What's happening?

[Kherkus]

This is a rather long story brought to a rather short synopsis that will like extreme detail.

When I was 15-16, I passed out in one of my school classes after stretching.  No one was able to tell me exactly what happened.  The only description of this event I was able to get was that I simply leaned back a little and then fell over, desk and all.  I did hit my head on the floor, but it was superficial at most.  The cranial impact was dismissed due to its insignificance.  A few weeks later, the real symptoms started to present themselves.  Random syncopal episodes that resulted in loss of consciousness, bradycardia to tachycardia in just a few seconds and vice-a-verse, angina and erratic heart rate.  My P.C.P. put me on a holter monitor and later an event monitor.  Both showed similar events of both increased and decreased heart rates in an irregular manner.  Nothing conclusive was acquired from these devices.  The other tests he put me through were an E.E.G., E.K.G, cardiac ultrasound, X-rays, tilt table test, stress test and further blood work.  All of these tests came back negative for anything...  The tilt table test provided the most interesting results after they administered nitro.  My H.R. spiked to nearly 180 and my B.P. stayed constant.  Fast forward to present time and I'm now beginning to have similar symptoms again.  It has been 12 years and once again my heart rate has been effecting me to the point I had to quit my job.  Last week I was on vacation and had a H.R. of 48 for 8 hours straight.  I was in a chair all day, barely conscious but fully coherent.  Any exertion was strenuous and exhausting.  While there, I had my mother and her husband, both first responders, 3 EMTs and at least 1 doctor.  All are at a loss for what's happening.

Any ideas will help.  I'd really like to figure this out.  There is a family history which I will explain on a later reply to this post, but it may be very significant.

Thanks in advance.

Steve

[Kherkus]

I have been on at least two event monitors in the past.  Once during the first occurrence and once recently.  Both were for thirty days.  The first one recorded events that were very odd.  HRs spiking as high as 220 for over a minute and dropping just as suddenly dropping to one record low event of 35.  The recent one however was almost useless because I had only a few episodes during my time with it.  The one episode that I was able to send into my cardiologist was, "Completely normal."  Despite the fact that the rhythm was all over the place.  My family has a history of A-fib, heart disease, MS and my father also had open heart surgery when it was still experimental and was one the first 200 patient to survive the operation.  This was to repair a deviated septum between his ventricles that was quite large.  We do not know anything about his family history because he is adopted.  Currently, this is all of the information I can correlate.  I'll keep working to find out more.

Steve

[CCFHeart MD25]

Both fast and slow heart rhythms can be associated with symptoms. Both can cause you to pass out, and both can make you feel weak and tired. Typically, a heart rate of 48 is not the cause of symptoms in the majority of patients. Also, symptoms such as passing out spells are usually associated with longer episodes of a sustained fast or slow hear beat (at least 30 seconds of fast). A longer event monitor may be an appropriate next step. Having a normal echocardiogram is reassuring. Thyroid testing is also a cornerstone of any initial work up for both fast and slow heart rates.