HEART RHYTHM COMMUNITY
Question regarding my 15 year old,

Question regarding my 15 year old,

My daughter has had episodes of blacking out frequently, she passed out completly a couple months ago so I took her to the Dr. (I was diagnosed with Hypoglycemia when I was her age so I thought that was what she had).  The Dr. performed an EKG which came back abnormal, all her blood work was fine.  Took her to Cardiologist and had another abnormal EKG, normal echo, and was put on Monitor for 30 days.  The monitor picked her heart rates upto 175 bpm frequently when she was not active, etc, she also did not feel this other than being dizzy which is a common feeling for her.  The doc then put her on beta blocker.  We had 30 day follow up yesterday from being on the medicine, her symptoms have not improved at all and he thinks she has Vasovagal as well as tachycardia.  She is now on two medications to treat these symptoms and 30 more days with a heart monitor.  If her symptoms do not improve we will go see a Electrophysiologist.  I am worried, but it seems like these are treatable conditions.  Just curious if anyone else has had this problem and know what we can expect.  My daughter is 15 by the way, pretty scary for her.
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Avatar_m_tn
She can't feel the symptoms? Can you specify what was abnormal about the ECG? Did they do a 24 hour holter monitor on her?
I think you should be very very persistant in her treatment and insist to see the doc again.
Here are some suggested questions and things to ask of them:
-Give me a 24 hour holter!
-Give me an appointment tomorrow with the electrophysiologist!
-What exactly did you pick up on the ECG? Can you be certain that it is above the ventricles (ventricular tachycardias are generally more dangerous than those of atrial origin)
-Can you rule out Long QT syndrom (syndrome), Wolff Parkinson White or any of the other potentially dangerous conditions?
-Why is she passing out. I know you don't know, but what are the possibilities. If there are dangerous possibilities, why are we waiting 30 days in between visits?

I think that your daughter is likely just fine and that she will at most simply have to live as we do: fearful from time to time but not-to-bad-off-considering.
Keep us posted
-A
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Avatar_f_tn
If her GP and Cardiologist are saying her EKG is abnormal, I would definitely request an appointment with an EP specialist as soon as possible. While, as Stutterheart points out, it is likely that there is nothing of immediate concern (if they were aware of any major concerns the Drs probably would have done more testing immediately) if it is disrupting and frightening for both of you, why wait? Also, many EP specialists are so good at what they do that they can sometimes tell just by looking at an "abnormal" EKG what the problem might be. They then may, or may not, suggest an EP study, titl table testing, or other tests, but you can cross that bridge when you come to it.

Hopefully your Dr or pharmacist told you that Beta Blockers, while really helpful for many conditions (including arrhythmias and vasovagal symptoms) can lower blood pressure in some patients, which can sometimes make fainting worse. Not every patient finds relief from the first drug they try and many have to try several drugs to find one that works in their individual case.

Vasovagal fainting is not uncommon and there are several studies linking vasovagally mediated loss of consciousness with some types of arrhythmia, while in other cases it is either a familial tendency or just an anomaly, but it is certainly something I would want investigated further since there are other things that can cause fainting and I would think you would want to rule those out first. However, if it is Vasovagal, there are some steps your daughter can take (such as changing diet to increase fluids and salt intake, doing muscle tensing exercises to keep blood circulating, getting proper cardiovascular exercise and plenty of good quality sleep) that help some patients avoid these episodes, but I wouldn't want to be doing any of that without first seeing an EP specialist.

I began having arrhythmia in childhood and am now over 50, so your daughter is likely to live a normal, happy life -- especially these days when there are more options for treatment. But, it is also my experience that being well informed and pro-active as a patient ensures the best and most appropriate care so I, too, would encourage you to keep asking questions until both you and your daughter have found some the answers and support you need to feel your best about the situation. Good luck!
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Avatar_f_tn
Yes, I would definitely see an EP soon. If it is a heart rhythm condition this is the doctor you want checking it out. The good thing is that Betablockers help most arrhythmia problems. I fainted as a child and it was terrifying, causing a lot of anxiety. I was told at the time that I was just neurotic like my mother and sister, but it turns out we have a genetic heart condition called Long QT Syndrome and I now have a pacemaker/defibrillator (ICD). Better safe than sorry.
Good luck
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