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Near Syncope

Medically reviewed by Last updated on May 1, 2023.

What is near syncope?

Near syncope, also called presyncope, is the feeling that you may faint (lose consciousness), but you do not. Each time you have this feeling is called a near syncope episode.

What increases my risk for near syncope?

Near syncope is often caused by a drop in your blood pressure that happens when you stand up quickly. The following can increase your risk for near syncope:

  • Certain medicines, such as medicine to lower your blood pressure
  • Dehydration
  • Low sodium or blood sugar levels
  • An abnormal heart rhythm
  • Hyperventilation (breathing too quickly)

What signs and symptoms may occur before a near syncope episode?

  • Feeling dizzy or lightheaded
  • Nausea, feeling warm, sweating, or clammy skin
  • Blurred vision, or vision that is blacking out
  • Confusion
  • Trouble breathing
  • A fast or fluttering heartbeat, chest pain, or a weak pulse

How is the cause of near syncope diagnosed?

Your healthcare provider will examine you. He or she will ask if you have other medical conditions. He or she may order the following tests to find out what is causing your symptoms:

  • Blood tests may be done to check your electrolyte levels, such as sodium. A problem with your electrolytes can lead to syncope.
  • Telemetry is continuous monitoring of your heart rhythm. Sticky pads placed on your skin connect to an EKG machine that records your heart rhythm.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.
  • A stress test may show the changes that take place in your heart while it is under stress. Stress may be placed on your heart with exercise or medicine. Ask for more information about this test.
  • A tilt table test is used to check your heart and your blood pressure when you change positions.
    Tilt Table Test
  • A Holter monitor is also called a portable electrocardiography (EKG) monitor. It shows your heart's electrical activity while you do your usual activities. The monitor is a small battery-operated device that you wear. It will show how fast your heart beats and if it beats in a regular pattern. Your healthcare provider may recommend this if you have syncope often over 2 to 3 days.
    Holter Monitor

How is near syncope treated?

Treatment depends on the cause of your near syncope. You may need any of the following:

  • Medicines may be needed to help your heart pump strongly and regularly. Your healthcare provider may also make changes to any medicines that are causing syncope.
  • Tilt training involves training yourself to stand for 10 to 30 minutes each day against a wall. This helps your body decrease the effects of posture changes and reduces the number of fainting spells.

What can I do to manage near syncope?

  • Keep a record of your near syncope episodes. Include your symptoms and your activity before and after the episode. The record can help your healthcare provider find the cause of your near syncope and help you manage episodes.
  • Sit or lie down when needed. This includes when you feel dizzy, your throat is getting tight, and your vision changes. Raise your legs above the level of your heart.
  • Take slow, deep breaths if you start to breathe faster with anxiety or fear. This can help decrease dizziness and the feeling that you might faint.
  • Check your blood pressure often. This is important if you take medicine to lower your blood pressure. Check your blood pressure when you are lying down and when you are standing. Ask how often to check during the day. Keep a record of your blood pressure numbers. Your healthcare provider may use the record to help plan your treatment.
    How to take a Blood Pressure

What can I do to prevent a near syncope episode?

  • Move slowly and let yourself get used to one position before you move to another position. This is very important when you change from a lying or sitting position to a standing position. Take some deep breaths before you stand up from a lying position. Stand up slowly. Sudden movements may cause a fainting spell. Sit on the side of the bed or couch for a few minutes before you stand up. If you are on bedrest, try to be upright for about 2 hours each day, or as directed. Do not lock your legs if you are standing for a long period of time. Move your legs and bend your knees to keep blood flowing.
  • Follow your healthcare provider's recommendations. Your provider may recommend that you drink more liquids to prevent dehydration. You may also need to have more salt to keep your blood pressure from dropping too low and causing syncope. Your provider will tell you how much liquid and sodium to have each day. He or she will also tell you how much physical activity is safe for you. This will depend on what is causing your near syncope.
  • Watch for signs of low blood sugar. These include hunger, nervousness, sweating, and fast or fluttery heartbeats. Talk with your healthcare provider about ways to keep your blood sugar level steady.
  • Do not strain if you are constipated. You may faint if you strain to have a bowel movement. Walking is the best way to get your bowels moving. Eat foods high in fiber to make it easier to have a bowel movement. Good examples are high-fiber cereals, beans, vegetables, and whole-grain breads. Prune juice may help make bowel movements softer.
  • Be careful in hot weather. Heat can cause a syncope episode. Limit activity done outside on hot days. Physical activity in hot weather can lead to dehydration. This can cause an episode.

When should I seek immediate care?

  • You have sudden chest pain.
  • You have trouble breathing or shortness of breath.
  • You have vision changes, are sweating, and have nausea while you are sitting or lying down.
  • You feel dizzy or flushed and your heart is fluttering.
  • You lose consciousness.
  • You cannot use your arm, hand, foot, or leg, or it feels weak.
  • You have trouble speaking or understanding others when they speak.

When should I contact my healthcare provider?

  • You have new or worsening symptoms.
  • Your heart beats faster or slower than usual.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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