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near syncope when standing
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near syncope when standing

Thanks for taking my question.I am 28 year old female with h/o IST(treated with 4 RF ablation to sinus node), and AAIR pacemaker insertion for slow juctional rhythm after 3rd ablation.I have been feeling pretty good and pacemaker has been in for almost 2 years.For some reason, I have noticed that whenever I crouch down(like to pick up something on the bottom shelf in the grocery)I black out whenever I go back to a standing position.It's only when I stand up from a crouched position with my knees bent.I black out(completely lose my vision) for about 5-10 seconds, then I recover.I have never fallen over or lost conciousness from this.I was painting a fence the other day and was crouched down for a long time, painting the bottom part and when I stood up I blacked out(but I was still awake) for about 10 sec. and this time I did have to grab onto something to keep from falling, but again did not pass out.I am not very concerned with this because I am used to it and can prepare for it to happen and it really doesn't bother me that much because I never pass out.Do you think it is my BP dropping upon standing?I check my BP occas. and it is always normal-110-120's/70-80's.I have never checked it immediatley after these episodes.I thought the pacemaker should prevent this from happening?The pacer is working great, I just had it checked at the beginning of March.They did up my lower rate to 80-is that to high for a lower rate?I feel fine with it at that rate.Should I just drink more water or up my salt intake?I am hesitant to tell my cardiologist because I feel like I bug him to much.
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239757_tn?1213813182
KAD.

Thanks for the post.

Im not sure what is causing your symptoms. It may be the shift in blood volume back to your periphery when you stand which micht cause a bit of orthostaisis. I would advise you to rise and stand from the seated position slowly. A pacemaker would not have sole control over this phenomenon as it is a combination of autonomic tone on the blood vessels  in combination with heart rate.  The rate settings are fine. I would discuss your symptoms with your physician as he/she will know you better than anyone.

good luck
5 Comments
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Avatar_f_tn
you shouldnt be scared to tell your cardiologist anything.. thats what hes paid for and thats what his job is... it sounds to me like low blood pressure, its common for people to get dizzy when standing up fast (alot of times its from dehydration) try drinking more water and eating more salt for a couple days and see if that helps.. otherwise ide probably see me doctor just to be safe.
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Avatar_n_tn
Hi,
I have had exactly the symptoms you discuss for, well, as long as I can remember. For me, its definitely the worst when I have been squatting with knees bent. I just never stand up directly from that position. I sort of straighten my legs slowly first, with my head low and then raise the upper part of my body slowly. Usually I just avoid squatting and just sit down on the floor. For me, I can get up from sitting on the floor just fine - the lightheadedness, blackout feeling only occurs after squatting.  My resting BP is usually about 115/65 and HR 60 or so. I think I may also have low blood volume at times, and I should probably be more careful about staying adequately hydrated. I've read that low blood volume can also cause, and/or mimic the rapid heart rate of panic attacks - which I also have. Best wishes, Andie
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Avatar_n_tn
I have neurocardiogenic syncope (and IST) and this happens to me.  Well, right now it rarely happens as I am being treated for it.  I was put on bb's and a salt tab.  I gave up the salt tab and just make sure to salt my food, and to keep hydrated as best I can.  Just be sure to get up slowly.
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Avatar_n_tn
I've been looking for answers to the fatigue and weakness when getting up from a crouching position.  If I bend over too much or crouch down too long I am wiped out for a number of hrs.
I have mitral valve disease and am reassured that this is a common symptom.   Will also try and stay better hydrated.
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