Cardiac Migraines

[Karis]

OUR DAUGHTER IS 16 YEARS oLD AND IN THE PASS 3 WEEKS HAS FAINTED 3 TIMES. sHE HAS NEVER DONE THIS BEFORE.  sHE IS 5 FT AND WEIGHS 116 LBS, AND OTHERWISE VERY HEALTHY. sHE EATS A GOOD DIET. tHE ONSET OF THESE fAINTING SPELLS COMES AFTER SOME TYPE OF PYSICAL EXURSION (gYM AT SCHOOL, AND MARCHING OUTDOORS DURING bAND wHILE PLAYING HER FLUTE).  sHE IS TYPICALLY A VERY ATHLETIC cHILD/GYMNAST AND IN GREAT sHAPE.  tHE EPISODES BEGIN WITH A DREAM LIKE STATE, FOLLOWED BY HER HEART POUNDING (TO THE POINT WHERE IT HURTS), THEN SHE FAINTS FOR A FEW sECONDS.  wHEN SHE COMES TO SHE IS DISORIENTATED, sHIVERS (NOT JERKING),lIGHT IS A rEAL PROBLEM FOR HER, AND SHE HAS A VIOLENT HEADACHE, WHICH LASTS FROM 30-45 MINUTES, THEN SHE RETURNS TO NORMAL. sHE HAS HAD AN ekg, mri AND ALL KINDS OF bLOOD WORK...ALL NORMAL.  SHE IS SCHEDULED FOR tILT TEST, eXERCISE TEST AND SLEEP DEPRIVED eeg.  tHE dOCTORS HAVE SUGGESTED THAT SHE INCREASE HER SALT AND WATER INTAKE, ALTHOUGH HER eLECTOLYTE TESTS WERE NORMAL.  sHE HAS NO MEMORY OF FAINTING, BUT REMEMBERS NOT FEELING WELL BEFORE THE EPISODES AND THAT HER HEART REALLY pOUNDS.  wE ARE FEARFUL AS pARENTS THAT NOT EVERYTHING IS BEING CONSIDERED FOR HER WELL-BEING.  hAVE YOU HEARD OF THESE SCENARIOS BEFORE?  kARIS

[CCF-Neuro-M.D.-JT]

Whenever we see a patient for fainting episodes (or syncope) which is actually quite common, the two big causes that need to be considered are cardiological (heart problem such as a leaky valve or rhythm problem) and neurological (seizures, strokes, etc...)  Your concern is understandable, but it sounds like your daughter's physicians have initiated the proper workup and I'm glad that the MRI was normal. The suggestion that she take in more salt and water is  to increase the amount of fluid in her vascular system which would theoretically increase venous return to her heart and subsequently provide adequate blood/oxygen to her brain (not to replace any electrolytes). In the meantime, you may want to discuss driving with your physician as the law differs from state to state. Finally, she may need more prolonged EKG monitoring. Good luck.

[snowgoer]

I am sorry to hear about your daughter, I know you must be terrified! If other tests turn out okay for your daughter, then a holter monitor should definately be tried. This is sort of like a portable continuous EKG box that will record her heart tracing. This is usually used for a 24 hour period, but should be used until it captures her rhythm during one of these events. It is possible that she could have a problem with the "wiring" so to speak, in her heart. If this is the case, there are medications or simple procedures which can cure this. I hope she has seen a pediatric cardiologist who will be able to tell you more about this. Best of luck to you and your daughter, let us know how it turns out.

[Mysterious Stranger]

The EKG has apparently ruled out epilepsy.  Have migraines been ruled out?  Your description of her episodes is somewhat consistent with migraine.  Does she consume aspartame (Equal, Nutrasweet,diet sodas, sugar-free foods), and if so, how frequently a day?
    Also, does she ever seem faint when she coughs or uses the toilet?