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Pounding heart prior to faint

I've just been diagnosed with postural hypotension and reflex syncope. Prior to fainting I feel my heart absolutely racing, if I then sit, drink lots water or sometimes just move around it begins to receed but I don't always have warning before blacking out or it comes on too quick. Ive had about 15 blackouts now in past 4 months, but most days feel I'm warding them off, it's generally when I've had to stand for a while, eg queuing, but sometimes comes on immediately on standing if I've sat still for a while, ie college/church etc. Info I've read talks more of a drop in heart rate for reflex syncope when mine definitely goes faster, but POTS although many similar symptoms, talks of a fast heart rate within 10 mins of standing. Mine rarely happens that quick, im generally already up and about and it starts when I then stand still. Tilt table, showed a drop in BP on standing then steadying, only slight rise in HR but after GTN spray whilst BP remained the same by HR increased to 150. I've been told I have to self manage but feeling rather frustrated as the blackouts happen more or less weekly and I'm concerned at whether there are any long term risks when my heart seems to race so much. Any advice?

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I am sorry you are struggling with these debilitating symptoms, which do appear confusing. As your doctor is saying self-manage, which is easier said than done (!), I suggest you use the Immediate action advice in STARS Reflex Syncope booklet. If you would like a copy sent, please email If you find these tips do not help then you should return to your doctor when he may offer some medication.

It is recognised that standing still for any length of time can trigger a syncope episode, particularly if your blood pressure is inclined to be low.


I do have a copy already thank you. I've been trying to "self manage" for months now without much success. The Dr said medication for Reflex syncope to combat the drop in blood pressure would make my already high blood pressure and higher heart rate worse so advice to self manage, hence the frustration.

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