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vaso vagal syncope and tachicardia spells
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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vaso vagal syncope and tachicardia spells

Hi, i am a mother of two children that have been diagnosed with VASO VAGAL SYNCOPE, my son was diagnosed with it when he was 8, and he is now 12 , and my daughter was diagnosed with it at the same age and she is now 9. when he has a syncope spell , his blood pressure and heart beat drop very low , but only warning signs of a spell coming on is he gets really bad stomach pains or hears the ringing in his hears. My daughter gets very sick to her stomach with stomach pains and then severe chest pains start and last up to 10 minutes.. They have both had Tilt Table Test, that turned out positive for vaso vagal syncope , but when my daughter has a episode , her heart goes into tachicardia which leads to severe chest pains and shortness of breath .. she has had the treadmill test which shows as heart beat increases she has a harder time breathing ..she was on atynolol and florinef for the last  year  , she wore a event monitor for 4 months , that shows tachicardia episodes while sleeping and while awake , and not all tachicardia episodes led to her passing out , just gave her alot of chest pain ..the doctors are still saying vaso vagal syncope... My question is why is her and my sons diagnoses the same if everything about their spells are so different .. and should i have them seen by another cardiologist..My son has started having severe leg pain and cant stand for long periods of time , before pain starts with dizziness.
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773637_tn?1327450515
Dear Southerneyes,

Without evaluating your children, it is difficult for me to say exactly what is going on here.  However, there are a few things that should be done for both of your children in the treatment of syncope, or fainting.  The first is to ensure that they have adequate fluid intake, with 32 to 48 ounces of fluid on a daily basis.  They should also have a salty snack, not skip meals, and limit caffeine intake.  This helps the majority of patientsn with simple vasovagal syncope.  Medications, such as Florinef (a steroid that helps the kidneys hold on to salt), atenolol (a beta blocker that can sometimes help to counteract the abnormal autonomic nervous system response), and midodrine (a medicine that helps to directly increase blood pressure), can all be helpful for this.  However, if they are both symptomatic despite medications, I would be concerned that they may have postural orthostatic tachycardia syndrome (POTS), which is a severe malfunction of the autonomic nervous system, or dysautonomia.  These patients have more than just typical fainting seen in adolescents, and often have other symptoms including severe fatigue, chest pain, headache, difficulty with concentration, chronic pain, exercise intolerance, heat intolerance, and other problems.  You may want to look at two different website for more information:  the Dysautonomia Information Network (www.dinet.org) and the Dysautonomia Youth Network of America (www.dynakids.org).  These sites will have more information regarding associated symptoms.  If you feel that your children’s problems are consistent with this syndrome, you should discuss this with your cardiologist.  And, if your cardiologist is not familiar with POTS, you may consider seeking a second opinion with one who is.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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