vasovegal syncope

[Harefieldfan]

does anyone else have fainting spells? This happens to me from time to time, usually precipitated by sweating, light-headedness and nausea. The latest was last Tuesday evening, in my choir. I was sitting down because of back pain and then with no warning I was out. I’ve had cardiology tests recently, revealing nothing. But I’m wondering if it’s heart-related. When I had my nstemi attack in 2021, I fainted. No pain. Now have two stents. Saw a GP today: she’s taking me off one of my blood pressure meds (Amiodipine). It is probably vasovegal syncope, she and other doctors have said, but I’m beginning to be scared. Sorry to go on - just want to know if this happens to anyone else. Thanks.

[mozart27]

My wife has had similar events. The last time we were able to measure her BP and heart rate, which were very low. We arranged an appointment with the GP and an ECG she had at the GPs surgery was normal. We arranged though for a private appointment with a cardiologist. While she was there, he carried out another ECG which identified heat block Soon afterwards she had an implanted device to provide the cardiologist with information to decide if she needs a pacemaker. Until then she is on no relevant medication but she has had to return her driving license to DVLA and notify travel insurers paying an additional premium.. We don't know how long it will take before a decision is made but understand the battery in the implanted device lasts about four years. Hope this helps.

[Harefieldfan in reply to mozart27]

thanks! I’m considering the implant, if I ever get to see a specialist

[Larivee]

I had a defective pacemaker. My heart was actually stopping which caused near fainting. Took docs 3 years to replace pacemaker. Now I am fine. They did not believe it was the pacemaker. Pacemaker had faulty leads going to heart.

[Harefieldfan in reply to Larivee]

I don’t have a pacemaker. Glad you got it sorted!

[Yisselda]

Hi Harefieldfan,

Your post is interesting and I’m not sure I can shed any light, just my experience.

I had a few episodes where my legs seemingly gave way in 2020/21. This was diagnosed as vasovagal syncope. The explanation, following a tilt-table test, was a sudden drop in blood pressure. I was offered an implantable device but decided not to take things any further as I was fit and well.

In 2023 I began suffering from breathlessness when out running/hill walking, this was diagnosed as CVD ( I have a calcium score of almost 7,000) and I received a stent in June ´23. Following an NSTEMI in October 2023 I received a further stent ( plus an extra because an artery was damaged during surgery).

I understand that the two conditions are connected but I’m afraid I’m not clear how. Perhaps someone better informed can enlighten us.

Best wishes,

Yisselda

[Judithdalston in reply to Yisselda]

I had a tilt test table test after 4+ years Long Covid giving me high BP ,HR with breathlessness doing minor domestic jobs ( eg brushing my teeth or stirring pot on stove)and was diagnosed with ‘postural hypotension’ as hypertension at rest plummeted to 60/40 on standing 8 mins…I had already adopted your list of tips plus compression socks ( as had self diagnosed PoTS from home NASA lean test the year earlier) but all I have been offered is a reduction in what had been 5 hypertensive drugs ( bisoprol and indapamide removed by Falls specialist) but GP this last month put me back on indapamide! What is CVD…should I be on the look out for it?

[Yisselda in reply to Judithdalston]

Hi Judithdalston, I’m sorry to hear about your long covid.

I’m afraid I’m not qualified to comment on your medication. I wasn’t given anything for Vasovagal Syncope, but am on the full range of heart medication for inherited cardiovascular disease (CVD). I still get breathless climbing the stairs or hills, but can’t be sure if this is because of my condition or a consequence of medication.

Yisselda

[Yisselda]

Generally recommended measures for managing the condition are:

The first step in treating this problem is to increase fluid intake. Patients who drink fluids regularly throughout the day seem to do better than those who don't take this task seriously.

If low salt intake is an issue, an increase in the amount of salt added to food is recommended. I have always been mindful of salt intake and could have been having too little. As we only ever cook from scratch there are no hidden salts in our meals. To be successful, though, the increased salt intake must be accompanied by a sufficient increase in the intake of water and other fluids.

Where practical, avoid circumstances that might bring on symptoms.

Shop at non-peak hours to avoid long lines

Take shorter showers and baths and aim for a cooler water temperature

Avoid saunas, hot tubs, and lying on a hot beach

Avoid standing still for prolonged periods in hot environments, and on very hot days

Flex your leg muscles and shift your weight when you are standing still, or better still, walk around.

Avoid alcohol because it leads to dilation of the veins and arteries, and this can steal blood away from the central circulation

I hope this is helpful.

Yisselda

[Harefieldfan in reply to Yisselda]

These are very helpful. I was dehydrated last time. I carry salted pretzels with me just in case. I’ve been avoiding salt for years - now seems a bad idea.

[Yisselda in reply to Harefieldfan]

Yes, it is a commonly held belief that all salt is bad for us but we do need a little. I think the problem for a lot of people is hidden salt in biscuits, cakes, cereals, prepared meals etc. If they are eaten and food is also salted at the table, you probably can have too much. But, if you cook from scratch and don’t eat biscuits, crisps etc you can end up with too little.

Fluid intake is very important.

[Robfromwales]

once while sitting down at 9 am in the morning. Lasted @ 3-5 mins before fainiting. It’s a horrible feeling. They told me vasavsgal through bp .

[RP1944]

Good morning, it happens to me occasionally , never found out why though.

[Harefieldfan]

definitely a horrible feeling!

[the-demi-god]

Syncope is the heart beating out of time ie it is not beating regularly the SA node that sends out a signal to beat is not functioning properly and I am surprised they have not taken action or have plans to in the very near future commonly a pacemaker is installed, sounds frightening but I promise it is a minor procedure but really necessary if you have not told them do so as a matter of some urgency and be sure not to underplay it. I cannot stress how much you need to take action please do not let it deteriorate further.

[Harefieldfan in reply to the-demi-god]

Thanks. My heart IS beating regularly. Always has.

[Coco51]

My husband had these episodes. Like you it could even happen when he was sitting. On all occasions he was rather hot. Head slumped forward and he was out for about 20 secs. He felt odd warning signs immediately before it with sweating, nausea and muffled hearing. The GP ruled he should not drive.

We went to see a cardiologist privately. He had many tests - ECG, stress echo test, holter monitor, 24 hour BP monitor, and a tilt table test. The heart was OK but his blood pressure was very low.

The treatment has been to drink more fluids adding electrolytes tablets - he has a bottle with him at all times now - and importantly wearing really tight compression socks or stockings. Since he's done these things he's had no more episodes! He's now cleared to drive again.

I hope you get a proper diagnosis. It's scary.

[Harefieldfan in reply to Coco51]

Where do you get electrolytes tablets?

[Coco51 in reply to Harefieldfan]

From Boots or health shops. They are called hydration tablets, marketed as sports drinks. E.g. O.R.S. but there are many other brands. Main ingredients are Potassium, Chloride, Sodium, Magnesium, Glucose. You add them to water. Hope that helps.

Electrolyte drinks

[Coco51 in reply to Coco51]

Compression socks are also important as they stop the blood pooling in the lower legs.

[BobbyCollins]

Hi there sorry to hear of your problems. Yes I have the same on occasion and have done since about 13 now 68. I have been checked out a couple of times and told everything was fine but it is very disconcerting. I find mine is somehow related to blood sugar has never happened at home but if out and about and I go a bit longer without food it can occur.Don't know if this resonates with you but definitely have it looked at. Take care