It's like a fainting spell, but you don't lose consciousness? Let's talk about (Presyncope)!

You've probably had this happen to you at some point. When you're standing, maybe in a group of people, or when you suddenly stand up , you feel dizzy, your vision goes black, and the whole world spins around you. You think, "Oh, I'm going to faint." But surprisingly, you don't lose consciousness, you just barely survive. That's what medical experts call ``presyncope'' (pronounced pre-sin-ka-pee). Some doctors also call it ``near syncope.'' ``syncope'' is when you actually lose consciousness and fall.

What exactly is `Presyncope`?

Simply put, `(Presyncope)` is when you feel like you are going to faint, but you are barely conscious without actually losing consciousness. This can last from a few seconds to a few minutes. For most people, this is not a big problem. However, for a very small number of people, what happens next can be a little more serious. For some people, `(Presyncope)` can actually cause fainting and fall, which can lead to injury. For others, `(Presyncope)` can be caused by something more serious, such as a heart condition.

What are the symptoms of this?

When you have presyncope, you may experience one or more of these symptoms:

• Lightheadedness: It can feel like there is nothing inside your head, like you are floating .
• Weakness: You may suddenly feel as if you are losing strength.
• Sweating: You may suddenly break out in a cold sweat.
• Upset stomach: You may feel like you are about to vomit.
• Heart palpitations: You may feel your chest pounding, or your heart rate may change.
• Pain in your belly/abdomen: Some people may experience pain in the lower abdomen.
• Blurred vision or seeing black spots: Like when the TV loses its signal, you may see lines, dots, or objects in front of your eyes that are blurry.

Why does this happen? Causes of `Presyncope`

The main reason is that the amount of blood that reaches your brain suddenly decreases. Imagine, if the blood flow to your brain stops for about six to eight seconds, you can lose consciousness. In ``Presyncope``, the blood flow is slightly reduced, but not completely stopped.

There are several causes of presyncope:

Common, less serious causes include:

• An event that causes intense pain, fear, anxiety, or distress: For example, seeing blood, getting an injection, or witnessing an accident.
• Orthostatic hypotension: This is what happens to most people. When you suddenly stand up from a sitting position, or when you get up from a lying position, your blood pressure suddenly drops, causing you to feel dizzy. This can also happen if you are dehydrated.
• Vasovagal syncope: This is also common. It can occur during prolonged standing, in hot weather, or when you hold your breath (for example, when coughing or straining to defecate).

Reasons to be a little careful:

• Certain medications: Medications for high blood pressure and some heart diseases can also cause this.
• Pulmonary embolism: A blood clot in the lungs.
• Pulmonary hypertension: Increased blood pressure in the lungs.
• Sepsis: A serious condition caused by an infection in the body.
• Aortic dissection: A tear in the lining of the large main blood vessel (aorta).
• Heart valve disease: Heart valves not working properly.
• Hypertrophic cardiomyopathy: Abnormal thickening of the heart muscle.
• Myocardial ischemia: The heart does not get enough blood.
• Heart attack.
• Carotid artery disease: Blockage of the main arteries in the neck that carry blood to the brain.
• Cardiac tamponade: A buildup of fluid in the sac around the heart, compressing the heart.
• Heart rhythm disorders (`Arrhythmia`).
• Anemia: For example, bleeding in the stomach or intestines (gastrointestinal bleeding) can cause blood loss.
• `Postural orthostatic tachycardia syndrome (POTS):` A condition in which the heart rate increases abnormally upon standing.

Important: Don't panic if you see these causes. Most of the time, ``Presyncope'' is caused by simple things. However, if it happens frequently, or if it comes with other symptoms, it's best to see a doctor.

Who is at higher risk of developing `presyncope`?

Although this condition can develop in anyone, some people are at higher risk:

• For those with high blood pressure.
• For those with diabetes.
• For those who use tobacco products (like cigarettes, beedis).
• For those who have already had ``Presyncope''.
• This condition is reported slightly more often in women than in men.

How does a doctor detect this?

When you go to see a doctor, he or she will first ask you about your medical history and the medications you are taking . Then he or she will do a physical exam . The doctor may ask questions like these:

• "What were you doing when you started feeling these symptoms?"
• "Has this ever happened before?"
• "What were you doing before you started feeling like this?"
• "Does anyone in the family have a chronic illness or heart disease?"

What are the post-mortem examinations?

The following tests can help find the cause:

• Electrocardiogram (ECG/EKG): A test that looks at the electrical activity of the heart.
• A heart rhythm monitor: A device worn for a day or two, such as a Holter monitor, or a week or two, such as a Zio® patch, monitors the heart's rhythm.
• `Exercise stress test`: An `ECG` is taken while you are exercising.
• Blood tests: Check for things like blood sugar levels (glucose) and anemia.
• Tilt table test: In this test, you are made to lie down on a special bed, and the bed is adjusted so that it suddenly stands up, and your heart rate and blood pressure are monitored.
• A `CT scan` (Computed tomography) of the brain.
• Echocardiogram: An ultrasound scan of the heart.

What are the treatments for `Presyncope`?

Treatment depends on the cause of presyncope.

Things you can do yourself (like in the future):

• Lie down or sit down immediately. If possible, keep your legs slightly elevated.
• Tense your arms, legs, or stomach muscles. For example, cross your legs or clench your fists. These are called counter-pressure maneuvers. This can slightly increase blood flow to the brain.

Medical treatment:

• Giving saline (IV fluids): If the body is dehydrated, saline with sodium may be given.
• Medications: Depending on the cause, antibiotics may be given for an infection, and blood thinners may be given to prevent blood clots.
• Some surgeries or procedures: Things like removing a blood clot or replacing a heart valve.
• Pacemaker implantation or a treatment called Ablation: To correct an irregular heartbeat (arrhythmia).

What kind of future can someone with presyncope expect?

Once you see a doctor, you may be admitted to the hospital, or you may be treated and sent home. After that, you should see your primary care physician (PCP) for a follow-up.

If a doctor finds a serious problem, you may need to see a cardiologist or another specialist. The severity of your presyncope will depend on the cause.

One study found that if a person with presyncope has any of these symptoms, it could be a sign of a serious condition:

• Heart failure.
• Shortness of breath.
• If the top number of `Pressure` (Systolic blood pressure) is less than 90 mmHg. (This is lower than the normal value).
• Abnormalities in the `ECG` test.
• If the `Hematocrit test` result is less than 30%, it means that the percentage of red blood cells in your blood is low, which means you have anemia.

Can presyncope be prevented?

Yes, if you know what causes it, you can help prevent `(Presyncope)`. You can reduce your risk by doing these things:

• Drink plenty of water before donating blood or getting an injection. Stay seated while getting an injection.
• Avoid things that make you anxious (e.g., watching horror movies) as much as possible.
• Don't get up all at once, get up slowly.
• Don't eat a lot at one time, eat small meals.
• If there is a medical condition that is causing presyncope, get it treated properly.

How should I take care of myself?

If you know what causes you to have presyncope, do everything you can to prevent it. For example, if you know that you tend to have it in hot, crowded places, plan ahead when going to those places. Bring a small fan, sit near a window, or go outside for a bit to get some fresh air.

Whenever you feel like you're about to faint, try sitting or lying down. Cross your arms and legs.

When should I see a doctor?

If you have presyncope , you should see a doctor for follow-up. In most cases, your doctor will be able to find the cause or refer you to someone who can help. If you actually lose consciousness (fainting), it is an emergency. Someone with you should call an ambulance immediately.

What questions should you ask the doctor?

You can ask your doctor questions like these:

• "What caused me to have this `(Presyncope)`?"
• "If this is caused by a medical condition, should I seek treatment for it?"
• "How quickly can it be treated?"
• "Are other people in my family at risk of developing `(Presyncope)'?"

Presyncope, whether it's your first time or a recurring one, can be a scary and uncomfortable experience. You may think, "Am I going to fall? Am I going to get hurt?" Or you may feel embarrassed when everyone asks, "Are you okay?" But the most important thing is to find the cause and get the treatment you need. Then you can control the condition.

Finally, remember this.

``(Presyncope)`` is when you feel like you're fainting, but you don't lose consciousness. Most of the time, this is due to simple reasons, but sometimes it can be caused by something serious, such as a heart condition.

Therefore, if you have ever had this experience, especially if it occurs frequently, or if it is accompanied by other symptoms such as chest pain, shortness of breath, etc., please seek medical advice. Don't be afraid, don't panic. With the right diagnosis and treatment, you can be well. Your health is in your hands!

` Presyncope, fainting, loss of consciousness, dizziness, vertigo, lack of blood to the brain, heart disease