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I became aware, after a recent black out following a sporting event, that I have apparently suffered from this syndrome all of my adult life. I can recall several episodes of syncope whilst at school, in the armed forces and later as I reached late adult life. It is not a common event but will occur if I become exhausted and dehydrated, particularly on a hot day. I underwent recent cardiac assessment and came through with flying colours with BP 120/78, resting pulse 64 and no untoward findings on an echocardiogram. For a 183 cm sixty year old who weighs 79kg, I felt vindicated about my health and life style. However when subjected to a four hour fast and performing the tilt table test, I lasted for four minutes in the upright position before I fainted. Fainting is fortunately a pleasant experience for me with no nausea or discomfort - sort of waking from a nice dream. The problem becomes what you hit on the way to terra firma. I have adjusted to the situation and avoid the extreme duress of exhaustion and dehydration and am just a little careful about leaping to my feet.