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Heart Disease (Expert Forum)
Re: Pre-Syncopy
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Re: Pre-Syncopy
by Cleveland Clinic, MD, Jan 01, 1995 12:00AM
, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - CRC on February 22, 1999 at 14:16:12:
In Reply to: Pre-Syncopy posted by Danielle on February 19, 1999 at 13:59:39:
I started taking Paxil for Depression and Anxiety about 5 weeks ago. I am currently taking 20mg daily and have been feeling pretty good. Earlier this week I had an episode where I got out of bed, went to the bathroom and went and sat down. After about 10 minutes from the time I got up, I got extremely nauseas (while still sitting down), then I started to sweat, heart started beating fast. My head went all spacey, I started to lose my vision, hands were sweating and going numb. I laid down until the feeling passed but then felt very weak and I heard "rushing water" in my ears. Today, I was still in bed just coming out of sleep and it happened all over again. I know you can get lightheaded if you get up to suddenly, but this time I was barely awake. This happened to me over a year ago at the same time of day but the doctor said it was a vaso vagel reaction due to a hemorroid. I was getting anxiety attacks and I have fully fainted before from the flu and I can tell the difference, this was not an anxiety attack but a purely physical reaction to something, but I don't have the flu. I currently have a psychiatrist and I saw my PCP in November and had a CBC which was normal. She had detected some sort of heart abnormality which she attributed to the anxiety. Also had an MRI of the brain and EEG last year, also normal. Any ideas? I concerned that this happened 2x in one week.
Dear Danielle,
The medical term for what you are describing is syncope (or near syncope if one dosen't actually pass out). This is a common but complex condition that has many causes. The most common cause is the common faint (neurocardiogenic or vasovagal syncope). This is the typical faint caused by strong emotional factors (i.e. the sight of blood) and is usually brief in duration. The person almost never harms themselves and the precipitating factor can usually be identified. More serious forms of syncope are due to cardiac and neurologic causes.
Syncope due to bradyarrhythmias (slow heart rate) or tachyarrhythmias (fast heart rates) are often hard to document. Holter monitors will only reveal the source if they are being worn during an event. "Event monitors" are devices that can be worn for months at a time and when an event occurs a button is pressed that saves the heart rhythm for the last 5 minutes. This can then be sent to the doctor over the telephone for a diagnosis. Other less common cardiac causes are carotid sinus irritability which is due to an abnormal structure in the neck that results in syncope when pressed upon.
Neurologic forms of syncope include autonomic nervous system diseases and seizure disorders. These are diagnosed with tilt table testing and seizures with an EEG.
As you can see the diagnosis is somewhat complex. Therefore, I would recommend that you see a specialist in the area of syncope. Two doctors that specialize in this area here are Dr. Fred Jaeger and Dr. Fetnat Fouad. You can make an appointment with either of them by calling the number below. Good luck.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
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.
In Reply to: Pre-Syncopy posted by Danielle on February 19, 1999 at 13:59:39:
I started taking Paxil for Depression and Anxiety about 5 weeks ago. I am currently taking 20mg daily and have been feeling pretty good. Earlier this week I had an episode where I got out of bed, went to the bathroom and went and sat down. After about 10 minutes from the time I got up, I got extremely nauseas (while still sitting down), then I started to sweat, heart started beating fast. My head went all spacey, I started to lose my vision, hands were sweating and going numb. I laid down until the feeling passed but then felt very weak and I heard "rushing water" in my ears. Today, I was still in bed just coming out of sleep and it happened all over again. I know you can get lightheaded if you get up to suddenly, but this time I was barely awake. This happened to me over a year ago at the same time of day but the doctor said it was a vaso vagel reaction due to a hemorroid. I was getting anxiety attacks and I have fully fainted before from the flu and I can tell the difference, this was not an anxiety attack but a purely physical reaction to something, but I don't have the flu. I currently have a psychiatrist and I saw my PCP in November and had a CBC which was normal. She had detected some sort of heart abnormality which she attributed to the anxiety. Also had an MRI of the brain and EEG last year, also normal. Any ideas? I concerned that this happened 2x in one week.
Dear Danielle,
The medical term for what you are describing is syncope (or near syncope if one dosen't actually pass out). This is a common but complex condition that has many causes. The most common cause is the common faint (neurocardiogenic or vasovagal syncope). This is the typical faint caused by strong emotional factors (i.e. the sight of blood) and is usually brief in duration. The person almost never harms themselves and the precipitating factor can usually be identified. More serious forms of syncope are due to cardiac and neurologic causes.
Syncope due to bradyarrhythmias (slow heart rate) or tachyarrhythmias (fast heart rates) are often hard to document. Holter monitors will only reveal the source if they are being worn during an event. "Event monitors" are devices that can be worn for months at a time and when an event occurs a button is pressed that saves the heart rhythm for the last 5 minutes. This can then be sent to the doctor over the telephone for a diagnosis. Other less common cardiac causes are carotid sinus irritability which is due to an abnormal structure in the neck that results in syncope when pressed upon.
Neurologic forms of syncope include autonomic nervous system diseases and seizure disorders. These are diagnosed with tilt table testing and seizures with an EEG.
As you can see the diagnosis is somewhat complex. Therefore, I would recommend that you see a specialist in the area of syncope. Two doctors that specialize in this area here are Dr. Fred Jaeger and Dr. Fetnat Fouad. You can make an appointment with either of them by calling the number below. Good luck.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
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.
