Heart Randomly stops beating while resting

[hobster1]

My girlfriend who is 29 has been having issues with her heart randomly stopping and starting after about 5 or 6 seconds. She has had numerous ecg/ekg's, blood tests, a 24 hour urine test, and an ultrasound of her heart only to find out everything was fine. No defects or blockages. When her heart stops, she gets a "buzzing" sensation in her head and then blacks out. She was diagnosed with syncope but was unable to get a diagnosis about her heart other than it "seemed" like her trouble was with the "electrical wiring" at the sinus node. she recently had a pacemaker implanted and is now linsopril(sp?), hydroclorothiazide(sp?) and Metaprolol.
Before she was on the medication and had the inplantation done, her blood pressure was fluctuating wildly from as low as 45/70 to as high as 189/145. And before her first "episode" she had a two week long stretch of massive migranes with her bloodpressure in the 160/100 to 180/140 range only to have her doctor put her on metaprolol and hydroclorothiazide. a few days later her blood pressure came down and the headaches went away. The first day her headaches disappeared  she had an "episode". She then started to having issues with tightness in the chest and continued to have "episodes". Her doctor took her off the meds thinking it was causing the problem. The tightness in the chest stopped but she still continued to have "episodes" hence why the pacemaker was put in.

Im frustrated with the results that we have gotten from the cardiologist and that a pacemaker was the only idea they could come up with for solving this problem. I feel like something just isnt adding up. I dont know where i should turn to next to try and get help solving this mystery. Any ideas would be much appreciated

[MichelleP_3811]

You know personally I would go see a cardiologist who specializes in dysautonomia.  It sounds like her body isn't regulating her respiratory system all that well.  I know you will have to do a search for a doctor who specializes in it in your area but it might be worth it.  You may even want to see a neurologist as well to make sure there isn't anything in the brain causing the regulation issues.  If your gut is telling you something more is going on then keep pursuing.  Go and exhaust all avenues before you settle on this is how it is going to be.  You may wind up back exactly where you are not but it is definitely worth looking in every nook and cranny to be sure.  Your girlfriend is very lucky to have you looking out for her.  Take care.

[hobster1]

they caught her heart starting to speed up before it paused. the only thing there is her heart also slows way down too hence why they set her pacemaker to not go any lower than 60 bpm.  She has a normal resting rate of 80-85 bpm but it still frequently revs up to around 100-105 while sitting.  Her pacemaker has gone off 3 times scince she had it implanted
but always on low bpm's because her upper limits arent set and she hasnt had any black out spells with her heart reving up.
The cardiologist says that the problem originates from the sinus node due to the "electrical wiring" not working right. but has yet to give her any kind of diagnosis. She has been taken off her meds and put back on them again with no noticable effects either way at this point.

[hobster1]

thankyou for your your response. I havent considered a specialist of Dysautonomia, but it seems like that may be something to look into even though it seems like it is a very broad spectrum topic. some other information that i didnt post before was her pulse was running high when she was resting like 100-110 bpm. But her heart was also slowing down to like 40-60bpm hence why they set her pacer at 60bpm with no upper. The strange thing is that when they caught her heart stopping on the monitor, it was speeding up before it stopped. her blodpressure normally runs a little high. mid 120's to low 130's over 80-85. When this all started we went through about two weeks of crazy migranes. her blood pressure had spiked for who knows what reason to 160-180/100-140. her doctor finally put her on bloodpressure meds. after a few days her bloodpressure stabilized somewhat and her migrane finally faded for the first time in several days. That nite while we were eating dinner she had her first episode. At first i didnt think anything of it but she dropped her plate and drink. when i asked her what happened, she just sat there staring at the wall. didnt blink, move, or say a word. When i tried to get her attention again, she remained unresponsive. then she just kinda rolled backwards and when i saw her face her eyes were completely dialated, and she was making this weird sucking sound. When she came too she had no idea what had happended and had no idea how long she had been out. She was taken off her meds but her episodes still continued. they even changed her birth control. now she's back on everything they took her off of for her bp and now the pacer.  The only thing that i have noticed is that is seems to happen when she is sitting down altough it did happen while she was taking a shower once and was able to sit down before she blacked out.  The cariologist insists that the migrane streak had nothing to do with the heart "stopping" problem and that her issue is with the wiring with the sinus node.
Everything is our bodies is connected to each other in some way and if there are no physical defects of the heart or no blockages that they can see after taking photos,disrupting the fuction of the heart,  the only thing that makes sense to me is a chemical issue or neurological issue.

Forgive me if i seem to be rambling a bit.. She can have multiple episodes one day and then go a week and a half before having a single one. Its frustrating when 1+1 doesnt equal 2 or when you have round holes to put square pegs into.  Things just dont seem to make sense.

i am curious as to why they never did a table tilt test or a stress test.

[abc85]

So what was it that they caught on the monitor?  Was it a sinus pause?  If that's the cause and she's having pauses that long, then a pacemaker would be the treatment for it, which she has.  I would have her talk to them about her meds and seeing if those are now causing the problem.  The beta blocker that she's on for her BP could be the culprit and they may have to try some other medications to find what works best for her.  It could also be that the settings on her pacemaker need adjusting.  However, if it was some other arrhythmia causing the syncope, then she may need some other treatment.  She could ask to wear a monitor again and see if the pacemaker is indeed doing its job or if something else is going on.

[hobster1]

they did on monitor she was wearing

[Mom2four85]

definitely look into Dysautonomia (Autonomic Dysfunction) as others have said...it may be a mix of ANS issues with something else...neurocardiogenic syncope can be perplexing to diagnose and many ANS patients are often misdiagnosed for many years.

has she had a tilt table test or blood pressure testing etc?

I have a mix of ANS dysfunctions and heart problems; have a pacemaker/defibrillator but still my bp/hr fluctuate after all the things they've had me try but others do have some success with Midodrine, Flucortisone (sp?) salt and fluid loading, compression clothing, tilt training etc

here's some info on Dysautonomia along with symptoms dr's treatments etc http://www.medhelp.org/health_pages/Neurological-Disorders/Autonomic-Dysfunction-FAQ/show/181?cid=196

[tom_h]

The key to a treatment whatever that may be, is to catch the problem in action.  How often does this occur?  If a 24hr. Holter isn't enough, then perhaps push for a 30 day monitor, a simple 2 leaded device the user wears 24/7 for an extended perior of time.  Electrodes are replace daily after the device is removed only for bathing or showering.  It will be programmed to autorecord a specific anomoly, but can be manually triggered to record by the wearer.  The longer she's monitored, the btter the chance of catching it.

[MichelleP_3811]

If her heart is indeed stopping for 5 seconds then it very well may be some scaring issue around the SA node, the heart's natural pacemaker.  A pacemaker is really the best solution for this problem.  If it is not actually stopping and is just becoming weak it is possible there is a blood pressure regulation problem going on.  You say she has been on numerous ekgs but to clarify has an episode been recorded?  This is the only way to know for certain what exactly the heart is doing.  If it is indeed stopping regardless of the blood pressure issues then a pacemaker like I said before is called for.  However if she has an autonomic nervous system disorder like Dysautonomia or some other neurological issue causing the problem meds may help correct the issue if it the problem is simply passing out from low blood pressure.  Has your girlfriend been to a doctor who specializes in Dysautonomia?  You may want to check it out if she is still having wild fluctuations in her bp.  So how has it been going with the pacemaker?  Is she still having a lot of issues or are her symptoms clearing up?  It is important that we push our doctors to get our questions answered.  If there is anything you aren't clear about don't hesitate to call the doctor and ask for clarification and guidance.  Take care.  I do hope she feels better soon.

[wmac]

I get the sensation of the heart stopping and starting too. But actually its not stopping its a pvc premature ventricular complex... extra beat from the bottom of the heart and then she probably feels a thump which is the next normal beat. just my guess im not a doctor.. I have just been through it all.. The fainting is from low blood pressure and heart beating to slow.. more than likely... She should have a tilt table test if she hasnt already... but I know lots of people with pacemakers... Im sorry she is going through this.. I know how aweful this can be. I still have bad days in fact just had an episode of nsvt and im having anxiety as well because of it.. good luck please keep us posted

[abc85]

Have they caught the pauses in her HR on an ECG or monitor?

[hobster1]

already have, but thank you anyway for your help!

[spade22]

I don't have an answer but strongly suggest your girlfriend gets a 2nd or 3rd opinion.  She needs to see an electrophysiologist (EP) who is a cardiologist that specializes in electrical disorders of the heart rather than a "standard" cardiologist who specializes in plumbing issues of the heart (blockages etc).