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Message
OT Medical folks - vasovagal syncope
Posted on 2/8/14 at 8:48 am
Posted on 2/8/14 at 8:48 am
mostly a lurker here and swore I would never do this, but here goes...
teenage daughter started having episodes of passing out at school this week. started Wednesday and took her to the ER. They hooked her up to EKG and ran some blood work. No obvious causes. Follow up with neurology on Thursday and cardiology on Friday yielded nothing significant. They did an echocardiogram in cardiology and everything is normal. She is an athlete and is in good physical condition. Her diet is not the best in the world but is pretty similar to mine at that age.
Told us that they think it is vasovagal syncope. They want to run a tilt table test but may be two weeks before we can get in. Meanwhile, I've got a teenage daughter passing out periodically with no real warning signs. She's afraid to go anywhere out of fear she will fall and hurt herself. School is not going to let her stay if she keeps dropping, and we don't have any real answers.
I've read some of the info on vasovagal syncope, and there are a couple of things that worry me. The literature all mentions some type of trigger and a drop in blood pressure that leads to fainting. My daughter doesn't seem to have any obvious trigger as it happens at various times. The first time was after climbing a flight of stairs which could be a trigger. But after that, it occurred while she was both sitting upright and laying down. When she was in the ER, she passed out a couple of times while laying in the bed and hooked to the EKG, and there was no indication of a drop in blood pressure.
There are no indications that it is a seizure of any kind as her body goes completely limp and there are no involuntary movements.
Anyone ever had anything similar or experienced syncope without apparent triggers?
teenage daughter started having episodes of passing out at school this week. started Wednesday and took her to the ER. They hooked her up to EKG and ran some blood work. No obvious causes. Follow up with neurology on Thursday and cardiology on Friday yielded nothing significant. They did an echocardiogram in cardiology and everything is normal. She is an athlete and is in good physical condition. Her diet is not the best in the world but is pretty similar to mine at that age.
Told us that they think it is vasovagal syncope. They want to run a tilt table test but may be two weeks before we can get in. Meanwhile, I've got a teenage daughter passing out periodically with no real warning signs. She's afraid to go anywhere out of fear she will fall and hurt herself. School is not going to let her stay if she keeps dropping, and we don't have any real answers.
I've read some of the info on vasovagal syncope, and there are a couple of things that worry me. The literature all mentions some type of trigger and a drop in blood pressure that leads to fainting. My daughter doesn't seem to have any obvious trigger as it happens at various times. The first time was after climbing a flight of stairs which could be a trigger. But after that, it occurred while she was both sitting upright and laying down. When she was in the ER, she passed out a couple of times while laying in the bed and hooked to the EKG, and there was no indication of a drop in blood pressure.
There are no indications that it is a seizure of any kind as her body goes completely limp and there are no involuntary movements.
Anyone ever had anything similar or experienced syncope without apparent triggers?
24
Posted on 2/8/14 at 8:51 am to Pinetar
Good luck
This post was edited on 2/8/14 at 8:53 am
Posted on 2/8/14 at 8:52 am to Pinetar
BP spikes don't necessarily require a physical trigger. Medicine can keep BP down.
Posted on 2/8/14 at 8:54 am to Pinetar
I have had it occur. It actually happened to me in a resturant. After coming to, my dad brought me to the ER. They said it was triggered like a brain freeze episode but caused by food that' was too hot, stimulating the vagus nerve. My cardiologist gave me some pills to take if I feel an episode coming on (which is dumb because it just happens and it's no "feeling it coming"). I have also almost passed out twice while driving, which is absolutely terrifying. Like at night if I break my focus and move my head quickly or something, I get an odd vertigo feeling
This post was edited on 2/8/14 at 8:56 am
Posted on 2/8/14 at 8:54 am to Pinetar
quote:
teenage daughter
Not trying be a dick. Hear me out.
You are doing the right things. These tests all need to be done. But if all check out normal. Look to her for changes in routine and behavior and ask yourself if she is acting out for ANY reason. Boyfriend, divorce, picked on in school etc.
Go through all appropriate eval. Don't dismiss emotional problems if all these come back normal.
Posted on 2/8/14 at 8:55 am to Pinetar
Wow. Not the time to ask for pics. We have some nurses on here so to you and your daughter,good luck. I have 3 teens so well nevermind I can't relate.
Posted on 2/8/14 at 9:03 am to Pinetar
One of my friends in high school went through something similar. She ended up being diagnosed with silent seizures. She would faint at random times. Sometimes it would be kneeling in church (catholic school), sitting in class, one time her and I were having a conversation and she just went quiet.
LINK
LINK
This post was edited on 2/8/14 at 9:05 am
Posted on 2/8/14 at 9:04 am to Pinetar
I didn't read any of the responses, so sorry if this has been covered.
I have this. Your daughter seems to have it more pronounced than me, but still , I have this. I would pass out at very in opportune times and my wife made me go to a doc about it.
They prescribed me beta blockers. (atenolol to be exact.) It was the perfect diagnosis and prescription for me.
Obviously, you need to see a doc, but please don't work yourself up about it until then. Taking a 1/2 a pill every night is no big deal at all.
Hope this helps.
I have this. Your daughter seems to have it more pronounced than me, but still , I have this. I would pass out at very in opportune times and my wife made me go to a doc about it.
They prescribed me beta blockers. (atenolol to be exact.) It was the perfect diagnosis and prescription for me.
Obviously, you need to see a doc, but please don't work yourself up about it until then. Taking a 1/2 a pill every night is no big deal at all.
Hope this helps.
Posted on 2/8/14 at 9:05 am to Pinetar
First of all, seizures are not just the Grand Mal type contortions that you see on TV. It is entirely possible to be affected by seizures that are just as you describe. Not saying that is what is happening here.
You are doing the right things by taking her to specialist but you are just going to have to keep pushing until they find the cause. Keep an accurate log of occurrences and activities proceeding the events. What she is eating, how much she is drinking (dehydration being a classic cause of positional syncope) and other factors. They should want to put a portable monitor on her for a couple of days that allows them to download and examine her status over time. Ask about that.
At this point, the best thing you can do is be an aggressive advocate for her care. Don't settle for IDK or NO or IT WILL BE TWO WEEKS.
You are doing the right things by taking her to specialist but you are just going to have to keep pushing until they find the cause. Keep an accurate log of occurrences and activities proceeding the events. What she is eating, how much she is drinking (dehydration being a classic cause of positional syncope) and other factors. They should want to put a portable monitor on her for a couple of days that allows them to download and examine her status over time. Ask about that.
At this point, the best thing you can do is be an aggressive advocate for her care. Don't settle for IDK or NO or IT WILL BE TWO WEEKS.
Posted on 2/8/14 at 9:07 am to Pinetar
no advice, but best wishes to your family
Posted on 2/8/14 at 9:08 am to Pinetar
what about an MRI?
Posted on 2/8/14 at 9:10 am to Pinetar
Where do you live and where are you taking her for cardiology visits? I am a cardiology fellow and would like to help anyway I can
This post was edited on 2/8/14 at 9:12 am
Posted on 2/8/14 at 9:15 am to Pinetar
quote:
When she was in the ER, she passed out a couple of times while laying in the bed and hooked to the EKG, and there was no indication of a drop in blood pressure.
What about EKG rhythm? A vasovagal event will usually have a systolic pause. Or a heart rate that goes from 80 to 30 or something like that.
My wife drew blood on a guy once. The "I hate needles guy" so she had him lay down. He had an event. She screams. We run like we are on TV. Find the guy coming around but his heart monitor had a full screen of only P-waves! We kept him the rest of the night. Which was about 4 hours and it never happened.
ETA cardiology fellow please explain P-waves I am too tired.
This post was edited on 2/8/14 at 9:18 am
Posted on 2/8/14 at 9:15 am to tiger114
By the way, the neurologist I see for this said that 25% of people have this condition. It is not abnormal at all.
Your little girl will be fine. Get her some beta blockers. Costs me $5 every 2 months and I have not fainted since taking them.
Your little girl will be fine. Get her some beta blockers. Costs me $5 every 2 months and I have not fainted since taking them.
Posted on 2/8/14 at 9:20 am to tiger114
quote:
Get her some beta blockers. Costs me $5 every 2 months and I have not fainted since taking them.
Beta blockers are good but are no joke. Give them to the wrong person and they will pass out. Low bp. Or low heart rate.
Posted on 2/8/14 at 9:23 am to BROffshoreTigersWife
Absense seuzures are amazing.... almost looks like they are day dreaming sometimes with no other symptoms... theres an exercise we do in the lab, make pt take deep breaths n it will induce the seizure... I about fell out of the chair when I saw the first one on the eeg monitor...
Posted on 2/8/14 at 9:23 am to Pinetar
I experience this same problem pretty severely and my trigger is blood/guts/anything internal. I have fainted many times at the sight of blood. The way I handle it is just to avoid situations with blood or, if I get a cut or something, just try to clean it without looking. I have to avoid certain TV shows and movies. It sometimes manifests even just thinking about blood, like right now while writing this post I'm getting lightheaded. Luckily it's manageable in my situation, but I hope that y'all can figure out what's going on with her.
Posted on 2/8/14 at 9:25 am to proger
Thanks for all the replies so far.
I don't think dehydration is an issue. She drinks a lot of water, at least 4-6 bottles a day. She does not drink soft drinks at all.
We live in Metairie and all treatment so far has been at Ochsner.
I guess my biggest reason for coming here is to see if anyone had anything similar that ended up being something different than syncope. Like I said, a couple of things don't seem to fit, and I want to have as much info as possible to push the docs as we go forward.
They want her to wear a halter monitor for 24 hours, but they didn't have any in the clinic yesterday. So, the earliest we can get one is Monday.
I don't think dehydration is an issue. She drinks a lot of water, at least 4-6 bottles a day. She does not drink soft drinks at all.
We live in Metairie and all treatment so far has been at Ochsner.
I guess my biggest reason for coming here is to see if anyone had anything similar that ended up being something different than syncope. Like I said, a couple of things don't seem to fit, and I want to have as much info as possible to push the docs as we go forward.
They want her to wear a halter monitor for 24 hours, but they didn't have any in the clinic yesterday. So, the earliest we can get one is Monday.
Posted on 2/8/14 at 9:29 am to LSU alum wannabe
Absolutely. The weird thing is that they LOWER blood pressure when low BP is the cause.
But it's all about making the your body not get stressed. (I.e., it does not affect your psychology or emotions at all). It's only physical.
By the way, I work in an industry where we all have to give high-pressure public presentations. Half of our sales team takes beta blockers just to calm down before a big presentation.
But it's all about making the your body not get stressed. (I.e., it does not affect your psychology or emotions at all). It's only physical.
By the way, I work in an industry where we all have to give high-pressure public presentations. Half of our sales team takes beta blockers just to calm down before a big presentation.
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