Need help

[Mom2four85]

Hi I'm new to this forum, but have been a member of the heart forum for awhile.  I had a head up tilt table test at the hospital due to dizziness; fainting, and lightheadedness since I was about 9 years old.

My HUTT results said I had Classic symptoms of neurocardiogenic syncope with cardioinhibitory and vasodepressor responses; Sinus Bradycardia and a Disorder of The Autonomic Nervous System Associated With Orthostatic Intolerance

BP 126/79 HR 77 - Start
BP 129/87 HR 101 - 20 min
BP 137/71 HR 109 Nitroglycerin given
By minute #4, the patient had a syncopal event with no palpable pulse and HR dropped precipitously to 20 bpm
BP 97/48 HR 78 - supine state

Any insight on what a possible diagnosis would be? Am I being obtuse in thinking that this is just a symptom of something else?   If I need a diagnosis for something, what direction should I take in searching?  What type of disorder/disease is this?

I do have Malignant ventricular arrhythmia's (V-tach/Vfib) and Non-Ischemic Cardiomyopathy with an ejection fraction of 45% which I had a cardiac ablation and a pacemaker/icd implanted.

Should I post this in another discussion or am I in the right place?

Thanks in advance for any help.

[Heiferly]

I absolutely agree that you need a new cardiologist/electrophysiologist pronto if the one you have now is not explaining things to you at all.  That's inexcusable.  Dysautonomia causes of syncope are diagnosed as "non-cardiac" causes of syncope so it needs to be clarified whether your cardiac issues are precipitating the syncope or not before you can have a clear diagnosis of NCS, etc.  That's something a cardiologist needs to sort out and explain for you since I don't think any of us here have that level of expertise in that area; we mostly know the dysautonomia side of things.

For a brief discussion of cardiac vs. non-cardiac causes of syncope, see Dr. Grubb's Overview on Syncope (Fainting) from Mechanisms to Treatments, here:

http://www.medhelp.org/health_pages/Neurological-Disorders/Further-Reading-on-Dysautonomia/show/696?cid=196

[Mom2four85]

Thanks for responding, this is really confusing trying to understand what's wrong with me when I haven't been given any information by my drs.  

I was given Midodrine and told my TTT was positive, but I thought that meant I had probs with my blood pressure.  I got all my results in the mail Sat, so now I have questions.

In June I went to my pcp and he sent me to a cardiologist; she did alot of different tests and sent me to an EP.  He did a HUTT, EPS w/ablation due to frequent complex pvc's (54,181 daily).   During the ablation he triggered long runs of polymorphic ventricular tachycardia, 3 different times that flatlined me,  and suspected either ARVD or cardiomyopathy.

His results were - Malignant ventricular arrhythmia's w/sudden cardiac death
my hospital release says V-tach, bradycardia; Syncope

He did a cardiac MRI & cath to rule out genetics & blockages.  I still don't have the results from the MRI and neither dr's office has them.  My EP suggested a pacemaker/icd either way and I had it implanted a few days after my ablation.

The results from my pm/icd implant show Non-Ischemic Cardiomyopathy with an ejection fraction of 45%, which is a 10% drop in about 6 weeks time.  I can only assume from these results that I did have CM instead of ARVD.

At this point, I'm ready to find another cardiologist after my f/u appt with her last Friday. Her office didn't have vital records they need, she didn't explain anything to me,  and rushed out the door like my questions weren't important and just put it off on my PCP.  

I want $350 of the $360 I paid for the visit back LOL think their office would go for that?

[AireScottie]

Hi!  Your tilt test certainly looks like neurocardiogenic syncope and orthostatic intolerance, but I don't have enough familiarity with your other heart problems to know how those would affect the results.  Most of us have electrophysiologists to deal with our POTS, orthostatic intolerance, or neurocardiogenic syncope.  Who's dealing with your test results right now?  What has s/he said about them?  It can be difficult finding someone familiar with these problems.  If you haven't already, check out all the great info under Health Pages in the upper right corner.