Blackouts accompanied by Chest Pain

I am a healthy 26 year old female. I do not smoke or drink and am an Asian vegetarian. Over the last one year I have had two complete blackouts, each lasting for about 10 seconds. In the first episode, I was seated in a chair drinking water and felt a strong wave of pain in my chest. The next thing I knew I had fallen off my chair. I had lost sense of time during the attack and my mother who was around when this happened told me the attack lasted for around 5 to 10 seconds. Also I did'nt seem to respond to her. The second attack happened last month round. This time I was walking (within my apartment) and I felt chest pain. I could immediately recognise the symptoms and tried to get back to my room before I fainted. However, I did black out before reaching my room and my friends helped me to my feet. This time I also noticed that I seem to have low BP (I always seem to have low BP - even my normal BP is 126/66) and chest pain seemed to linger long after the attack.
These fainting spells have happened to me before too, and the keyword has always been a very strong stab of chest pain.
I have had a complete health check up done - blood tests (Diabetes, Thyroid), ECG, PFT, Ultrasound, Stress Test (TMT), EEG, Carotid Dopler. Everything is normal. But I do not feel normal.

[Sara Khan]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

With your symptoms, I would be more concerned with problems with the heart rather then the brain. Have you seen a cardiologist or had an Echocardiogram??  If it always starts with chest pain, it is possible that something happens with the heart, which results in decrease blood pumping to the brain which subsequently causes you to faint. Problems with the heart can include transient rhythem abnormalities or structural abnormalities. Sometimes problems with the rhythem can only be diagnosed after your heart is monitored for a long duration. This can easily be done by an ambulatory monitor called the holter monitor.

As far as neurology is concerened, it could be very rare for seizures to present like this. The chest pain could be an "aura" or a feeling that warns about the coming seizure, and the loss of consciousness could be the seizure. Unfortunately in between episodes the EEG may be completely normal. Again you may have to be monitored for a longer period of time to actually catch these spells and record them.

I would suggest that you start of by seeing a cardiologist. Once issues with the heart are ruled out, then the next step would include neurological testing.

I hope this helps. Good Luck!