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- Sat Jan 01, 2005 10:04 pm
I have recently started having episodes of syncope. These always occur when I am standing still for several minutes, I feel non-specifically unwell with blurred vision then collapse with brief loss of consciousness (seconds). On recovery I feel disorientated and washed out for 20mins then back to normal. Friends have commented that I look pale and clammy pre collapse, pulse immediately afterwards approx 100bpm, BM glucose 4-5 mmmol/l.
The first few episodes of syncope coincided with a fever and viral illness but they have persisted 3weeks after recovery.
I have been under investigation for several years for episodes of palpitation (?separate problem as I am not aware of palpitations with the syncopal episodes). These are typically sudden onset approx 180bpm las 10-30 seconds then suddenly stop, associated with SOB + chest pain + sometimes pre-syncope.
Investigations to date:
ECG - sinus rhythm 90bpm, Rightward axis, notched QRS V1 normal QRS duration
Echo - normal
Holter - sinus rhythm + sinus tachycardia (no palpitation or syncope during tape)
Signal averaged ECG - ventricular late potentials
Electrophysiology study - no accessory pathway found.
Could these problems be linked? Any possible diagnoses?
| Dr. Yasser Mokhtar
- Mon Jan 03, 2005 10:58 pm
i think you should contact your doctor right away to tell him/her about this new event.
These episodes could be due to
1. The episodes of tachycardia that you get (even though you don't feel any palpitations).
2. Other cardiac causes not related to arrhythmias. Syncope can be caused by cardiac depression through neurological mechanisms.
3. Non-cardiac related causes such as epilepsy espcially with your recent history of viral infection.
i suggest that you have
1. An eeg (recording of the electrical waves of the brain) which shows whether or not you have epileptiform activity in your brain, which could explain the syncope.
2. A ct scan of the brain.
3. A tilt table test where the autonomic function of the circulation and the heart are tested and see whether the syncope that you have is secondary to the heart conditions that are not related to arrhythmias.
4. An event monitor would not be unreasonable.
Please, refrain from driving or operating any heavy machinery till the cause is identified and effective treatment is started.
Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.
Yasser Mokhtar, M.D.