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Heart Disease (Expert Forum)
Fainting - Is this a problem?
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Fainting - Is this a problem?
by MarkSw, Sep 21, 2002 12:00AM
I have fainted with almost no warning on 4 occasions over the last few months. In each case I have quickly regained consciousness without any lasting effects. On two occasions this occurred in public shortly after a meal, which scared my fellow diners. On the other two occasions it was at home, once in the bathroom, and the other while working at my computer.
The pattern seems to be first a feeling of dizziness, I am sweating profusely and feeling generally unsteady. The onset in rapid and I black out completely within the next one to two minutes. On one occasion I was aware of tunnel vision a few seconds before fainting.
I am told that I regain consciousness quite fast once I am on the floor, in any event enough to head off those around me from calling an ambulance. Although I can't know this from my own experience, I guess that we must be talking around 30 seconds of unconsciousness.
When I come to at first I have no knowledge of where I am or how I got there. I am feeling quite contented with no pain. Full feeling and awareness quickly return, probably within one to two minutes, although I never actually remember the point of passing out.
Once I have recovered I feel perfectly fine, no pain, no shortage of breath, normal heartbeat etc. The only symptom is a slight headache.
On one occasion I took my blood pressure shortly afterwards. The reading was slightly low at 110/65. I take Atenolol for hypertension (v. effective). I am 47, male.
I am concerned lest this is symptomatic of some kind of intermittent heart problem.
The pattern seems to be first a feeling of dizziness, I am sweating profusely and feeling generally unsteady. The onset in rapid and I black out completely within the next one to two minutes. On one occasion I was aware of tunnel vision a few seconds before fainting.
I am told that I regain consciousness quite fast once I am on the floor, in any event enough to head off those around me from calling an ambulance. Although I can't know this from my own experience, I guess that we must be talking around 30 seconds of unconsciousness.
When I come to at first I have no knowledge of where I am or how I got there. I am feeling quite contented with no pain. Full feeling and awareness quickly return, probably within one to two minutes, although I never actually remember the point of passing out.
Once I have recovered I feel perfectly fine, no pain, no shortage of breath, normal heartbeat etc. The only symptom is a slight headache.
On one occasion I took my blood pressure shortly afterwards. The reading was slightly low at 110/65. I take Atenolol for hypertension (v. effective). I am 47, male.
I am concerned lest this is symptomatic of some kind of intermittent heart problem.
Doctor's Answer
by CCF-M.D.-RCJ, Sep 21, 2002 12:00AM
MarkSw,
Thanks for the question.
Your limited description of the episodes is classic for an arrthymic cause of the blackouts (syncopal spells).
You need prompt medical evaluation. If a spell happens over this weekend, you need to be seen at the nearest Emergency Room. Given that these have been happening over the past few months and given that you have not suffered any ill effects from these spells, I think it is probably ok to wait until Monday to contact your doctor about these spells. However, you need evaluation this week at the latest.
The cause could be something as relatively benign as atrial fibrillation with RVR, to something more concerning such as Vtach or Vfib.
Heed my advice on this one.
Thanks for the question.
Your limited description of the episodes is classic for an arrthymic cause of the blackouts (syncopal spells).
You need prompt medical evaluation. If a spell happens over this weekend, you need to be seen at the nearest Emergency Room. Given that these have been happening over the past few months and given that you have not suffered any ill effects from these spells, I think it is probably ok to wait until Monday to contact your doctor about these spells. However, you need evaluation this week at the latest.
The cause could be something as relatively benign as atrial fibrillation with RVR, to something more concerning such as Vtach or Vfib.
Heed my advice on this one.
There are various triggers for Syncope events. One of mine was sitting down in the car, which is not a good one. Of course syncope can be very dangerous.
Try another class of blood pressure med such as an ace inhibitor or calcium channel blocker.
Don't hesitate get checked out.These forums are not for diagnosis, only suggestions
It has been my understanding that Vfib is a lethal rhythm, which will result in death unless prompt defibrillation is administered (electric shock).
Is my understanding wrong? Can a person go into Vfib, come out spontaneously and live?
Even if that is the case, shouldn't such a person get definitive treatment ASAP, because in a whole lot of cases the patient isn't so lucky. Over a quarter of a million people dead from sudden cardiac arrest this year. (see http://www.padl.org/).
Anyway, if you have symptoms which are alarming (as the questioner did), call a doctor ASAP. Don't use the Internet then. Better to be overcautious than undercautious and dead.
However this doesn't explain the fainting, which remains a concern because the fainting obviously could be dangerous in itself, and also could still be symptomatic of some intermittent problem. I intend to ask my doctor about whether a portable monitor would be appropriate.
My dosage of Atenolol is currently 50mg, which is dramatically effective: BP down from ave 180/100 to ave 120/80, heart rate down from widely fluctuating range 60-120 to range 45-60. Since I am now being told that there isn't anything basically wrong with my heart (not readily detectable anyway) I am wondering whether in my case the Atenolol is just too much of a good thing, that is at times my heart is so damped down by the drug that it simply isn't responding fast enough to increased demands (e.g. diversion of blood flow to digestive system after a heavy meal combined with standing up).
I am loth to come off Atenolol entirely because it is simply so effective after the diurectics that I tried, which in my case were useless. Also I normally have no side effects from it, and despite my slowed down heart I have plenty of energy, wedding tackle still works etc. Are there lower dosage tablets available? Perhaps 25mg would be effective enough for me? (I am 180lbs, 6 feet tall). Any opinions?
They do have a 25mg pill and you can split the 50mg, but that may not solve the problem. Your autonomic system may be too sensitive to it.
There are a lot of different BP meds. I had to try a few until I found that a combination of Altace (ACE inhibitor) + Norvasc (calcium channel blocker) was effective for me with no noticable side effects.
There are other non-medical things that you can do to help BP also.
If you do get off Atenolol, you need to taper off. You should check with your doctor on that.
They said it was the clariton D that he was taking for allergies to our cat so he stopped taking it. He even did a tilt table but it was inconclusive. About three months later he blacked out again after dinner walking down the sidewalk on vacation. an hour later sitting down at home he blacked out again. He has blacked out sitting down, laying down, and standing up so there is no apparent pattern. At this point I became extremely worried. I have had him see numerous cardiologist and he had more blood tests to check his thyroid, he had an echocardiography, he even has been wearing an event recorder to record him after he blackes out but it's been 6 weeks and they want it back which does no good cause the usual pattern is three to four months in between blackouts. The cardiologist thinks it a neurological problem. The neurologist did an EKG to test if there was any seizure activity. He had one done in the hospital after the first episodes in March as well and they show nothing.
She thinks he's having seizures possibly from a bad skateboard accident that he had a couple years ago but the test don't show seizure activity. My Husband is stubborn and done with tests. He's allowed me to drive him for the last 6 weeks but without any test proving anything he's going back on the road. I know there must be an explanation for these fainting spells. Could it actually just be stress. The Doctor's can't actually detect anything causing it. I don't know where to go from here. He is a hairdresser. He's on his feet long hours a day. He's been doing this for about five years. He's around chemicals all day. But no new chemicals. I don't know what to think????