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Presyncope
Presyncope is a state consisting of lightheadedness, muscular weakness, blurred vision, and feeling faint (as opposed to a syncope, which is actually fainting). Presyncope is most often cardiovascular in etiology. In many patients, lightheadedness is a symptom of orthostatic hypotension. Orthostatic hypotension occurs when blood pressure drops significantly when the patient stands from a supine or sitting position. If loss of consciousness occurs in this situation, it is termed syncope. Presyncope is frequently reported in patients with forms of dysautonomia such as the postural orthostatic tachycardia syndrome. ==Clinical test== The tilt table test is an evaluative clinical test to help identify postural hypotension, a common cause of presyncope or syncope.〔Natale, A., Akhtar, M., Jazayeri, M., Dhala, A., Blanck, Z., Deshpande, S., et al. (1995). Provocation of Hypotension During Head-Up Tilt Testing in Subjects With No History of Syncope or Presyncop. American Heart Association, (92), 54-58. doi: 10.1161/01.CIR.92.1.54; url: http://circ.ahajournals.org/content/92/1/54.full〕 A tilt angle of 60 and 70 degrees is optimal and maintains a high degree of specificity.〔 A positive sign with the tilt table test must be taken in context of patient history, with consideration of pertinent clinical findings before coming to a conclusion.
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