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Family Medicine (Expert Forum)
vasovagal syncope
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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vasovagal syncope
by lucita, Oct 04, 2005 12:00AM
Excuse the disjointed nature of this...Just need some advice. I am a healthy ( I think) 32 year old woman with panic/anxiety disorder. I am currently in CBT therapy for this, and am making progress. My question is about vasovagal syncope....I have what I think is low blood pressure - it averages 110/69. I have fainted seven times in my life - twice as a child from being immunized, once as a teenager from a high strep throat fever, once in my 20's from a high-flu fever, and once a few months ago from awful menstrual cramps. My father faints when he is punctured with a needle. He recently went to the doctor with what turned out to be sinus/lung infection and fainted when they drew blood. The doctor claimed his heart stopped for 10 seconds. They rushed him to the hospital because the doctor was worried about this "nontypical" faint, put in an IV and he fainted again, again with no heartbeat for 10 seconds. All in all, he was diagnosed with a sinus/lung infection, but was given a pacemaker due to the apparant lack of heartbeat during the faint. Docs said his heart was fine, and that the pacemaker is a "precaution" for an older person with slower response times to get the heart giong again. (?) So here I am, and I have never been alarmed or worried about my faints in the past - they always had a "cause", and I never considered them to be cardio in nature. I have woken up from all of them within seconds or minutes.I had an ekg when I was 20 and had my first panic attack, everything was fine. I have never had a doctor tell me that my blood pressure was strange, although a doc I saw for a rash on my arm last year mentioned she heard a "slight murmer" in my heart, nothing to give a thought about. IN SUM: I am dealing with conquering my anxiety, and want to overcome the silly fear I now have about fainting. In your opinion, do I need to have a tilt table test done, or any other test for that matter, to find out why I fainted? What about vasovagal syncope and a murmer? Is it dangerous? Should I waste my time worrying about this? Thank you for taking the time to answer this girls anxious concerns!
Doctor's Answer
by Kevin Pho, MD, Oct 05, 2005 12:00AM
, Oct 05, 2005 12:00AM
All the possibilities you mentioned, including vasovagal syncope, can be considered. When considering syncope, 1/3 of the causes are cardiac in nature, 1/3 neurologic in nature, and 1/3 are unknown.
To evaluate the heart and murmur, an echocardiogram can be considered to evaluate the heart and valve structure. If you are at risk for coronary disease, this can be done in conjunction with a stress test.
To evaluate the neurological causes, a CT or MRI can be done of the head, as well as an assessment of the neck arteries.
A tilt-table test can also be considered to evaluate for vasovagal syncope. If a drop in blood pressue is an issue, there are medications used to prevent a sudden decrease.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
To evaluate the heart and murmur, an echocardiogram can be considered to evaluate the heart and valve structure. If you are at risk for coronary disease, this can be done in conjunction with a stress test.
To evaluate the neurological causes, a CT or MRI can be done of the head, as well as an assessment of the neck arteries.
A tilt-table test can also be considered to evaluate for vasovagal syncope. If a drop in blood pressue is an issue, there are medications used to prevent a sudden decrease.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
BTW I am also a colon cancer suvivor, I was diagnosed and had colon resection over 12 years ago and have been clean ever since (thank the lord). Any advice would be great, Thanks
soarsy
Hiya, You are not alone at all. Although my dad has never had this I sure do. I am 36 years old and I was scheduled to get a pacemaker 3 weeks ago but apparently after I took the TTT (table tile test) I was sent home and was told to increase my salt intake. It is scary though, I have also found that all these incompassionate get over it anxiety talkers and I have alot in common except one thing. I PASS OUT! oh and I Flatline!!! Uh. . . Thats not anxiety, thats just scary. So just like you I am dealing with the fear, I won't take any medication that could supress my brain from teling my heart to wake up! Who knows. I may end up with a pacemaker. I am going to see a neuro spec before the end of the year, I will visit my cardiologidt and a Phsychatrist again before the end of the year. I am even going to see an ENT because one doctor says I have vertigo. (yea but Vertigo never made anyone pass out either) Let me know your progress. Ill keep you posted of mine. Thanks for the post. With peace andprayer Im with you all the way.
To All Those MD's I have seen. I know the industry is a business to you, The more patients you see the more money and everyone wants a piece of the pie. PLEASE help me get better and stop labeling me with some diagnosis and sending me home. I don't want to be sick, if you can't help me find someone who can.