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Syncope, arm numbness, chest pain, shortness of breath, dizziness, normal BP
As my ID indicates, I am at wits end with researching my wife's condition. I pray that a fresh pair of eyes sees this post and can offer us some insight.
Background:
My wife, caucasian, 27, was admitted to the hospital in March 2003 after fainting while sitting with me on the couch (watching TV). Her BP was a bit high for her. She had many tests: EP study, EKG, chest MRI, Stress Echo. Everything "normal". She failed the tilt-table. Diagnosis: Neuro cardiogenic syncope. Treatment: Celexa, 20mg daily. NO pacemaker implanted.
NOTE: This does not seem to be stress related. Also, this happens when sitting, standing and lying down.
Back in the hospital a few weeks later. Added 10mg Celexa and Florinef (spelling?) to raise BP.
Symptoms:
She sporadically has "episodes" where she gets VERY dizzy, has chest pain (described as "cramping"), varying pulse, shortness of breath, fainting (not always), nausea, feeling of coldness, tingling in all four limbs, and just recently - lasting numbness in her left arm.
We were back to the hospital again last weekend due to the numbness and another fainting spell. Neurologist ran CAT Scan and head MRI (both normal). Heart doc dismissed all symptoms as "normal".
We are currently seeing a herbal doc that has her on mega doses of C, E, B-100, Magnesium, Omega-3, calcium and a daily multi.
This illness has not been terribly debilitating. However, she cannot drive (passes out) and she has been increasingly having more severe "episodes". I CANNOT STAND PEOPLE TELLING US THIS IS NORMAL! Thanks for your help!!!
Background:
My wife, caucasian, 27, was admitted to the hospital in March 2003 after fainting while sitting with me on the couch (watching TV). Her BP was a bit high for her. She had many tests: EP study, EKG, chest MRI, Stress Echo. Everything "normal". She failed the tilt-table. Diagnosis: Neuro cardiogenic syncope. Treatment: Celexa, 20mg daily. NO pacemaker implanted.
NOTE: This does not seem to be stress related. Also, this happens when sitting, standing and lying down.
Back in the hospital a few weeks later. Added 10mg Celexa and Florinef (spelling?) to raise BP.
Symptoms:
She sporadically has "episodes" where she gets VERY dizzy, has chest pain (described as "cramping"), varying pulse, shortness of breath, fainting (not always), nausea, feeling of coldness, tingling in all four limbs, and just recently - lasting numbness in her left arm.
We were back to the hospital again last weekend due to the numbness and another fainting spell. Neurologist ran CAT Scan and head MRI (both normal). Heart doc dismissed all symptoms as "normal".
We are currently seeing a herbal doc that has her on mega doses of C, E, B-100, Magnesium, Omega-3, calcium and a daily multi.
This illness has not been terribly debilitating. However, she cannot drive (passes out) and she has been increasingly having more severe "episodes". I CANNOT STAND PEOPLE TELLING US THIS IS NORMAL! Thanks for your help!!!
Not to worry, we can tell that you are a very intelligent and caring husband and only want to help your wife. I know what you mean about House, and I would bet that the CC is the closest you will find. They probably are the cutting edge. Let us know what happens.
A Pacemaker seems a bit extreme as opposed to what, having her pass out while driving down the road, and possibly killing herself or someone else?
If she is passing out with regularity due to a heart condition, a pacemaker is perfectly applicable given that this fellow's wife likely wants to try and lead a normal life again. (As stated, she is no longer driving due to the possibility of passing out.)
If you are convinced that something maybe is being missed by the current cardiologist, please go and see another one for at least a second opinion. While getting 'reassurance' online may be comforting, it certainly is no substitute for proper medical care.
Remember, doctors are only human, and therefore, are far from flawless. It cannot hurt to get reassured by a proper cardiologist, and just maybe the next one might pick up on something the one you are seeing now is 'missing' or just blindly overlooking. Unfortunately I've seen many instances where doctors get 'tunnel vision' and either are convinced that a patients symptoms are not indicative of a larger problem,when indeed they are, or otherwise simply do not wish to see the truth of test results that are staring at them from the papers in their hands.
My suggestion is to get to another cardiologist ASAP.
Best of luck to you and your wife.
BNB
If she is passing out with regularity due to a heart condition, a pacemaker is perfectly applicable given that this fellow's wife likely wants to try and lead a normal life again. (As stated, she is no longer driving due to the possibility of passing out.)
If you are convinced that something maybe is being missed by the current cardiologist, please go and see another one for at least a second opinion. While getting 'reassurance' online may be comforting, it certainly is no substitute for proper medical care.
Remember, doctors are only human, and therefore, are far from flawless. It cannot hurt to get reassured by a proper cardiologist, and just maybe the next one might pick up on something the one you are seeing now is 'missing' or just blindly overlooking. Unfortunately I've seen many instances where doctors get 'tunnel vision' and either are convinced that a patients symptoms are not indicative of a larger problem,when indeed they are, or otherwise simply do not wish to see the truth of test results that are staring at them from the papers in their hands.
My suggestion is to get to another cardiologist ASAP.
Best of luck to you and your wife.
BNB
Thanks for the reply! She was on a Holter monitor during the first two stays in the hospital. She was also on an extended monitor system at home after the first visit for about a week. All of the heart docs claimed things were within the bounds of "normal".
A pacemaker seems a bit extreme. Did they mention any heart arrhythmias? Has she had a Holter on when she had an episode? That might be something to think about, or maybe even an implantable loop recorder. It must be very distressing and definitely affects both your lives. Keep us posted!
Thanks for the quick reply! What you mentioned are many things that we have heard before (for the most part) but it is nice to have some reassurance that we are doing all that we can.
You mentioned some new medications, is Toperol (spelling?) included on that list as well? One doc we saw suggested she try that, but our primary care doc dissuaded her from trying it due to potential side-effects. What do you think? Are the others that you mentioned all Beta-blockers?
She does not normally have high blood pressure and according to all of the cardiac tests her heart is "normal". So maybe we will try the high-sodium diet. Would sports drinks (Gatorade, etc) be a good place to start? How else can one safely add additional salt to a diet? Literally just use the salt-shaker on everything?
These "episodes" can occur while sitting, standing or lying down - as I mentioned. Is this still "normal" for a case of
Vasovagal syncope? Could we be facing something more serious do you suppose? What about the newer symptom of left arm numbness. She also mentions the feeling of coolness running through her arm after the episodes - like when you first get an IV put in (she has not IVs in when she feels this).
As for the pacemaker, the Electrophysiologist decided not to implant one. Should we get a second opinion on that?
What is tilt training?
Thanks SO MUCH for your time and willingness to help us finds some answers. We are getting pretty discouraged in our quest for a cure but people like you keep me hopeful. :o) Sorry for all of the questions above. I REALLY appreciate your thoughts!
Ultimately, I suppose this problem with her is not the end of the world - it is just a major inconvenience to the life we want to live together. We are always having to think about "what if you have an episode" and that really limits what we can do together - and more so - what she can do alone (driving, etc). Or goal of course is perfect health with no medications. But we are willing to have a go at any new ideas that can at least give her symptom-free days. Thanks again and have a Blessed Saturday!
You mentioned some new medications, is Toperol (spelling?) included on that list as well? One doc we saw suggested she try that, but our primary care doc dissuaded her from trying it due to potential side-effects. What do you think? Are the others that you mentioned all Beta-blockers?
She does not normally have high blood pressure and according to all of the cardiac tests her heart is "normal". So maybe we will try the high-sodium diet. Would sports drinks (Gatorade, etc) be a good place to start? How else can one safely add additional salt to a diet? Literally just use the salt-shaker on everything?
These "episodes" can occur while sitting, standing or lying down - as I mentioned. Is this still "normal" for a case of
Vasovagal syncope? Could we be facing something more serious do you suppose? What about the newer symptom of left arm numbness. She also mentions the feeling of coolness running through her arm after the episodes - like when you first get an IV put in (she has not IVs in when she feels this).
As for the pacemaker, the Electrophysiologist decided not to implant one. Should we get a second opinion on that?
What is tilt training?
Thanks SO MUCH for your time and willingness to help us finds some answers. We are getting pretty discouraged in our quest for a cure but people like you keep me hopeful. :o) Sorry for all of the questions above. I REALLY appreciate your thoughts!
Ultimately, I suppose this problem with her is not the end of the world - it is just a major inconvenience to the life we want to live together. We are always having to think about "what if you have an episode" and that really limits what we can do together - and more so - what she can do alone (driving, etc). Or goal of course is perfect health with no medications. But we are willing to have a go at any new ideas that can at least give her symptom-free days. Thanks again and have a Blessed Saturday!
I am so sorry for your troubles, and i must say you are quite the husband to continue to help your wife find some peace.
Neuro cardiogenic syncope is kind of a broad term.. Its basically, an unusual drop in blood pressure by a usually unidentified trigger, in an otherwise healthy person that results in fainting. its much more common in young women, and it can happen in any position, although having it happen while sitting or laying down is more rare than standing up.. Here are some other treatment options ive come across..It sounds like your wife has more severe case, taking into consideration the fainting while sitting, and the lack of improvement
In people with frequent or disabling symptoms, treatment with beta-blockers (such as Metoprolol or Atenolol) may help. Other medicines that can be used include Scopolamine, Disopyramide, or Theophylline.
Some patients may need to be on a high salt diet or wear compression stockings. (this is because sometimes during strain or stress, blood pools in the legs and this causes the fainting.
For people with frequent episodes of fainting caused by Slow Heart Rate, they may need a pacemaker.
Vasovagal syncope is usually not a very serious problem and is usually very easily treated. If care is taken, repeat episodes may be avoided.
Heres so more things you can try to decrease symptoms
Stand or sit up slowly.
Neuro cardiogenic syncope is kind of a broad term.. Its basically, an unusual drop in blood pressure by a usually unidentified trigger, in an otherwise healthy person that results in fainting. its much more common in young women, and it can happen in any position, although having it happen while sitting or laying down is more rare than standing up.. Here are some other treatment options ive come across..It sounds like your wife has more severe case, taking into consideration the fainting while sitting, and the lack of improvement
In people with frequent or disabling symptoms, treatment with beta-blockers (such as Metoprolol or Atenolol) may help. Other medicines that can be used include Scopolamine, Disopyramide, or Theophylline.
Some patients may need to be on a high salt diet or wear compression stockings. (this is because sometimes during strain or stress, blood pools in the legs and this causes the fainting.
For people with frequent episodes of fainting caused by Slow Heart Rate, they may need a pacemaker.
Vasovagal syncope is usually not a very serious problem and is usually very easily treated. If care is taken, repeat episodes may be avoided.
Heres so more things you can try to decrease symptoms
Stand or sit up slowly.
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