Fainting Episodes During Physical Activity

Jase123,

You do not say if you have any medical conditions, are on any medications, your overall health status, and your age. Have you had any recent illnesses? All of these can play into what is going on.

Unfortunately, "the weak and dizzies" is often a very difficult problem to ferret out. Usually, the physician will look at the patient's past medical history and any current medications, to see if anything there jumps out.

The following is taken from some articles in the Annals of Emergency Medicine: The weak and dizzy patient presents a dilemma for the emergency physician. Because of the non-specificity of symptoms, the physician is often faced with uncertainty as to how to initiate his/her evaluation. A retrospective study examined the case histories of 106 consecutive patients who presented to a large urban ER with the chief complaints of weakness and/or dizziness. Weak and dizzy patients over the age of 60 had a greater incidence of potentially serious disease. Patients under the age of 60 were more likely to have anxiety related issues, easily treated viral infections, urinary tract infections, and/or dehydration. Twenty percent of the over 60 age group had symptoms directly attributable to prescribed medications.


You do have some specific symptoms: such as the first episodes occurring during light exercise, but later, it was just standing in line. You do not have tachycardia (fast heart rate), which rules out a lot of things, but makes it just that harder to figure out what is going on.


Unfortunately, if the episodes persist, the only way to find out what is going on, is to be evaluated. A thorough H&P (history and physical) would be the starting point. Some baseline labs and an EKG would need to be obtained also. If nothing jumps out of this, then the physician will have to start the detective work. If the H&P and/or studies suggested a cardiac origin, then further testing with an echocardiogram, a Holter monitor, and/or stress test would be indicated.

Usually, in the ER setting, the physician is basically looking for life threatening disorders, which need urgent treatment. All other patients will be referred to their primary care physician. The ER does not have the resources nor the time to fully evaluate chronic conditions. So, most likely, you are correct, in that a trip to the ER would be a waste of money, unless you are in the “throws” of an episode, where your symptoms could be evaluated. But, most of the time, by the time patients get to the ER, they are feeling better and/or their symptoms have subsided.


Sorry for not having an easy answer for you, but you have one of those conditions which can be very difficult to diagnose. And, many patients with basically the same symptoms, can have very different underlying etiologies. So, it is dangerous, when someone who has your same symptoms and who tells you it is X, for you to assume that you have the same thing. This is why every patient has to be examined and treated as an individual.


Keep track of your symptoms, keeping a journal if necessary. Often, a pattern will show up in the symptoms and circumstances, which will finally point to a specific etiology.

Good luck.