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November 24, 2009
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Fainting (cont.)

Orthostatic hypotension

Blood vessels need to maintain their tone so that the body can withstand the effects of gravity with changes in position. When the body position changes from lying down to standing, the autonomic nervous system (the part of the brain not under conscious control), increases tone in the blood vessel walls, making them constrict, and at the same time increases the heart rate so that blood can be pumped upward to the brain. As people age, blood vessels may become less resilient, and orthostatic hypotension (relative low blood pressure with standing) may occur and cause syncope.

Vertebrobasilar system

Blood vessels to the brain are no different than any other blood vessels in the body and are at risk for narrowing with age, smoking, high blood pressure, high cholesterol, and diabetes. While most people are aware of the carotid arteries that supply the thinking parts of the brain, another set of arteries supply the base of the brain. This vertebrobasilar system is also at risk for narrowing, and should there be a temporary disruption in the blood flow to the midbrain and the reticular activating system, fainting or syncope may occur.

Electrolyte imbalance

Electrolyte and hormone abnormalities may also be responsible for syncope; however these causes are due to their effects on the heart and blood vessels.

Other medications and drugs

Other medications or drugs may also be potential causes of fainting or syncope including those for high blood pressure that can dilate blood vessels, antidepressants that can affect heart electrical activity, and those that affect mental status like pain medications, alcohol, and cocaine.



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