syncope and bowel movements

[John]

Recently, my mother has had 6 or 7 episodes of fainting immediately after a bowel movement in the early morning (4:00 am

[John]

Dear Dr. Wolff,

We will pursue the recommendations in the CCF Cardio MD answer.

Would you suggest any other avenues of exploration?

Many thanks.

[it is my belief]

that not only can vagal menuvers stop a psvt attack...but they can also start one. i have been able to trigger attacks on myself by simply bending over and coughing at the same time....your mother may be experiencing psvt, that would explain the rapid heatbeat and fainting (her other symptoms also sound soooooo typical of this "affliction)....most docs will tell you that this is impossible, on the other hand, i am living proof, because i have been able to produce this "phenomonon" on demand. there is a connection.

[CCF CARDIO MD - DLB]

The upper GI barium test definitely did not cause these problems or damage the vagal nerve. However, bowel movements can cause the vagal nerve to slow the heart sufficiently to cause fainting. A work-up should include a review of her medications to see if she is taking anything that would slow the heart rate excessively, Holter monitoring to seee if her heart rate is dipping too low with bowel movements or any other activities, and consideration for a pacemaker implantation. If she is constipated and straining excessively during bowel movements, this may be causign the episodes and a GI evaluation for constipation should be performed. A cardiac electrophysiologist would be the appropriate doctor to investigate the fainting further.