Bradycardia, syncope, negative tilt

[footinmouth]

I am a 30 year old woman. In 2011 I had a fainting spell, and was tKen to the ER. I was admitted to the hospital because I was in a semiconscious state and had a HR of 40 BPM for several hours. While in the hospital I had an echocardiogram and an EEG. They were both normal. I was discharged after three days of monitoring and told to follow up with a cardiologist to have a holter monitor. I wore it for 7 days but had no symptoms. Since then I have fainted six more times. I have worn event monitors twice following episodes but again had no symptoms during the monitoring. Recently I had a tilt table test that was also negative. The fainting spells are usually preceded by a feeling of being in a daze and getting winded when doing household work. I have gone to the ER again this week because I was feeling like I might faint and I wanted to catch it, but by the time I got there I felt completely normal. The blood work was good. There were 2 PVCs observed on the monitor. The ECG was fine. I am very concerned that I may have a heart condition. What is my next step? I am afraid to drive or hold my daughter in my arms.

[Joseph Sclafani, M.D.]

Hello. Thank you for your question.

The scenario you describe it not uncommon. The goal of evaluation syncopal episodes like yours is to capture the symptoms on an ECG or monitor when they occur to make a "symptoms-rhythm" correlation. When this cannot be achieved in the hospital while on telemetry, or on a Holter or an Event monitor with recurring symptoms, the next best intervention is a Loop Recorder.

They are implanted by electrophysiologists, who are cardiologists with advanced training in management of arrhythmias (abnormal heart rhythms). I recommend you ask your cardiologist for a referral to one of these types of cardiologists and ask about a loop recorder.

Very Respectfully,
Dr. S

[alejandradr]

Base on my experience i would highly recommend first, make a medical récord with all The ekg and test you have.
Then make appointments for both cardillogist/electrophisiologist and neurologist.
Thats not normal. Push until you find an answer