Fainting

[spearce]

I had a vaso vagal episode at the weekend and was unconscious for 10 minutes. Could this be caused by PMR or predisalone? I was diagnosed a year ago and it has never happened before.

[PMRpro Ambassador]

What were you investigated for? Ten minutes is a fair time - must have been scary for the family. Had you had any similar episodes before - even if much milder?

I had a fainting episode last May, resulting in a beautiful shiner and a wrenched knee but we have no idea if I actually lost consciousness or not as my husband found me sitting on the loo and suffering from my third transient global amnesia (TGA) which means I remember nothing of what happened and several hours before and after. However, when taken to hospital I was quite agitated so they gave me an infusion of diazepam before my husband got there to tell them not to: it causes severe atrial fibrillation for me. That was a positive though - they found I was having bradycardic (slow heart rate) episodes where I was having asystoles (pauses in heart beat) of up to 7 seconds. I had had repeated occasional dizzy spells for some time - very likely associated with the vasculitis of PMR as an increased dose of pred reduced the frequency. It had never been possible to catch on even an extended 24-hour ECG and with no evidence nothing could be done. I was about to go and ask for their new super-dooper external loop recorder which you trigger when it happens and the previous 4 minutes of trace is sent to the hospital. I was given a pacemaker, problem solved.

If it were to be due to an arrythmia then it could be due to either PMR or pred - the autoimmune part of the vasculitis can damage the electrical cells in the heart and the cardiologist is confident that is what caused mine. Pred can cause arrythmias but I would have expected you to have had palpitations previously.

[spearce in reply to PMRpro]

They tested everything in a and e and said it wasn't a t ia or anything wrong with my heart, but that my blood pressure had dropped so not enough blood was getting up to my head. Eating a meal could have contributed so I'm now just eating small amounts - but also wonder if I should be on the blood pressure medication! Like you I knew nothing about it, and was completely unresponsive to shouting and pinching! Thank you for answering.

[PMRpro Ambassador in reply to spearce]

I think my first notable manifestations were like that - I would feel hot and then feel very very dizzy briefly and then OK. Standing in a warm shop in winter was a trigger. I had a 24 hour BP Holter monitor and it happened to catch one just as I left a shop and my BP had plummeted suddenly. They dismissed it but adjusted the BP meds. The dizzy spells then were much less until I had the episode I described.

I'd say be aware, if you have anything keep a record. Mine were just like a wave passing over, couldn't even dignify them as dizzy spells! Just a few seconds with my ears ringing a bit and gone. Would even happen when sitting - less obvious then of course.

[spearce in reply to PMRpro]

PS no never fainted before.

[piglette]

Unlike you I have had fainting attacks since I was five years old. No one has diagnosed anything, doctors just say “Oh you tend to faint a lot”. I did faint twice last year and refused to go to hospital, perhaps that was a mistake. Once was in a greengrocers and once at the cafeteria at my swimming pool. I was probably only out for a couple of minutes though.

[Blearyeyed]

Are you on blood pressure medication as well , you mentioned it in replies , just wondering what other health issues you may have as well because these make a difference , when it comes to dizziness and unconsciousness you have to consider your whole medical history as each thing can be contributing to what occurred. As does any other illnesses or Stresses you may have had in the weeks before.

You may not have fainted before but have you been experiencing more dizziness or near fainting ( called Pre Syncope) , extra headaches or trouble breathing especially with exercise or prolonged standing , extra brain fog , palpitations or periods of chills or sweating?

What tests did they do in A and E?

Have they arranged for you to see a Cardiologist or someone from Neurology to be sure that it isn't something else and not just a side effect of your present illnesses and medications.

If not , I think I would be speaking to the GP after they have read your A and E letter to see what their conclusions were and what they are choosing to do next.

It could have been an isolated occurrence , but it would be better to be sure , especially if you take blood pressure medication , a 24 HR BP monitor test that can be ordered via the GP may be helpful so that they can see if you are experiencing more regular mini changes in blood pressure or heart rate through the day .

[Janstr]

I've had 3 fainting attacks since getting PMR, 2 of which were when I was in pred. I was fully checked out after the first one & have benign ectopic beats ( missing beats) which after a fainting attack are every other beat. My GP thought it might have been caused by PMR damaging the electrical cells. I was taken to hospital by ambulance after the 2nd attack (where I was sprawled out in the floor of a cafe) & they told me that if I feel the symptoms coming on again to lie down on my side in the recovery position for 20 mins. This worked the 3rd time

[Devonspinner]

Hi

Exactly the same thing happened to me in Ocober 2018. Like you, I was out for 10 mins. My husband called the ambulance and I was in hospital for 3 days. Like you I remember nothing. I was on a continuous heart monitor but nothing could be found. I had to voluntarily suspend my driving licence for 6 months. Thankfully it hasn't happened again and no one knows why

[Orpheus82]

I’m a great fainter and have been since the age of nine years but usually only when I’m ill or have injured myself. If I feel I’m about to go I try and lie down on my right side and stay there till it passes. I have always had low blood pressure. I have had post prandial fainting which is caused by a drop in blood pressure following a heavy meal - have even done this in a restaurant when most people think I’m drunk! I can even faint when already lying down. Had a horrid vomiting bug last year and after coming out of the bathroom felt faint so lay down and promptly passed out not once but again after coming round from the first. I now put it down to my adrenal insufficiency at the time. They play a big part in BP control and are compromised whilst we are on higher doses of steroids. Ten minutes is a long time to go out for as most faints only last a very short time. Do hope it doesn’t happen again for you as it is such a horrid feeling.

[Gaycreasey in reply to Orpheus82]

I’ m also a great fainter and was before pmr. I once fainted at a Weightwatchers meeting. I laid myself on the floor and went in and out of consciousness but could not speak or open my eyes. It was only when the ambulance crew gave me an injection that I was able to open my eyes. It was an expensive episode because they were unsure whether I had had a fit so I had to have an appointment with a neurologist. Unfortunately that was not available for 5 months so I had to pay £200 for a private appointment, or I would not be able to drive. I also fainted at the table in an Italian restaurant during my friend’s 70th birthday meal. My head hit the table and my husband thought I’d had a stroke. It’s not fun!!