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Causes and symptoms of Presyncope - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
User :   I am 50 years old and yesterday I was training with a trainer and we were doing high intensity interval training . After one such training , I started feeling faint after I stopped the session. I leaned on my trainer and went and drank a glass of cold water from a fountain and then slowly started feeling better.
Doctor :   Hi
User :   Hi would you need any other question answered ?
Doctor :   Can you describe the symptoms that occurred along with the sensation of fainting - if any?
User :   It was not the spinning sensation, It was a feeling of about to pass out?
Doctor :   Ok
Doctor :   May I know when was this episode?
User :   Yesterday 8:30 AM CST
Doctor :   Ok.
Doctor :   for how long was this episode lasting?
User :   Difficult to Tell .. Maybe a minute and I walked to the fountain and bent down to drink cold water ... couple of gulps and then started feeling better. Maybe couple of minutes max
Doctor :   Did you have blurring of vision/nausea/loss of consciousness associated with those symptoms?
User :   Do not remember blurry vision , I did not lose conciousness . All i was thinking was to let the trainer know that he may have to call an ambulance
Doctor :   Ok
User :   Slight Nausea but that was not the overwhelming symptom ?
Doctor :   Did you experience chest pain or breathing difficulties too?
User :   No none of that
Doctor :   Ok
User :   BTW I had a echo done in January and my LVEF WAS IN THE 55-65 RANGE
Doctor :   May I know if these symptoms were associated in a certain position?
Doctor :   I mean if these episodes started after you stood up from a sitting or lying position?
User :   I was doing aternate jumps with weights for 1 minute. MY HR went to 156 . While I was exercising ,, I did not feel anything. Whenn I finished my 1 minute and stopped to put the weights in the rack.. while I was walking it hit me
Doctor :   Ok.
Doctor :   Have you ever had similar symptoms in the past?
User :   No .. I have not excercised at this intensity level in the past either ..
Doctor :   Ok
Doctor :   Do you have history of diabetes, hypertension / heart disease in the past?
User :   None
User :   My BP is around 115/76 and resting HR is 49
Doctor :   May I know the reason, why the echo was done earlier?
Doctor :   Are you on any medications?
User :   I had a spell of loss of balance (not vertigo or dizziness) . if I close my eyes, I tend to sway of late , i never had this before. Doctors did MRI ..nothing conclusive and then went to the circulatory system check .. did stress test etc
User :   No medications
User :   Incidental to the test they did a ct of chest and found mild calcification of the coronaries
Doctor :   Ok
Doctor :   Let me explain it to you.
Doctor :   Your condition is medically described as presyncope.
Doctor :   It may have occurred due to a vasovagal response to either the rapid heart rate or due to dehydration.
Doctor :   However a very small possible chances are that they may have occurred due to a cardiac causes too.
Doctor :   The last possibility is a less significant consideration, when compared to the previous ones.
Doctor :   Are you following what I am saying?
Doctor :   Are you there?
User :   Yes. I think I understand .. so when I stpooed exercising the HR dropped(which is correct MY recovery rate is rapid) with the vessels dilated the BP dropped hence not enough blood to the brain hence felling faint
Doctor :   Yes, that is exactly what is meant by a syncope.
Doctor :   It is a physiological response to the sudden drop in the blood pressure, so that the blood flow to the brain is restored.
User :   I did not understand the last part. Feeling faint how does it restore blood flow ?
Doctor :   Since it is a physiological response, that may not need treatment, if the cause is last one, you would need evaluation and possible medications.
Doctor :   When one has fainting spell, the natural response is that you would want to sit, or if the sensation is severe, he would collapse to the floor.
Doctor :   Do you agree to what I am saying?
User :   What you say makes sense because vaso dilation occurs when exercising at high intensity
Doctor :   If yes, the changes in the position eliminates the action of gravity and thereby increasing the circulation of the brain.
Doctor :   Vasovagal attacks refers to sudden vasodilatation which occurs to either of those conditions.
User :   Yes I agree the organism is forced to lie down ? I have another question ? how did my drinking water make me feel better(cold water) or does it have anything to do with it ?
User :   BTW de- hydration I may rule out because I was drinking water every minute ?
Doctor :   This is a transient response and it is restored to normality in a split second.
User :   Also it is not a hypoglycemic episode because there were no tremors
Doctor :   You drinking water is mainly due to the thirst feeling which one usually get during these attacks.
User :   ok
Doctor :   And even if you had not drank the water, the change of position(siting or standing) would have cleared those spells.
Doctor :   Hypoglycemia usually gets reversed only after consumption of sugar and not water alone.
User :   Ok thanks , What symtoms should I look for in case it is of cardiac origin ?
Doctor :   And hence not a hypoglycemic spell.
User :   ok
Doctor :   As I had mentioned to you earlier, if the cause was due to the first too cause, precautions such as not to over exert while exercising, drinking plenty of water before and during the exercises should take care and prevent these conditions from recurring again.
User :   Great thanks ..
User :   BTW can I have you name in case I have a follow up question ?
Doctor :   The last condition would mean strict restriction of severe exercises, dietary and lifestyle modifications and if needed aspirins may be needed.
User :   What tests will help identify if it is Cardiac condition ?
Doctor :   I would suggest you to follow these too as part of preventive measures, as you have history of coronary arterial narrowing.
User :   ok
Doctor :   The test would include EKG, echo and stress test are essential.
User :   I have done all that few months back ?
Doctor :   However doing these test now, may not be necessary, since your symptoms were very transient.
User :   They all came back normals . cholesterol was borderline, 199, HDL 37
Doctor :   However, I would suggest you to discuss the issue with your primary doctor and if needed to use aspirin daily.
Doctor :   Please fill the feed back form too.
Doctor :   Thanks for consulting me. Bye for now. Please refer your friends to our service.
User :   Thank you
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