for gentle work around the neck: pressure on the neck can trigger reflex fainting in some people (NINDS).
  • Tell your therapist about fainting, heart conditions and blood pressure medicines. Rare serious problems from massage have been reported, more often with vigorous massage or in people at higher risk, such as older adults (NCCIH).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

A coach helps you turn your care team’s advice into habits — after a medical evaluation, never instead of one.

Drink enough

Once you know why you faint, staying hydrated is one of the steps that can help prevent it (NINDS), and dehydration is a common trigger (Mayo Clinic). Ask your provider how much is right for you.

Rise slowly

Get up from lying or sitting slowly (MedlinePlus). After a faint, standing up within about 15 to 30 minutes risks fainting again (Mayo Clinic).

Know your warning signs — and act on them

Learn your own early signs, such as lightheadedness, nausea, sweating or fading vision (NINDS). The moment they start, lie down and lift your legs, or sit with your head between your knees (Mayo Clinic). Don’t try to “push through” it.

Leg crossing and handgrip

If you can’t lie down right away, cross your legs and squeeze your thighs together, or make a fist and tighten your arm muscles (NINDS, NHS). A coach can help you practice until these moves become automatic — see Counter-pressure moves for warning signs below.

Heat, alcohol and meals

Needles, shots and blood draws

  • If having blood drawn makes you faint, tell your provider beforehand and lie down for the test (MedlinePlus).
  • For vaccines, experts recommend sitting or lying down for the shot and being watched for 15 minutes afterward; a drink, a snack or some reassurance has been shown to prevent some fainting (CDC). Fainting after shots is most often reported in teenagers (CDC).

Keep a symptom diary

Write down each episode: when it happened, how long it lasted, what you were doing, and any symptoms before it (Mayo Clinic, Mayo Clinic). Note new medicines, and ask anyone who saw it to describe what happened (MedlinePlus). Bring the diary to your doctor. MBHA coaching cost estimate being researched.

Another approach

What to do when someone faints

  1. Check breathing. If the person is not breathing, call 911 and start CPR (Mayo Clinic, MedlinePlus).
  2. Lay them on their back and raise their legs about 12 inches (30 cm) above heart level if there are no injuries, and loosen belts, collars or other tight clothing (Mayo Clinic). If they are pregnant, especially more than 28 weeks, lay them on their side instead (NHS).
  3. If they vomit, turn them on their side to prevent choking (MedlinePlus).
  4. Watch the clock. Most people wake within 30 seconds (NHS). If they don’t regain consciousness within one minute, call 911 (Mayo Clinic).
  5. Don’t let them get up too fast. Keep them lying down for 10 to 15 minutes, ideally somewhere cool and quiet; if that isn’t possible, sit them forward with their head between their knees (MedlinePlus). Sipping cold water can help recovery (NINDS).
  6. Treat any injuries from the fall, using direct pressure to control bleeding (Mayo Clinic).

Check the alert box at the top of this page for every reason to call 911. Even when all seems well, a first faint should be checked by a provider (MedlinePlus).

Another approach

Counter-pressure moves for warning signs

“Counter-pressure” moves tense large muscles, which raises blood pressure (Krediet et al., 2002). They are for people whose doctor has confirmed reflex or standing-up fainting and who get warning signs. Start as soon as you feel faint (NINDS):

What the research says

These moves are not for fainting during exercise, while lying down, or with chest pain or palpitations — those need emergency care (NHS).

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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