Trumpet, Trombone, French Horn, Tuba
From time to time someone asks my medical opinion about why players sometimes pass out while trying to play high notes. The fact that I am a medical doctor, mouthpiece designer, and trumpet player suggests that I should be able to easlily explain what is happening. The physiology involved is quite complex, but here is the condensed version of what is usually going on. It is not as simple and needing to breathe more to prevent “stale air”.
Generating the air flow required to play in the upper register generally requires high intrathoracic (inside the chest) pressures. This high pressure has several effects.
1. Return of blood from other parts of the body above and below the chest is slowed down, so less blood enters the large blood vessels leading to the heart, and the heart itself.
2. Pressure is exerted on the chambers of the heart, reducing their filling even more.
3. As a result the heart pumps less blood, resulting in the brain not getting sufficient blood.
4. Too little blood getting to the brain can cause the player to feel light headed, or to nearly or completely black out or faint. The medical term for a loss of consciousness like this is syncope.
That more or less sums up what is usually going on when you get light headed while playing high notes. Stay tuned to read about what players sometimes do to make the problem worse, and more importantly what they can do to prevent it from happening.