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Having pain in chest, strange heart rhythms and unexplained blackouts. What is the problem?

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Practicing since : 1981
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I am a 40 year old male Caucasian 172cm, 71kg, normal blood pressure. I exercise a couple of times per week and don't drink or smoke. I had a heart exam 3 years ago following some unexplained chest pains which included a treadmill stress test. My heart structure showed up as normal in the echo and so I was told that I had nothing more than IRBBB. The Duke Treadmill Score was -29. I have unexplained blackouts twice per year and sometimes feel like I have strange heart rhythms before I go to sleep.
Recently I have needed to nap more in the daytime and feel excessively tired. My GP wants me to have a sleep test for sleep apnea. I have also had another of my blackouts. I am concerned that my unexplained blackouts could be caused by Brugada syndrome. I am considering going back to my cardiologist but it is expensive here so I want a second opinion to review my ecg results before I make an appointment.
Posted Sun, 7 Oct 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 1 hour later
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence and reviewed the investigations you sent along with.
The EKG is not of a typical Brugada Syndrome but your concern that your blackouts are related to abnormal rhythms of heart is legitimate. At the same time, your doctor must have seen something which I can not know, I do not think you have sleep apnea syndrome. No harm in getting a HOLTER examination done if you have to pay for sleep studies. That may reveal more. However, if you do not have to pay for sleep studies please go ahead. I urge you to definitely seek appointment with a cardiologist after these investigations, he will be able to form a opinion. My guess is you are getting intermittent arrhythmia (bradyarrhythmia is a possibility so is tachyarrhythmia causing black out). I would have chosen an event monitor to investigate further the cause for blackout as it is infrequent. Let your cardiologist decide. If you have any further query I will be happy to answer. Regards.

With best wishes.
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
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