HEART DISEASE EXPERT FORUM
desperate for help!!!

desperate for help!!!

My mother is in desperate need for help.  She is 56 y.o. and in the last 2 1/2 yrs has completely lost her normal life.  She started with recurrent syncope that, after a full year of it worsening, was diagnosed at Mayo as neurocardiogenic syncope.  She was told it was caused by a virus and to increase fluids and salt and she should improve after about 6 months.  3 months later, she came down with an Aspergillus (aspergillosis) infection in her lungs. (Of note, she had the same thing removed from sinuses 8 months before syncope began) They removed the fungus ball and started her on prednisone, augmentin, and an antifungal that she took for a month.  The syncope was profound during this infection and she was admitted to the ICU for 5 days.  As the prednisone doses increased (up to 60 mg/day), it seemed to raise her bp enough to stop the syncope for the next few months.  Then, the respiratory problems, syncope, and fatigue worsened again and she started having swelling of her throat.  The docs and ED all told her they can't do anything for it because Epi didn't help, so they weren't sure what else to try.  She went to Jewish National the first week of Oct. and was diagnosed with ABPA (allergic bronchopulmonary aspergillosis), but they could not find a cause for the throat swelling, either.  They started her on Symbicort, which she had a reaction to, so they lowered the dose.  They want her to start another antifungal, but with the reactions she's having to the Symbicort, they told her to wait until she's baseline.  Over the past 2 weeks, her health is dramatically worsening (syncope 4-5 x day).  She is fading right in front of us and there is nothing we can do!  Her doctors here tell her they are at a loss.  She is at the hospital right now in yet another attempt for some help and relief, but we know it will be another wasted trip with no answers.  Can anyone help us????  There has to be a doctor or specialist out there somewhere who knows what this is and how to help her!!  
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It sounds as if she is dependent on the exogenous corticosteriods, and when these are tapered she starts to experience syncope. Has she been worked up for addison's disease? If so and she does not have it then she may need a longer taper of steroids that does not cause her to syncope.
Of course there are many causes of syncope that you have not excluded yet. For instance she may have an unreliable pacemaker, or fast ventricular rhythms. In other words, if the characteristics of the syncope have changed, then she may need to be re-worked up.
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