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Near syncope?

jan
Dear Dr.,
I am a 44 yr. old female, I am 5'5" at 120 lbs. (+ a few lbs. from the holidays :) ).I exercise reg. I have mild MVP w/mild MR and mild TR, Inappropriate Sinus Tachy. and Neurocardiogenic Syncope. I take atenolol 12.5 mg (higher makes me feel as bad as I did before the meds) and verapamil 180 mg and a 1g salt tablet. My questions are about something that happened Thursday night. It started with waves of nausea in the afternoon, I thought at 1st it was pre-syncope,but that's all that happened at the time. During the night when I woke up (which isn't unusual), I had 3 waves of nausea and light-headedness in about a 1 minute period. I thought with each I was surely going to faint. I was real curious about this event because I was laying down. Can you faint laying down? Do you think it was the NCS or maybe I had a little something else going on? Do I need to bother my cardio about it (I really don't want to!)? Thank you.
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jan
Thanks for writing about your experiences with the ep study and the dentist. It's good to know. My cardio is an ep and the one I am scheduled to switch to in June is, also, an ep.
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Avatar universal
I feel the same way ie I've had alot of these episodes and I'm still going strong so I guess everything is OK.  If your Drs gets their act together and wish to send you to an electrophysiologist for an EP study, don't be too frightened.  I had one done here in Australia and it was NO hassle, I just slept through most of it.  It went for 1 hour and I was home that night.  The EP doc said he put my heart through the gammet (sp?) and it was fine.  It was a big relief, but that's just my personal experience.  BTW I went to the dentist this morning and had a BIG needle which was very painful...I almost passed out and had the usual NCS symptoms eg tachy, hot/cold lightheadedness etc.  It passed after a few minutes and a cold drink of water.  The dentist said it was not uncommon, especially in "fainters", so I guess you can have NCS symptoms whilst lying flat!
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jan
Hi! My bp use to be 90/60, when I hit 40 it went to 110/70. Since being on the meds it is anywhere from 100/70 (Mon. at PCP) to 133/88 , but has never been as low as 90/60 again. If I have another episode I will try to force myself to call my cardio., because I will need the peace. I was hoping to tell my neuro. because my cardio. wanted him to follow up on another kind of episode I had had just recently, but I think I fell thru the cracks,so... You know after awhile it gets tiring trying to keep up with dr.s, especially when they mess up and forget. I figure I lived thru these episodes, hopefully if they happen again, the same will hold true. I've never had an EP study and I don't want one either!
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Avatar universal
Jan - I think you should definitely tell your cardio, even if he/she is a pain, they know far more than your general practioner. My cardio thinks I am a nutter sometimes because I bug him whenever something wierd happens but I don't care.  My doc also thinks I may have had a viral thing but I think he generally assumes that because I have low BP at rest then this is to blame....do you have low BP as well as the NCS?  Have you had an EP study done to rule out dangerous arryhthmias?
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Avatar universal
jan
To whoever posted Near Syncope...in reply to my post,
I am not going to tell my cardio., the relation is too strained. So, if you find out anything, please post and let me know. I did mention it to my PCP and he said maybe I had a touch of the virus. Who knows? If it happens again I will "force" myself to tell my cardio., although my PCP said he would want to see me. I don't think my PCP should really be handling it.
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Avatar universal
Jan, you're the first person I've ever heard like me who has an overwhelming feeling of the need to go to the bathroom when you feel like fainting. I don't feel so strange now. It's a terrible problem when it happens. You imagine the paramedics will come in and find you on the floor passed out with your panties down! First hot then cold, then hot...I had many arrhythmias that I felt and that showed up on Holter monitor, and had an ablation this past year. It's been months without any feeling of faintness.
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Avatar universal
jan
Ro,
I don't have the bathroom/fainting thing going on. I am not sure where you got that idea, but I have seen others post that very thing and even seen it mentioned on different fact sheets.
What arrhythmias did you have an ablation for?
jan
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Avatar universal
Jan
I too have felt like fainting while lying down, I have the same feeling...one moment I am fine, the next thing I have waves of nausea and the usual hot and cold sensations (as well as the overwhelming need to use the loo). I have been diagnosed with NCS but I don't take B blockers because of asthma.  I was extremely worried it was sinus arrest or ventricular tachcardia, so I had an EP study.  all was normal, so my Dr said not to worry but I still do.  It only happens occassionally, but I am thinking about asking for a king of hearts monitor at my next appointment. Please post if you find out what's happening and good luck!
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Avatar universal
WJS
I think the problem might be in the low dosage.  I was very sensitive to it and 50 mg overwhelmed me.  Breaking the 25 mg in half was just about right for me.

I didn't really feel that it was necessary to wean of such a low dose, but perhaps I should have cut back more slowly.

I do think that you will find Atenolol to be the culprit in the end.

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Avatar universal
Pat
My family has a documented 5 generation history of syncope in adolescents.  We have the sort that seems to disappear after age 21.  The most recently diagnosed is my teenaged son.

The interesting part of the family history is that different things kicked off the syncope for each individual.  One was stress.  One was standing entirely still.  One was the common cold.  One was getting very tired.  The great, great aunt who is the first to be documented simply enjoyed it and would "faint" at the drop of a hat.  We know she had syncope because the "faints" were classic and then there were the other 4 generations following her.  I knew the woman and can promise you that she lived to enjoy 92 years of "frail" health.

One interesting thing about following something like this through a family is how the affected individuals and other family members approached/approach the problem.  There are a number of family stories that have been passed down and then there are the ones we're still making.  All of the stories are related as "funny stories."  My family seems to take frightening, stressful things and, after time has passed and we understand what's going on, defuse them by making them amusing.
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Avatar universal
Pat
My family has a documented 5 generation history of syncope in adolescents.  We have the sort that seems to disappear after age 21.  The most recently diagnosed is my teenaged son.

The interesting part of the family history is that different things kicked off the syncope for each individual.  One was stress.  One was standing entirely still.  One was the common cold.  One was getting very tired.  The great, great aunt who is the first to be documented simply enjoyed it and would "faint" at the drop of a hat.  We know she had syncope because the "faints" were classic and then there were the other 4 generations following her.  I knew the woman and can promise you that she lived to enjoy 92 years of "frail" health.

One interesting thing about following something like this through a family is how the affected individuals and other family members approached/approach the problem.  There are a number of family stories that have been passed down and then there are the ones we're still making.  All of the stories are related as "funny stories."  My family seems to take frightening, stressful things and, after time has passed and we understand what's going on, defuse them by making them amusing.
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Avatar universal
jan
Thanks everybody for your replys.
Pat,
It sounds like your family is dealing with NCS, all that you speak of would be typical for that. Fainting laying down,as the dr. said, is not typical with NCS. Seeing I am already being treated for one arrhythmia and that the meds I take for it can also cause arrhythmias, it's very possible it was just that - another arrhythmia. I am not terribly concerned about it, but I am taking care as my mother died of CHF and her family history isn't good either. Unfortunately I don't like my cardio. (and his blundering staff) and I was going to switch in May in time for my bi-annual check up. That makes it such a hassle.
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Avatar universal
jan
Dear Bill,
Thanks for your reply. I have already been diagnosed with dysautonomia. I was put on the atenolol because of the syncope and I feel so much better since being on it, that I can't imagine that's my problem. I am used to the syncope from the NCS, but that usually happens while I am in an upright position. That's why when this happened I thought I would post. As for your experience after stopping the atenolol, you didn't mention being weaned from it,so that could be what lead to your problem. You cannot stop it cold turkey.
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Avatar universal
WJS
Hi Jan,

I was put on 50 mg of Atenolol after an MI in July 1999.  I quickly reduced to 25 mg and then to 12.5 mg which I took for about 9 months.

I suffered several episodes of syncope.  The first was very severe.  I was extremely dizzy, nauseaus, and really thought that I was going to die.  I threw up for about 10 minutes and my heart rate sunk into the 40's.  

Other episodes seemed to be triggered by emotional of physical stress or sometimes just sitting down in the car.

After I was off of Atenolol for a while they seemed to stop.  In July I started taking the 12.5 MG again for a week while I was hiking at high altitude.

The first day that I discontinued Atenolol after coming down to normal altitude, I had a real bad episode.

I suspected the Atenolol, although it is sometimes prescribed for syncope.  I have never taken it again and have not had another episode, except I felt close a couple of times within the first month.

My laymen's opinion is that Atenolol desensitized my autonomic system.
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Avatar universal
It does indeed sound like near-syncope. It is possible to lose consciousness while lying down, though this is unusual with NCS. However, certain arrhythmia can cause fainting in any position. You should definitely bring these episodes to the attention of your doctor.
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