help .. please

[OKboogie]

I'm a 30 yr old male,  I started having tachycardia bouts that was leading to syncope, frequent palps, often the palps are brought on by taking a deep breath,.....well,  they wanted to take me into the EP lab for a study, but I just don't know if that's right....by my own observation I get in these "lightheaded modes" to where i'm constantly lightheaded for hours,  even if not tachycardic

I feel this constant indescribable feeling in my gut/chest 24/7 like I'm falling , that rush of a feeling you would get on a roller coaster, this is the WORST symptom by far...constant malaise / nausea, it's hard to describe but it's intense, i can't pin a single word to describe on it

My fiancee is a nurse and she has taken my orthostatics and often but not always my pressure will be systolic 20-30 points HIGHER when standing  especially when I'm in that lightheaded / tachycardic mode and then the least disturbance makes my pulse go up as if I have some sort of overly hypersensitive adrenal receptors,    I have also had increased fatigue, inability to hold a deep breath or strain without quickly fainting,  and bad headaches.

I have had the standard obligatory CBCD, CMP, lytes, TSH and T4's (not the free T4's or T3s)....Chest xray, Echo, EKG...The tachycardia looks like plain old sinus tach I guess...
How would you suggest I take this thing on?  I am definitely not ready for the EP lab, it doesn't make sense in my mind to do that yet especially with all the other weird symptoms...do you agree with me?  if so, what can I do?  
Should I get a tilt table test or something,  or any special labs that aren't the standard?  What about sleep apnea or something else so obvious it's overlooked?  Or the rare stuff like orthostatic syndromes, POTS, etc?   As you can see I am clearly lost and need help.  I even need help describing my symptoms ...

[MILTJ]

Hello,
   Correction...diagnoses for the vertebral artery was either by 3D ultrasound or MRI, I'm just not sure which one.I just know it's was in 3D.Sorry that I can't give you more info.

[MILTJ]

HCOM, which is Hypertrophic Obstructive cardiomyopathy. Patients with obstruction have a blockage inside the heart that results in the heart overworking as it pumps blood to the body.Which inturn causes my symtoms. HOCM used to be called IHSS or (Idiopathic Hypertrophic Subaortic Stenosis)  Cardiomyopathy.The narrowing of the vertebral artery was diagnosed with a 3D MRI .It contributed in part, but not just that one thing, it is thought to be all three that contributed to my problem.I must tell you that when I was 4 , I was diagnosed with cancer on my vocalcord and I recieved 4 times the dose of med to my neck and parts of my upper chest. That was more than an adult would get now today.Just to be alive today is a blessing.

[blookie]

Let me ask you a few things before we continue, then I will check back here soon...What is HOCM?    How was your narrow vertebral artey diagnosed, was it by ultrasound or MRI?     DId your doctor think the narrow vertebral artery was contributing to your symptoms in a major way?

[MILTJ]

I'm not a member..., just trying to find some answers .I've been dealing with my condition since about the age of 8 and since 2001,after a heart attack I'm 40 now and it has only gottten worse.From palpatation,difficulty breahting,pressure in my head and chest,fatigue,suddenly stop and cant move when walking,if I continue then syncope, because my blood pressure suddenly drops.I was told by my Dr. in Houston that I had a Narrow Verebral Artery,Subclavian Steal and HOCM.What can I do...,PLEASE HELP!!!!!!!!!!!!!!

[Cleveland Clinic]

It sounds clinically that you have POTs syndrome, although not all of the symptoms are related to this disorder and some of it may be neurological in nature. These episodes of feeling as if you are falling are almost certainly not cardiac in nature, and I suggest that a head CT or even a brain MRI be performed to exclude auto-immune disorders or tumors in the cerebellar-pontine junction.
Once this is sorted out, a tilt table test can be performed to assess what your actual problem is: is this a volume issue or a vasodilatory issue or are you prone to pauses. All of these can happen, even in combination and they are generally treated differently. If the medical treatments fail then you may be a candidate for an EP study, but I don't think this should be the first step.