Passing out due to abnormal heart rhythm

I am a 23 year old male 6' 185 and have always been in good shape until I injured my back 2 or so years ago. I was just released from the hospital after passing out in the shower this morning.  Over the last couple of years I have noticed that occasionally my heart will beat abnormally and it will make me cough. The same thing happened this morning but when I coughed it didn't go away, my face went numb and I blacked out. After I went down, for how long I don't know, when I came to I tried to stand and blacked out again hitting my head on the side of the shower. I finally crawled out of the shower and laid on the floor until I could get up to get to the phone. They ran some tests an EKG and echo; all came back normal. They sent me home with monitor and told me to report in when something wasn't right.
Also when I was 16 I passed out driving home from football practice, they accredited this to being dehydrated. Coincidentally this is where I injured my back breaking L3 and L4 I have 2 bulged disks that have given me some nerve issues. I have had several epidurals and a nucleoplasty, spell check?, done to fix this. Once again right before all this happened I have been having back pains as well as upper back and chest pains. I though all this was due to nerves/muscle spasms. The day before I passed out I had a steroid epidural done. While I was being checked in during these my bp was high usually 150-155/ 110. I know there is a lot going on here but I am constantly tired and in pain, 3 years ago I was able to run, lift and lead an active life. So I have a couple of questions:

What symptoms would accompany heart problems that I should be paying attention to that are not being caused by my back?

I have 3 different specialists a cardiologist, pain management and spine, what questions should I be asking? And is there a chance all of this is linked together?

How serious are the heart problems and how common are they at my age?

[Brooke_38]

Hello...

I'm sorry to hear all that you've been through. You are so young to be going through all of this. There are many things that could account for your syncopal episode.

The few things that come to my mind are a vasovagal syncope related to chronic pain. There are many factors that could contribut to this kind of episode. Is this related to your heart? That is a tough call to make since it has not been confirmed by any type of monitoring.

As far as the EKG you had done which came back normal...if you were not experiencing any symptoms during this, it would be normal. When you have isolated rhythm disturbances, EKG's are really not the best diagnostic tool to uncover what could have caused this to occur.

You mentioned that you were given a moniotor, is this a holter (24 hour monitor)? Again, not the best to detect an underlying issue unless you are symptomatic everyday. For isolated symptoms, event monitors are usually the best to capture any significant alteration of the conduction system in the heart.


What symptoms would accompany heart problems that I should be paying attention to that are not being caused by my back?  There are many...A state of tachycardia can cause palpitations, rapid heart beat, shortness of breath, chest pain, dizziness, lightheadedness, fainting or near fainting. Premature beats may be felt as a "palpitation" or "skipped beat" or a "flip-flop."  Premature beats that occur often or in rapid succession may cause a greater awareness of heart palpitations or a "fluttering" sensation in the chest or neck.

All of this could be linked together with your injury. This would really be the Dr's call as to whether it is or is not.

What you have experienced does not neccissarily mean that you have heart disease. It could be some type of arrhythmia. What kind? Again, it is hard to say since it has never been seen on an EKG or monitor. These things can be expereinced by just about anybody at any age.

Since you have had 2 syncopal episodes that have had injuries result as a consequence, you really need to have this figured out. When you see you cadiologist you should ask about an event monitor. Another device that is used, especially with people who suffer syncope, is an ILR (internal loop recorder) this is an implanted type of event monitor. With syncope, it's pretty difficult to be interacting with a device when your passed out on the floor. The ILR does all the work for you.

Another thing to ask about is an Echocardiogram, if you haven't already had one. This ultrasound of the heart will let the Dr determine the health of your heart's chambers and valves as well as predict the EF (ejection fraction) of your heart.

Please keep us updated with any developments you have. In the mean time if there is anything more we can do to help you out please just ask:)

The best of luck to you!

[BOwnz]

Thanks for the advice, it was an event monitor that they put me on, forgot to specify. I went back in today and they ran some more blood work, and reviewed my echo and everything seemed fine. They also did a thyroid test thinking that would explain my constant fatigue and and unusual heart rate. So at this point I'm just waiting for some results - Thanks

[Brooke_38]

Thanks for the update. At least your Echo confirmed a healthy appearing heart. Have you had anymore arrhythmias?