Fainting and Chest Pain: Are These Symptoms Normal?

Fainting three times and experiencing angina is not normal?

Hello, doctor.
I have fainted three times, and I suspect the reasons are as follows.
The first time, I had a sandwich for breakfast, and while standing on the bus to school, I suddenly felt bloated, had abdominal pain, broke out in a cold sweat, and felt dizzy.
I closed my eyes tightly for a moment; when I regained consciousness, I was lying on the ground with bystanders calling for me, and the entire bus had stopped (I was on my menstrual period at that time).
The second time, I also had breakfast that day.
As the bus was approaching my stop, I felt bloated, had abdominal pain, dizziness, and a slight urge to vomit, so I quickly got off and managed to sit down in a public restroom.
Later, I experienced dizziness again and when I regained consciousness, I was leaning against the toilet with cold sweat on my face (not during my menstrual period).
The third time, I had a piece of bread for breakfast, but I hadn’t eaten dinner the night before.
By noon, while on the bus, I felt bloated and a bit dizzy (thinking it was motion sickness).
After getting off, I felt the need to go to the restroom, so I rushed to a convenience store's restroom, locked the door, and sat on the toilet.
Again, I experienced a sudden headache; when I regained consciousness, I was lying face down on the floor with my right cheek very painful (possibly from hitting something when I fell, as it was already swollen) (not during my menstrual period).
The duration of unconsciousness during these three fainting episodes was about 1-3 minutes each.
The warning signs were always dizziness, bloating, possibly cold sweats, and feeling fatigued while walking or talking, followed by a severe headache before losing consciousness.

Q1 - Could the above incidents simply be due to low blood sugar? I regularly donate 250cc of blood (which I have been doing for two years), so it’s unlikely to be anemia, right? Four months ago, I needed a health check for work, and all the test results were normal… However, after the third fainting episode today, my family is very worried, so I would like to consult you, doctor! Thank you!
Q2 - When I was younger, I often experienced chest pain, which felt like my heart was being squeezed, and any movement or breathing would cause pain.
This would last for 1-2 minutes.
When I grew up, I asked a doctor about it, and they said this phenomenon was normal, so I didn’t pay much attention to it.
Now, I experience this chest pain less frequently, only occasionally, and it lasts for a very short time.
Could this be a symptom of angina? Is it normal?

Ali, 10~19 year old female. Ask Date: 2018/03/28

Dr. Huang Xunying reply Family Medicine

It is advisable for you to see a neurologist or a cardiologist for further examination as soon as possible, considering that the episodes have occurred multiple times.

Reply Date: 2018/03/28

More Info

Fainting and chest pain can be concerning symptoms that warrant careful evaluation. Based on your description of the fainting episodes, it seems that you experienced a combination of gastrointestinal discomfort, dizziness, and loss of consciousness. These symptoms could potentially be attributed to several factors, including vasovagal syncope, dehydration, or even anxiety-related responses.

Understanding Fainting Episodes
1. Vasovagal Syncope: This is a common cause of fainting, often triggered by stress, pain, or prolonged standing. It occurs when your body overreacts to certain triggers, leading to a sudden drop in heart rate and blood pressure, which can result in fainting. The symptoms you described—such as feeling lightheaded, sweating, and abdominal discomfort—align with this condition.

2. Dehydration or Low Blood Sugar: Given that you mentioned feeling faint after not eating properly (e.g., skipping dinner), low blood sugar could be a contributing factor. Additionally, dehydration can exacerbate feelings of dizziness and fainting, especially if you are not consuming enough fluids.

3. Gastrointestinal Issues: Your episodes often coincide with abdominal discomfort. Conditions such as gastritis, irritable bowel syndrome (IBS), or even food intolerances could lead to symptoms that might trigger fainting.

4. Anxiety: Anxiety can manifest physically, leading to symptoms such as dizziness, sweating, and gastrointestinal distress. If you are experiencing stress or anxiety, it could be a contributing factor to your fainting spells.

Chest Pain Considerations
Regarding your history of chest pain, it is essential to differentiate between various types of chest pain:
1. Musculoskeletal Pain: Given that you mentioned the pain feels like pressure and is associated with movement, it could be musculoskeletal in nature. This type of pain is often benign and related to muscle strain or tension.

2. Cardiac-Related Pain: While you mentioned that this chest pain has become less frequent, it is crucial to rule out any cardiac issues, especially since you have a history of episodes that could be concerning. Chest pain that feels like pressure or tightness, especially if it is associated with exertion or stress, should be evaluated by a healthcare professional.

3. Gastroesophageal Reflux Disease (GERD): Sometimes, gastrointestinal issues can mimic cardiac pain. If you have a history of acid reflux or other digestive issues, this could be a potential cause of your chest discomfort.

Recommendations
1. Medical Evaluation: Given your symptoms, it is advisable to seek a thorough evaluation from a healthcare provider. This may include blood tests to check for anemia or blood sugar levels, an electrocardiogram (ECG) to assess heart function, and possibly an echocardiogram if deemed necessary.

2. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur, their duration, and any associated activities or triggers. This information can be valuable for your healthcare provider.

3. Lifestyle Modifications: Ensure you are eating regular meals, staying hydrated, and managing stress effectively. If anxiety is a concern, consider discussing this with a mental health professional.

4. Follow-Up: Since you have experienced multiple fainting episodes, it is crucial to follow up with your healthcare provider to ensure that any underlying conditions are addressed.

In conclusion, while your symptoms may not indicate a severe underlying condition, they should not be ignored. A comprehensive evaluation will help clarify the causes of your fainting and chest pain, allowing for appropriate management and peace of mind.

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