Tiredness and Fainting

 Conditions Associated with Sudden Tiredness and Fainting

1. Hypoglycemia

Symptoms: Sweating, shakiness, hunger, confusion, irritability, blurred vision.

Differentiation: Low blood sugar (<70 mg/dL), often occurs in diabetics or after prolonged fasting.

2. Dehydration

Symptoms: Dry mouth, dizziness, decreased urine output, rapid heart rate.

Differentiation: Recent history of poor fluid intake, prolonged heat exposure, or diarrhea.

3. Orthostatic Hypotension

Symptoms: Lightheadedness on standing, dizziness, blurred vision.

Differentiation: Drop in systolic BP >20 mmHg or diastolic BP >10 mmHg upon standing.

4. Vasovagal Syncope

Symptoms: Nausea, pallor, sweating, preceded by emotional stress or pain.

Differentiation: Trigger event (e.g., standing for a long time, emotional shock), transient loss of consciousness.

5. Cardiac Arrhythmias (e.g., Atrial Fibrillation, Bradycardia)

Symptoms: Palpitations, chest discomfort, shortness of breath.

Differentiation: Irregular or slow heart rate on ECG; history of cardiac disease.

6. Acute Myocardial Infarction (MI)

Symptoms: Chest pain radiating to arm/jaw, sweating, nausea, breathlessness.

Differentiation: Elevated cardiac enzymes (Troponin I), ECG changes (ST elevation or depression).

7. Pulmonary Embolism

Symptoms: Sudden breathlessness, chest pain, hemoptysis.

Differentiation: Elevated D-dimer, CT pulmonary angiography showing embolus.

8. Anemia (Acute Blood Loss or Chronic)

Symptoms: Pallor, fatigue, tachycardia, shortness of breath.

Differentiation: Low hemoglobin levels, history of blood loss (e.g., menstruation, GI bleeding).

9. Seizures

Symptoms: Aura, tonic-clonic movements, postictal confusion.

Differentiation: Witnessed jerking movements, tongue biting, postictal drowsiness.

10. Electrolyte Imbalances (e.g., Hypokalemia, Hyponatremia)

Symptoms: Muscle cramps, confusion, fatigue, arrhythmias.

Differentiation: Abnormal serum sodium or potassium levels.

11. Stroke (TIA or Ischemic)

Symptoms: Sudden weakness, slurred speech, facial droop, limb paralysis.

Differentiation: Focal neurological deficits, confirmed with CT/MRI brain.

12. Adrenal Insufficiency (Addisonian Crisis)

Symptoms: Fatigue, abdominal pain, hypotension, hyperpigmentation.

Differentiation: Low cortisol levels, hyponatremia, hyperkalemia.

13. Panic Attack or Acute Stress Reaction

Symptoms: Palpitations, hyperventilation, chest tightness, dizziness.

Differentiation: Normal ECG, history of stress/anxiety trigger.

14. Carbon Monoxide Poisoning

Symptoms: Headache, confusion, dizziness, cherry-red skin (rare).

Differentiation: Elevated carboxyhemoglobin levels, history of exposure to smoke.

15. Drug or Alcohol Intoxication

Symptoms: Altered mental status, slurred speech, unsteady gait.

Differentiation: History of substance use, positive toxicology screen.

16. Hypercapnia (CO2 Retention)

Symptoms: Fatigue, confusion, shallow breathing, headache.

Differentiation: Elevated arterial CO2 levels, respiratory acidosis on ABG.

17. Sepsis

Symptoms: Fever, hypotension, confusion, tachycardia.

Differentiation: Positive blood cultures, elevated procalcitonin, leukocytosis.

18. Pheochromocytoma

Symptoms: Episodes of palpitations, sweating, headache, hypertension.

Differentiation: Elevated urinary/plasma metanephrines.

19. Hypoxia (e.g., from high altitude or respiratory failure)

Symptoms: Confusion, breathlessness, cyanosis, fatigue.

Differentiation: Low oxygen saturation (SpO2), arterial blood gas abnormalities.

Approach to Diagnosis

1. History: Onset, triggers, associated symptoms (e.g., chest pain, palpitations, stress).

2. Examination: BP, pulse, ECG, SpO2, blood sugar, hydration status, neurological exam.

3. Investigations: Blood tests (CBC, electrolytes, glucose, cardiac enzymes), imaging (ECG, CT/MRI, chest X-ray), and ABG if needed.

Timely differentiation and targeted management can prevent complications and improve outcomes.