Why Do I Feel Like I'm Going to Faint But Never Actually Pass Out? POTS Explained

POTS and the Feeling of Passing Out but not Fainting

If you have ever felt like you're passing out after standing up but never actually did, you are not alone. It's a shared experience among people living with POTS. What causes this, and is there a way to prevent it? Continue reading to learn more.

POTS and Presyncope

The term for feeling like you are about to faint without losing consciousness is "presyncope." The symptoms include:

• Lightheadedness or dizziness
• Blurred or dimming vision
• Weakness or shakiness
• Feeling hot or sweaty
• Nausea
• Racing or pounding heart
• Brain fog or difficulty thinking

Does the list look familiar? That's because POTS also cause them.

Gravity pulls your blood down to your lower body when you stand up. A healthy person's brain sends signals telling the blood vessels to constrict to help prevent that.

If you are living with POTS, that response is impaired, or it misfires. That reduces effective blood circulation back to your heart and to the brain. That results in your brain temporarily not getting enough oxygen, which triggers warning signs of fainting.

To compensate, your heart has to beat faster. This can contribute to lightheadedness, weakness, visual changes, and the sensation of impending fainting.

Why Don't I Actually Faint?

The warning signs of fainting are triggered, but the condition is not severe enough to actually cause fainting. The blood flow to the brain is temporarily reduced, but it's still above the threshold needed to keep you awake.

Presyncope does not transition fully to syncope, or loss of consciousness.

Furthermore, the warning signs include dizziness, tunneled vision, muffled sounds, and more. These usually prompt you to sit or lie down, returning to a position where blood can go back efficiently to your heart.

But even if you're not actually fainting, presyncope can still be severe and disruptive. So it's important to learn what causes this feeling and how to react when it happens.

What Can Trigger Presyncope in POTS?

• Standing too long gives gravity more time to contribute to blood pooling.
• Not drinking enough fluids can reduce the amount of blood circulating in your body.
• Eating a large meal can temporarily send more blood to your digestive system.
• Hot weather, hot showers, and other sources of heat can widen your blood vessels and make it harder for your body to keep enough blood flowing to your brain.
• Symptoms may occur during or after an exercise activity, particularly when returning to an upright position.
• Morning adrenaline surges may cause air hunger, nausea, and panic attacks.

What Should I Do When I Feel Like I'm About to Faint?

Sit or lie down as soon as possible. It is safer than trying to push through the sensation. Do not try to walk it off, especially if you feel like you're close to losing consciousness.

If the situation allows, also lift your legs above your heart level.

Suppose heat is contributing to symptoms. Ask someone to help you cool the room or help you move to somewhere cooler.

Once symptoms settle, get up slowly. Do not go straight to standing up.

When Should You Seek Medical Care?

Not every episode of presyncope is caused by POTS. Seek medical evaluation for unexplained, worsening, or frequent episodes.

Furthermore, consult your doctor if you experience the following during those episodes:

• Chest pain
• Severe shortness of breath
• Severe irregular heartbeat
• Injury from a fall
• Actual fainting
• Fainting that occurs without warning

POTS Support in Melbourne and Online

If you are searching:

POTS and fainting Melbourne

POTS feeling like I'm going to faint

POTS presyncope

POTS specialist Melbourne

I offer chiropractic neurological consultations:

• Face-to-face in Melbourne

• Online across Australia

• Online worldwide

If you regularly feel lightheaded, unsteady, or like you are about to faint without actually passing out, I invite you to book a consultation.

Your symptoms are real. Understanding why they happen can be the first step toward finding the right support.

Frequently Asked Questions

Is It Normal to Feel Faint but Not Actually Pass Out With POTS?

Yes. POTS can cause a strong feeling that you’re about to faint, called presyncope, without actually causing you to lose consciousness. Fainting is not required to have POTS.

Is feeling like I'm going to faint dangerous?

Presyncope itself does not always mean something dangerous is happening. However, it increases the risk of falling and can have other causes that need evaluation.

Research Articles

• Fu Q, Vangundy TB, Galbreath MM, et al. Cardiac origins of the postural orthostatic tachycardia syndrome. Journal of the American College of Cardiology. 2010;55(25):2858-2868.
• Jeong JH, et al. Decreased upright cerebral blood flow and cerebral autoregulation in normocapnic postural tachycardia syndrome. American Journal of Physiology - Heart and Circulatory Physiology. 2009 
  Stewart JM, et al. Reduced cerebral blood flow with orthostasis precedes hypocapnic hyperpnea, sympathetic activation, and postural tachycardia syndrome. Hypertension. 2014. 
• Novak P, et al. Oscillatory cerebral blood flow is associated with impaired neurocognition and functional hyperemia in postural tachycardia syndrome during graded tilt. Clinical Science. 2014.
• Hainsworth R, et al. Cerebral blood flow during supine rest and the first minute of head-up tilt in patients with orthostatic intolerance. Clinical Autonomic Research. 2005.
• Okamoto LE, et al. Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion. Hypertension. 2022.
• Fu Q, Levine BD. Exercise in the postural orthostatic tachycardia syndrome. Autonomic Neuroscience. 2015;188:86-89.
• Sheldon RS, Grubb BP, Olshansky B, et al. 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal Syncope. Heart Rhythm. 2015;12(6):e41-e63.