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Heart Disease (Expert Forum)
Help with vascovagal syncope/blackouts
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Help with vascovagal syncope/blackouts
by Lights Out, Sep 18, 2005 12:00AM
Thank you so much for your time. I’m a 39 year old female with vascovagal syncope. I don’t drink or smoke. I’ve had 4 black outs in the last 12 months, all which have lasted up to 10 minutes each. I’ve been told that my eyes are opened and my body is very stiff and I make moaning sounds. One occurred while standing, the others when seated. My cardiologist says that there is no way that these black outs are because of the vascovagal syncope but another doctor said that they are. I was referred to a neurologist to test for epilepsy, which came out negative. No one can seem to tell me for certain what is causing the black outs. Every doctor says “we’ll do a follow up in 6 months”. I went back to my family doctor and had them look at my medical history over the last 2 years. I’ve had numerous infections (folliculitis, cellulites, urinary track infections, stiffness of the neck & back, leg/foot pain, hand tremors, irregular dilation, serious change in my vision, and sleeplessness. He then put me on Metoptolol which after 2 days caused my blood pressure to drop. Now I'm on Paxil, which makes me sick to my stomach. What is the purpose of Paxil? I thought that was for stress or anxiety. I’m at the end of my rope. What could this be? I feel like no one really knows or maybe there is just no answer. These test have been done,Spinal Tap,angiogram,CAT scan,MRI,tilt table test,EKG,EEG. The tilt table was the only one positive. Where do I turn to next? Can the infections cause the blackouts? Everytime I have a spell I have sores on my face. Can you give me direction? Lights out
Doctor's Answer
by CCF-M.D.-MJM, Sep 18, 2005 12:00AM
Hello,
Sorry to hear about your black out, but you get an "A" for effort for having a sense of humor about it.
Syncope is a tough problem -- expecially vasovagal syncope. The positive tilt table suggests that VV may be the cause, but it depends a bit on how the doctor interpretted the results. Did you pass out? did your blood pressure drop and heart rate drop or did you blood pressure drop and heart rate increase or did heart rate increase preceed blood pressure drop? It is important to see the results and rhythm strips to see exactly how your heart rhythm responded. If you live near Cleveland, Dr. Fouad here at the Cleveland Clinic only sees syncope patients -- it is her forte.
What is the purpose of Paxil?
Many people that suffer syncope also have anxiety problems. Sometimes syncope is preceeded by anxiety attacks, most of the time not. Some doctors try paxil incase there is a strong anxiety component just to see if it helps. In some patients it makes sense and actually helps.
What could this be?
I would guess it is vasovagal syncope, but would need to see the tests or repeat them to know for sure.
Where do I turn to next?
I would see a doctor that specializes in syncope. Syncope is a tough thing to treat and sometimes even tougher to diagnose with certainty. Look for a specialist near your home or come see us.
Can the infections cause the blackouts?
Yes, but probably not with the frequency you describe. You tell me you have a fever and are dehydrated everytime it happens, maybe, otherwise, probabaly not in your case.
Everytime I have a spell I have sores on my face.
Do you mean from trauma -- from falling so quickly?
You have had a lot of different tests and it sounds like you are still searching for a definite answer. That makes me think it must be difficult to diagnose. Look for a specialists -- someone that says they have a particular interest in syncope. I think that is the next place to start.
Typically other things we do are a high salt diet, beta blockers,support hose, and midodrine. Other people may benefit from sensitization training if a particular trigger for syncope is identified.
Hope this helps -- good luck!
Sorry to hear about your black out, but you get an "A" for effort for having a sense of humor about it.
Syncope is a tough problem -- expecially vasovagal syncope. The positive tilt table suggests that VV may be the cause, but it depends a bit on how the doctor interpretted the results. Did you pass out? did your blood pressure drop and heart rate drop or did you blood pressure drop and heart rate increase or did heart rate increase preceed blood pressure drop? It is important to see the results and rhythm strips to see exactly how your heart rhythm responded. If you live near Cleveland, Dr. Fouad here at the Cleveland Clinic only sees syncope patients -- it is her forte.
What is the purpose of Paxil?
Many people that suffer syncope also have anxiety problems. Sometimes syncope is preceeded by anxiety attacks, most of the time not. Some doctors try paxil incase there is a strong anxiety component just to see if it helps. In some patients it makes sense and actually helps.
What could this be?
I would guess it is vasovagal syncope, but would need to see the tests or repeat them to know for sure.
Where do I turn to next?
I would see a doctor that specializes in syncope. Syncope is a tough thing to treat and sometimes even tougher to diagnose with certainty. Look for a specialist near your home or come see us.
Can the infections cause the blackouts?
Yes, but probably not with the frequency you describe. You tell me you have a fever and are dehydrated everytime it happens, maybe, otherwise, probabaly not in your case.
Everytime I have a spell I have sores on my face.
Do you mean from trauma -- from falling so quickly?
You have had a lot of different tests and it sounds like you are still searching for a definite answer. That makes me think it must be difficult to diagnose. Look for a specialists -- someone that says they have a particular interest in syncope. I think that is the next place to start.
Typically other things we do are a high salt diet, beta blockers,support hose, and midodrine. Other people may benefit from sensitization training if a particular trigger for syncope is identified.
Hope this helps -- good luck!
I have been diagnosed with NCS and am being treated for it. I've had this diagnosis confirmed by another EP at another university hospital.
I have, also, been diagnosed with E by 1 epileptologist, but it's doubted by another (many neuros believed I had E and NCS). One epi said the abnormal VEEG helped determine this, the other said VEEG didn't convince him. This has been gone on for over 4 years. I had a Reveal monitor implanted for 15 mos. to figure what was from the syncope and what was possible seizures.
I still have to be monitored by EEG, because they say my seizures may be deep enough not to register on EEG. A normal EEG doesn't mean you don't have seizures.
You might want to check out this link, a nice forum on epilepsy:
http://brain.hastypastry.net/forums/forumdisplay.php?s=&daysprune=&f=133