I have always thought that writing articles about health would inspire me to take better care of myself. But there I was, lying in the back of an ambulance. “Ma’am, you fainted just now. We need to run some checks to make sure you’re okay,” said the paramedic.
I had started the day without breakfast and told myself that I’d make up for it with an early lunch. And lunch did happen but only after 4pm at a wine bar. Still, I gave myself a pat on the back for eating something before ordering a sundowner to wind down with.
I had barely taken a few sips of my drink when I started to feel dizzy. Splashing some water on my face should help, I thought, and began finding my way to the bathroom, all the while repeating to myself: I can make it.
Apparently, I didn’t. But neither do I recall losing consciousness even though my vision was speckled like a corroded film reel en route to the bathroom. All I remember was closing my eyes for a few seconds to collect myself. Then, my chin and left knee felt very sore (I must have fallen and hit myself). And oh, an ambulance had arrived.
Some people tolerate a low blood pressure with no symptoms, whereas others feel giddy with a relatively slight drop in pressure.
WHY YOU BLACK OUT
The fainting was likely caused by low blood pressure, the paramedics informed me. The symptoms fit, which, according to Dr Ooi Chung Ping, a family physician from Ang Mo Kio Polyclinic, National Healthcare Group Polyclinics, include dizziness, a lack of concentration, blurring vision, fatigue, cold and clammy skin, rapid and shallow breathing, a rapid and weak pulse, and of course, fainting.
Drinking alcohol was probably another contributing cause. Alcohol can cause blood vessels to dilate, making it difficult for the body to regulate the blood pressure, said cardiologist Sahlen Anders Olof from Gleneagles Hospital. This can consequently lead to a drop in blood pressure.
As it turns out, I'm not the only one blacking out with no prior medical condition. Dr Sahlen said he sees about three or four fainting cases each week. Friends who heard of my fainting episode shared with me their own incidents, and they too, do not have any health issues.
What's behind these one-off fainting spells? Compared to high blood pressure, which can lead to strokes and heart attacks, what bad can come from low blood pressure other than causing a scene involving worried faces and paramedics?
A single low reading is nothing to worry about if you don’t have symptoms that might point to other issues, said Dr Ooi. In fact, he said there is “no specific number at which your day-to-day blood pressure is considered too low”.
Furthermore, not everyone reacts to blood pressure the same way, said Dr Sahlen. “Some people tolerate a low blood pressure with no symptoms, whereas others feel giddy with a relatively slight drop in pressure,” he said.
What about TV dramas that depict actors fainting upon receiving bad news? There may be some truth to them, according to Dr Sahlen. Extreme emotions from grief or the sight of blood can produce changes in the “tone of the arteries”, making it more difficult for the body to control the blood pressure in the arteries, and leading, subsequently, to a drastic drop in blood pressure, he said.
There are also other causes of low blood pressure or hypotension, said Dr Ooi, and it can affect people of all ages. In fact, there are three types of hypotension: Orthostatic hypotension (from standing up after sitting or lying down), neurally mediated hypotension (from standing for long periods), and postprandial hypotension (after a meal).
No thanks to gravity, blood pools in your lower extremities when you stand up after sitting, or if you've been standing for a while. To offset the drop in blood pressure, your body usually signals to the heart to beat faster and for your blood vessels to constrict. But in the above-mentioned hypotension situations, that doesn’t happen and fainting spells can be the result.
As for the drastic drop in blood pressure after a meal, this affects mostly older individuals. Typically, blood flows to your digestive tract to help with digestion after you eat. Again, your body would increase your heart rate and constrict certain blood vessels to help maintain normal blood pressure. But in some people, these mechanisms fail, causing dizziness and faintness.
“Older adults are more likely to have orthostatic and postprandial hypotension, while children and young adults are more likely to have neurally mediated hypotension,” said Dr Ooi. Pregnant women, too, are likely to experience hypotension but it usually resolves after giving birth, he said.
Disorders of the central nervous system such as Parkinson's disease, some heart conditions as well as hormonal issues such as a thyroid problem or diabetes can also increase the risk for hypotension. Other reasons include medicines for hypertension and depression.
WHEN LOW BLOOD PRESSURE IS A CONCERN
First of all, what qualifies as low blood pressure? That would be a reading below 90 millimeters of mercury (mmHg) for the top number or systolic; this measures the pressure in the arteries when the heart contracts and pumps blood into them.
As for the bottom number or diastolic, which measures the artery pressure when the heart relaxes, 60mmHg is considered to be a low reading. For comparison, the normal blood pressure for systolic is about 90mmHg to 120mmHg; for diastolic, it is between 60mmHg and 80mmHg.
Low blood pressure can also translate into certain health issues. Ironically, hypotension can cause strokes, heart attacks, kidney failure and in extreme cases, shock, according to Medicine Net. Sometimes, it can be a sign of medical conditions such as internal bleeding caused by an ulcer in the stomach.
In a less extreme scenario, it means that the blood flow to your organs isn’t adequate, and that your body is not getting enough oxygen and nutrients, which explains the fainting, according to the website.
As for my own fainting episode, I'm just thankful that I didn't hurt anything (or anyone) else, other than my chin and knee – and my ego.