why am I (almost) blacking out?

May 30, 2007 7:14 PM

why am I (almost) blacking out?

perhaps you know these moments: you look into the sun and for a few seconds you see these dark spots everywhere, your head hurts, your balance is thrown off, you have to stand still and close your eyes. it feels a bit as if the blood has rushed out of your head. this has been happening to me on and off for about a week now, sans sun. it takes very little to trigger this - I get up from the couch and it happens.

I know this feeling from that one time I ran a 10k in 85F and got dehydrated. I run 5k daily, consider myself in decent shape (6"4, 29, 215) and I am certain I drank plenty yesterday, the day this happened last. I just walked up a flight of stairs and when I grabbed the door handle it hit me like a ton of bricks. I literally had to stop right there for close to a minute.

obviously something is wrong and I should see a doctor. if you are in chicago, please also do feel free to recommend one, but the more important question is what this might be. it's certainly freaking me out.

posted by krautland to health & fitness (29 comments total)

Hmm. Have you had any recent changes in diet?

I experienced what you are describing some years ago when I switched to a vegetarian diet. This didn't happen until three months or so after becoming vegetarian (and I was very careful about what I was eating in terms of balanced nutrition). The symptoms disappeared after I gave up and ate a steak.
posted by needled at 7:24 PM on May 30, 2007

Low blood pressure.
posted by pompomtom at 7:24 PM on May 30, 2007

this might be off the wall, but have you ever had an anxiety attack before? If you feel right otherwise, that's a strong possibility. However, you might want to go to an ER if it happens again cause you wouldn't want this to happen while driving or something.
posted by Raichle at 7:28 PM on May 30, 2007

might be orthostatic hypotension (basically: low blood pressure caused by changes in position).

yeah, go see a doctor, and get an ekg (a doctor should be able to do it in his or her office--it takes about 10 minutes and doesn't hurt or require anything besides putting stickers on your chest). you're young and healthy, so a busy doctor might be inclined to dismiss your symptoms, but do be insistent.
posted by thinkingwoman at 7:33 PM on May 30, 2007

On a more complicated side of things, I was blacking out. It was kind of funny, because I forgot, but then one morning in the middle of the night I passed out in the bathroom and woke up I don't know how much later, freezing on the ceramic tile floor. Then I decided to see a doctor.

I wore an event monitor for 30 days, I had echocardiograms, eKg's, myocardial perfusion scans, blah blah blah. Like $10k worth of crap. Then someone suggested a tilt table test. Basically they baseline you for about 20 minutes standing up, then they lay you back and stress your heart for about 20 mins, then they stand you up again to see if they can replicate the symptoms. It took me 9 minutes into the first cycle to pass out.

Final diagnosis? Neurocardiogenic Syncope. Syncope's a broad diagnosis, just means being unsteady/passing out. For me, when my blood vessels should CONTRACT to send blood to my head (standing up, for example, forces blood into your legs, the vessels contract and send it back to your head) they dilate, and vice versa. Normal people stand up and their bp goes UP as the vessels contract, then it levels back out after about 8-10 seconds. Mine would go from, say, 65/100 to something rediculous like 38/50, then as it attempted to compensate it would shoot to about 185/130. Then BANG I'm on the floor.

Treatment? A year of beta blockers and a retest, cuz apparently I've got a mitral valve prolapse too---they wanted to see if it'd get better. Came back a year later, doctor was gone, nobody could find my file, and nobody could figure out why I'd need another scan. Horray!

It sort of went away, but occasionally it'll hammer me. I've got to be sure to keep salts up and be hydrated, hot days and temperature fluctuations really destroy me.

But it could be lots of things. Could just be a virus, could be dehydration, could be the telltale signs of a heart condition. Make sure you keep track of when and how these things happen, the conditions, and what it feels like. These things will help your doctor figure out what steps to take.
posted by TomMelee at 7:33 PM on May 30, 2007

Definitely see a doctor (as you mentioned in your question)... But, also consider making an appointment with an optometrist (who is also a doctor, of course, but will look for things that a general practioner won't).. When I was an optometrist's assistant, we had several patients who were referred by their regular doctors, who presented with "the sensation of almost blacking out"... There are lots of possible causes, some easily-treated and some very dangerous, so it's best to cover all your bases by seeing a medical doctor and/or an optometrist as soon as you can.
posted by amyms at 7:34 PM on May 30, 2007

Vasovagal syncope, maybe?

IANAD surely, but I have had experienced this several times. It is usually brought on by blood rushing to my head, either because I stood up too quickly, or was completely grossed out (once by a description of a brutal crime in a book, another when I cut my hand and saw a piece of my own HAND FAT slip down the drain...oy.)

I've been advised to immediately place my head between my knees when this happens.
posted by TryTheTilapia at 7:35 PM on May 30, 2007

Ahh crap, now I can't remember. They waffled back and forth between Vasovagal and Neurocardiogenic. I think they decided on neuro b/c it seemed that my brain stem wasn't sending the right destructions.
posted by TomMelee at 7:37 PM on May 30, 2007

I know the feeling. You're probably anemic. Plus low blood pressure. When it happens again, squat down so you don't keel over and hit your head. But then, I'm no doctor, so yes, go see one.
posted by misozaki at 7:38 PM on May 30, 2007

orthostatic hypotension

I get this too, particularly if I have been resting or otherwise either relaxed or low on food. It's especially bad when I get up in the morning, I often have to siton the edge of the bed briefly before standing straight up. I have never passed out, just gotten the spots before eyes thing. Doc says "low blood pressure" and not to worry. You shoudl get it checked out, of course, but there are some pretty normal things that could cause this.
posted by jessamyn at 7:52 PM on May 30, 2007

any medications? including herbals/non-prescription meds?
posted by ruwan at 7:59 PM on May 30, 2007

Have you had any recent changes in diet?
none. 2000cal daily. I did not run for about a week when I was on vacation but the symptoms began showing during that time, thus I doubt they are related to my taking back to running now.

Low blood pressure. / might be orthostatic hypotension (basically: low blood pressure caused by changes in position).
oh? at 29? that sounds bad. I will get an EKG. I wonder if I should see a general practicioner or a specialized md. sports medicine, perhaps?

have you ever had an anxiety attack before?
I am not sure what an anxiety attack even is. if it is panic, fear or anything alike, the answer is no. I think I am quite stable.

also consider making an appointment with an optometrist
good idea. I will do that.

any medications? including herbals/non-prescription meds?
none right now. I did take tylenol and aleve for about two weeks until three weeks ago when it began warming up. the seasonal changes always get me debilitating headaches.

You're probably anemic.
oh crap, there is a lot in the wikipedia article for this that sounds vagelue familiar. loss of concentration, fatigue ... I just ran an abysmally bad time and I feel like a man twice my age. this really bothers me. I want nothing more than being a good runner.

Vasovagal syncope
wikipedia makes it sound like these episodes were pretty predictable, which doesn't really hold true for me. they come much more in moments when I am barely doing anything... I usually stand there and wonder what the hell I might have done now to deserve that.

something else just occured to me: my sense of balance is kind of weak. I don't exactly fall over all the time but standing on one leg isn't as easy as it seems for other people. I have always been like that.
posted by krautland at 8:33 PM on May 30, 2007

I agree with the suggestions of low blood pressure, which might be exacerbated by some dehydration. For me, it seems to be caused mostly by getting up too fast from a prone position. Luckily I've only completely blacked out twice in my life (my LBP was diagnosed decades ago) but that recurring "almost" feeling is really discomforting.

It will be good if your situation is treatable but if it's not, I've found it helpful having learned how to fall when I took skiing lessons. The gist of it is to not be afraid to fall. If you're going to fall, fall and don't try to stop it, just try to make a good landing. However, you do have to be able to relax and get quickly "in the moment" during those few seconds you have before you're on the ground wondering what happened.
posted by fuse theorem at 9:48 PM on May 30, 2007

"Low blood pressure. / might be orthostatic hypotension (basically: low blood pressure caused by changes in position).
oh? at 29? that sounds bad. I will get an EKG. I wonder if I should see a general practicioner or a specialized md. sports medicine, perhaps?"

Re: possible hypovolemia causing the orthostatic hypotension: assuming dehydration, this is a gradual, cumulative process, and takes many days of largish quantities of water to remedy. One day of good drinking wouldn't do much to make you feel better, if that's the problem.

Good luck at the doctor's.
posted by moira at 10:07 PM on May 30, 2007

I agree that the described symptoms are most likely symptomatic of low blood pressure. Low blood pressure, however, isn't a diagnosis; it is just a physical sign.

There is something wrong causing low blood pressure. The symptoms you describe in an otherwise healthy 29 year old male taking no medicines are somewhat alarming to me. Some folks have mentioned some fairly benign diagnoses that could cause these symptoms.

There are, however, others that are much less benign. Here are four nasty and possible things off the top of my head: aortic stenosis; idiopathic hypertrophic subaortic stenosis; a malignant cardiac arrhythmia, intermittent or continuous; or a silent myocardial infarction. All these put you at significant risk for sudden death.

Further discussion on the internet will not identify your problem. You need to see a doctor pronto. An E/R doc, a cardiologist, or a primary care doc would all be able to deal with this effectively.
posted by ikkyu2 at 10:31 PM on May 30, 2007 [1 favorite]

Moira's wrong, by the way. If your stomach, intestines, heart and kidneys are operating properly, a few liters of water with some salt will correct symptomatic hypovolemia in an hour or two.
posted by ikkyu2 at 10:32 PM on May 30, 2007

I once asked a question about dealing with hypotension.
posted by stray at 11:37 PM on May 30, 2007

I feel like this a lot when I'm anaemic. Which is a lot. I eat meat and am otherwise pretty healthy, but various small factors combine such that I need to take iron tablets daily as well. This isn't too alarming for a female, but anaemia in an adult male is always cause for concern. If you are anaemic the doctor should follow up with extra tests to track down why (colonscopy is often high on the list).

Yours could be this, could be lots of other things. See a doctor, get it sorted. Life's a lot nicer when you don't have these fainting feelings.
posted by shelleycat at 1:36 AM on May 31, 2007

for a few seconds you see these dark spots everywhere, your head hurts, your balance is thrown off, you have to stand still and close your eyes. it feels a bit as if the blood has rushed out of your head.

Yeah, this happens to me now and again, especially if I crouch and stand up suddenly, or if I've been seated for some time and stand up suddenly. Usually only happens when I'm tired, or haven't been eating for a while, and it only lasts for a few seconds. I never feel like I'm about to black out though; I feel momentarily dazed, but mentally I'm fully conscious.

I've never been too worried about it -- I always assumed it was just a momentary blood/oxygen depletion in my head due to the sudden movement, and the other comments here about low blood pressure would support that -- but don't feel silly about asking a doctor about it; that's what they're there for.
posted by macdara at 5:14 AM on May 31, 2007

Moira's wrong, by the way. If your stomach, intestines, heart and kidneys are operating properly, a few liters of water with some salt will correct symptomatic hypovolemia in an hour or two.

Then I was misinformed by another medical professional, though she wasn't talking about replacing electrolytes. I believe you, of course.
posted by moira at 8:14 AM on May 31, 2007

okay, this seals it for me. I am trying to find a doc as I am writing these lines. thanks everyone, especially ikkyu2.
posted by krautland at 8:48 AM on May 31, 2007

moira, you can't be hypovolemic without an electrolyte disturbance. Water is the main occupant of plasma volume, but sodium is the oncotic decider about where that water is going to be.

It is possible to get hypovolemic enough that your kidneys shut down and your intestines decide to suspend all activities, including absorbing electrolytes. At that point you're headed for an ICU for a week or two. That's not where krautland is so I didn't mention it.
posted by ikkyu2 at 9:05 AM on May 31, 2007

another late night thought, having made a 9.30am appointment with a doc: I wonder if this could be in any way related to the high sodium contents in lean cuisine, which I haven't eaten in three weeks but consumed regularly before that (200-300 cal per meal make them a great weight-loss tool)?
posted by krautland at 7:53 PM on May 31, 2007

update: I went to the doc this morning and upon having n EKG done got put into an ambulance. I am now sitting in the northwestern ER, mooching a wireless connection. strange, surreal experience. extremely low heart rate is what I was told, blood work to be done. everyone seems to be freaked out, I don't know much beyond that I am dizzy.
posted by krautland at 9:52 AM on June 1, 2007

You better mark my answer best before you pass out again, man.

Hope everything turns out O.K. and you feel better soon.
posted by ikkyu2 at 10:15 AM on June 1, 2007

thank you, I just got home. very low heart beat ... think 34bpm. not sure what it is, they need to run more tests. I requested to have them done as an outpatient and they agreed. no workouts for three days.
posted by krautland at 4:23 PM on June 1, 2007

Good luck, Krautland, keep us updated.
posted by msali at 5:29 PM on June 1, 2007

I hope everything turns out OK, krautland. Sometimes I feel like the crow of doom, squawking "disaster! disaster!" on these threads, but I hope you will understand that I am never pleased in these cases to be correct.
posted by ikkyu2 at 10:27 PM on June 3, 2007

Did they ever find out what was wrong?
posted by ikkyu2 at 8:17 PM on June 12, 2007