Methods of treating NeuroCardiogenic Syncope

I am a 26 year old female who has been dealing with Neurocardiogenic syncope for atleast 5 years.  I got real bad with my last pregnancy then got better for a while.  A couple years after that it all started again but wihtout pregnancy being involved. I finally found a Cardiologist that could tell me why I was passing out.  After a tilt table test it was confirmed as NCS.  I have been on 50 mg Toprol .2 mg florinef but now it is time to try to get off the Florinef and my body doesnt agree. I am back to passing out and I am extremely exhausted.  I cant work bc of this and I am tired even if I am not passing out.  They put me on Paxil this week to see if that will help to get off the Florinef.  I am back on .1 mg of Florinef until the Paxil is in my system and then I will go backwards with it again.  DO I have to go off Florinef? It seems to work and I was doing so well.  Being a mother of 2 young kids this is so hard for me and my family.  Are there any other suggestions I can try?  They say last resort would be a Pace Maker and that scared me to death.  Other than the outragous weight gain the Florinef has caused it works.  I wish I could just be skinny again and stop passing out.  My BP is usually very low and on average my heart rate is about 90-110.

Any information would be helpful.  Even ideas of food I can eat to keep up my sodium.

[Cleveland Clinic]

jdjjkd,

There really is no great way to treat NCS.  Some people respons to a variety of different treatments such as paxil, florinef, or a high salt diet. Im not sure why you are stopping florinef if it works.  You should discuss this with your physician.  

Pacemakers really are not effective unless you definitely can correlate a very bradycardic (slow) rhythm associated with your symptoms. Even then the efficacy of a pacemaker is not clear.

Other possible treatment options include fluid and salt loading, isometric muscle changes, and tilt training.

If your symptoms are truly this severe I would recommend you seek evaluation in a clinic specially geared towards syncope. We have on in our electrophysiology division here at the clinic and many tertiary referral centers also have them


good luck

[Med Help]

Never stop taking a medication without the knowledge of your personal physician!  Stopping the use of beta-blockers suddenly, can have very serious consequences such as chest pain or even heart attack.

If your doctor decides you should stop taking a beta-blocker, he or she will instruct you in how to slowly reduce your dose over a period of time before stopping it completely!

Med Help International

[mika_k]

You should ask your doctor about midodrine (brand name is proamatine).  My sister has neurocardiogenic syncope and it has been a life saver for her.  I think it works by raising your blood pressure while you are standing.  She was able to stop florinef and rarely passes out now.

[jaime_erin]

I'm 22yrs old and this fall I was diagnosed with NCS.  I was put on Midodrine over a month ago.  Since being put on Midodrine I've felt the best I've felt in months prior.  Some side effects are a little frustrating but they are easy to handle.  But, there are the "bad" days recently I awoke very sick to my stomach and on my way to the bathroom I notice my warning signs that I would soon faint.  I sat down and was able to get a hold of my nurse (I live on a college campus) and she laid me down and took my blood pressure.  The top number was in the 80's they sat me up and I started feeling faint agian and they took my blood pressure again and it was in the 70's and lowering.  Is this frustrating absolutely I wonder why it shows up so suddenly after being a healthy teen but I deal.  The medicine is great but I do have bad days even now.  The good days are really good but the bad days really stink.  I would recomend the Midodrine if you would talk to your doctor and see what they say about it.