Long history of presyncope

I am a 44-year-old man who has for the past decade has had pre-syncope episodes that come on with no warning signs and are brief but intense. These episodes have occurred while walking, standing and sitting. What they share in common is that I notice nothing wrong or unusual, no light-headedness or dizziness, when they suddenly strike me. I feel a rush in my head and I often start to pitch forward and feel as if I need to grab on to something to keep from falling. I do not feel dizzy or sense rotation -- I just feel as if I am about to black out. The sensation typically lasts only a second or two and I find myself instinctively flexing the muscles in my head and neck as I come out of it. Afterward, I often feel weak and flushed.

I have two episodes the past couple of weeks; I haven't tracked their frequency in the past but I would guess I would average close to one episode a month.

A bit more about me: I am 35 pounds overweight and have moderately high blood pressure an elevated cholestrol, both of which are being treated.

What testing, if any, would you suggest I undergo? What might be the cause of my symptoms and what can we rule out already?

[kay2486]

its difficult to say as a guess, your doctor, your bloods would be tested first, ecgs and maybe a brain scan to rule out any abnormality, even an ear infection can be the root cause this may also be an anxiety attack
do you have any palpatations, blurred vision,headaches, tingly sensations in body, this also might be down to the meds you are on, if your bp has gone from high to lower then this can cause these symptoms, i hope you find the answer to problem

[Jsher]

Thanks for your reply. A couple of points:

(1) I began getting presyncope 10 years ago, long before I was on any meds and the episodes have continued whether my bp was low, moderate or high.

(2) I have absolutely no warning signs before an episode - no palpatations, blurred vision,headaches or tingly sensations in body.

(3) I am certain these are not anxiety attacks as I experienced a few anxiety attacks 20 years ago and learned through behavioral methods not to have them again. An anxiety attack comes during moments of stress and the buildup is noticeable -- racing heart, faster breathing, tingling in extremities and the resolution is gradual too. What I am callin presyncope happens at times when I have no stress and there is no buildup and the resolution takes a few seconds.

[big12dude]

Are you still having your symptoms?