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What Causes Syncope?

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Posted on Mon, 23 Jun 2014
Question: I had a heart murmur as a child. I had insomnia as a teen. At 23 I started having syncope episodes. I got dizzy and blacked out and broke my nose. I woke up with my heart pounding and very scared. At the hospital they said nothing looked abnormal in my ekg. It continued every few months for a year then tapered off. It seems to come back in times of high stress. It happens almost always when having my blood taken. It started happening again severely last year at work where I would sweat and turn red and get very dizzy and need to lay down. Mild epilepsy runs in my family. Both mother and grandmother had the same symptoms and were diagnosed epileptic. I've never had a seizure so I'm not sure. It's been getting bad lately with my job becoming more stressful. Do I take a medical leave or disability? Mental health doctor or general practitioner?
I also have a sensory disorder called misophonia which I've had most of my life. I've been reading that these could all be related.
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Answered by Dr. Sudhir Kumar (11 hours later)
Brief Answer:
You need HUTT test.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms and family history.

Based on the description, the episodes seem more like syncope rather than seizures.

We need to exclude neurocardiogenic syncope. This can be done by doing a head up tilt test (HUTT). HUTT test can be done under the supervision of a cardiac electrophysiologist.

There may be associated anxiety and consulting a psychologist would also help.

Taking a few weeks medical leave may be helpful, while you undergo evaluation and treatment is started.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6232 Questions

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What Causes Syncope?

Brief Answer: You need HUTT test. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms and family history. Based on the description, the episodes seem more like syncope rather than seizures. We need to exclude neurocardiogenic syncope. This can be done by doing a head up tilt test (HUTT). HUTT test can be done under the supervision of a cardiac electrophysiologist. There may be associated anxiety and consulting a psychologist would also help. Taking a few weeks medical leave may be helpful, while you undergo evaluation and treatment is started. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, XXXXXXX XXXXXXX Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in