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Heart Disease (Expert Forum)
Dizzy spells and HOCM
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Dizzy spells and HOCM
by Dolly, Aug 18, 1999 12:00AM
My 9 year old son has severe Hypertrophic Obstructive Cardiomyopathy. He was diagnosed 4 years ago following a routine kindergarten physical. Since his diagnosis he has been on a steady decline. His medical history and records for the past 4 years are VERY long so I will not try to give the complete story here. (you can read the whole story and all details at http://www.geocities.com/HotSprings/Villa/3835 on the *Story* and *Updates* pages)
This is a VERY brief summary. He was diagnosed in 1995. At that time his septum measured 2.5cm, his LVOT gradient was at 25mmHg, mild mitral valve regurgitation, long QT and many other electrical abnormalities. He was immediately put on Beta Blockers which he continues to take today. 4 months later he had a follow up echo which showed worsening of his HOCM (both septum growth and increase of LVOT gradient). A cath was then done to confirm the echo results. It confirmed the echo results. His septum at 3cm and the LVOT at 71mmHg. A septal myectomy was performed in February 1996 with good results. His LVOT dropped into the teens, but he continued to have chest pains.
In April of this year he started having symptoms again; shortness of breath, fatigue with activity, cyanotic and more severe chest pains. Tests were done, including an echo and thallium stress test. The echo showed much progression of the disease with worsening of his septum size, mitral valve regurgitation and electrical abnormalities. The thallium stress test showed lack of blood supply to the heart. A cath was then done to check the coronary arteries, but they looked fine. The results of the myectomy were still good, with the gradient in the 20s.
We were told on a scale of 1-10 he is at a 10 and is very high risk for sudden death, BUT they were at the end of the road as far as treatments for him. We were informed the only option left was an ICD implant for security. We were also told there is a chance it might not be enough to save him in the event of an arrest. His ICD implant was on June 23 1999. ( I also should mention his cousin died in 1994 at the age of 7 from sudden death due to HOCM)
Finally on to my question. He has just started experiencing dizzy spells this week. I know dizzy spells are common with some HOCM patients, but he has NEVER had them before. Each time he has had an episode was when he was sitting down and stood up. They have lasted a long time (appr. 15 minutes) and his legs get weak and shaky. Being as getting dizzy is common for HOCM patients, and even for healthy people who just stand up too quick, I have been hesitant to call his cardiologist.
Any suggestions? Since this is a new symptom for him could it possibly be a problem with his ICD settings?
Thank you for your time!
Dolly
This is a VERY brief summary. He was diagnosed in 1995. At that time his septum measured 2.5cm, his LVOT gradient was at 25mmHg, mild mitral valve regurgitation, long QT and many other electrical abnormalities. He was immediately put on Beta Blockers which he continues to take today. 4 months later he had a follow up echo which showed worsening of his HOCM (both septum growth and increase of LVOT gradient). A cath was then done to confirm the echo results. It confirmed the echo results. His septum at 3cm and the LVOT at 71mmHg. A septal myectomy was performed in February 1996 with good results. His LVOT dropped into the teens, but he continued to have chest pains.
In April of this year he started having symptoms again; shortness of breath, fatigue with activity, cyanotic and more severe chest pains. Tests were done, including an echo and thallium stress test. The echo showed much progression of the disease with worsening of his septum size, mitral valve regurgitation and electrical abnormalities. The thallium stress test showed lack of blood supply to the heart. A cath was then done to check the coronary arteries, but they looked fine. The results of the myectomy were still good, with the gradient in the 20s.
We were told on a scale of 1-10 he is at a 10 and is very high risk for sudden death, BUT they were at the end of the road as far as treatments for him. We were informed the only option left was an ICD implant for security. We were also told there is a chance it might not be enough to save him in the event of an arrest. His ICD implant was on June 23 1999. ( I also should mention his cousin died in 1994 at the age of 7 from sudden death due to HOCM)
Finally on to my question. He has just started experiencing dizzy spells this week. I know dizzy spells are common with some HOCM patients, but he has NEVER had them before. Each time he has had an episode was when he was sitting down and stood up. They have lasted a long time (appr. 15 minutes) and his legs get weak and shaky. Being as getting dizzy is common for HOCM patients, and even for healthy people who just stand up too quick, I have been hesitant to call his cardiologist.
Any suggestions? Since this is a new symptom for him could it possibly be a problem with his ICD settings?
Thank you for your time!
Dolly
Doctor's Answer
by CCF CARDIO MD - DLB, Aug 18, 1999 12:00AM
Dear Dolly
First of all, you should tell his pediatric cardiologist about these important symptoms. It should not be related to the ICD, as the device is only active when it detects certain types of arrhythmia. The dizziness could be related to an arrhythmia of the sort not treated by ICDs. Most likely, the dizziness on standing represents the effects of worsening HOCM in the ability of his heart to pump blood around the thickened septum.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
First of all, you should tell his pediatric cardiologist about these important symptoms. It should not be related to the ICD, as the device is only active when it detects certain types of arrhythmia. The dizziness could be related to an arrhythmia of the sort not treated by ICDs. Most likely, the dizziness on standing represents the effects of worsening HOCM in the ability of his heart to pump blood around the thickened septum.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Member Comments (1)
by debwat, May 27, 2009 09:40PM
A related discussion, Is there anything else I can do for HCM after septal ablasio and septal myoctomy was started.
