Alexa Ray Joel Faints On Stage

Singer/songwriter Alexa Ray Joel collapsed on stage Saturday night at the New York cabaret Café Carlyle. The 28-year-old was completing a two week run at the club when she told the audience she was not feeling well but would try to continue anyway. She said she had recently pulled her back and neck. Shortly afterwards, she collapsed and was taken to New York Presbyterian Hospital’s emergency room. There she was diagnosed with vasovagal syncope and released.

In a statement Monday, Joel (daughter of Billy Joel and Christie Brinkley) thanked fans for their support:

“I wanted to thank everyone for coming out to support me…I was excited and determined to fulfill my final performance and I really wanted to end my run with a bang, but this was not what I had in mind and hope I have the opportunity to make it up to the wonderful audience very soon. Thanks for all the concern.”

What is vasovagal syncope?

Syncope is a medical term used to describe a temporary loss of consciousness due to the sudden decrease of blood flow to the brain. Syncope is commonly called fainting or “passing out.”

faintedSyncope is surprisingly common. About one-third of people have a syncopal episode at some point in their life.

Just before fainting, you may will feel dizzy, lightheaded, or nauseous and your field of vision may “white out” or “black out,” or you may experience “tunnel vision.” Your skin may become cold and clammy.  You then drop to the floor and lose consciousness.

After fainting, a person may be unconscious for a minute or two, but will revive and slowly return to normal.  Syncope can occur in otherwise healthy people and affects all age groups, but occurs more often in the elderly.

There are several types of syncope:

  • Vasovagal syncope usually has an easily identified triggering event such as emotional stress, trauma, pain, the sight of blood, or prolonged standing.
  • Carotid sinus syncope happens because of constriction of the carotid artery in the neck and can occur after turning the head, while shaving, or when wearing a tight collar.
  • Situational syncope happens during urination, defecation, coughing, or as a result of gastrointestinal stimulation.
  • Syncope can also be a symptom of heart disease or abnormalities that create an uneven heart rate or rhythm that temporarily affect blood volume and its distribution in the body.

During vasovagal syncope the nervous system briefly malfunctions as a result of a trigger. The trigger could include:

  • Standing for long periods of time
  • Overexposure to heat
  • The sight of blood
  • Blood drawing
  • Fear of bodily injury
  • Straining, such as to have a bowel movement

As a result, the heart rate slows and blood vessels dilate causing blood to pool in the lower part of the body. This causes a drop in blood pressure and a drop in the blood flow to the brain.

Most episodes of syncope are not serious (although one may injure oneself if you hit something when you fall). If there is more than one episode, your physician will probably run some tests to see if there is a specific cause for the syncope.

What should I do if I think I’m going to faint?

Before fainting, you may feel lightheaded, dizzy, like the room is spinning, sick to your stomach. You may also have blurry vision or a hard time hearing. If you feel like you’re going to faint, lie down. If you can’t lie down, sit and bend forward with your head between your knees. This helps get the blood flowing to your brain. Wait until you feel better before trying to stand up. When you stand up, do so slowly.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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