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Dr. Andrew Rynne

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Can palpitations cause fainting spells?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6436 Questions

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Posted on Mon, 26 Oct 2015 in General Health
Question: Hi again Doc. You had answered a previous question of mine giving me some advice in regards to a recent incident and following symptoms I've experienced (http://doctor.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=226156). I was wondering though, Is it possible that my palpitations could have caused my fainting spell and not the vagus nerve as suggested. I have had palpitations for around 6 months, and I know they are generally considered to be benign, but could they in certain cases become more dangerous? I ask because I experienced the same sensation I had felt before passing out the first time a couple of days later while sitting still, where seemingly the vagus nerve could not have been the culprit. The sensations I am feeling are a warm tingling that rapidly crawls from my chest and super back into my neck, face and head. This is followed by sweating, and finally my vision narrowing and becoming faint. My main question here is are there circumstances in which palpitations can become dangerous and cause something such as what I experienced? I don't typically feel my heart race. Just a skipped beat followed by a hard thud when it kicks back on. I have only had a different feeling 2 other times that I recall very recently where it felt like my heart just stopped and I felt what was like a shot of adrenaline in my body at the same time.
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Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
A cardiac arrhythmia would partially explain your symptomatology.

Detailed Answer:
Hello!

Thank you for asking again on HCM!

I read carefully your question and understand your concern.

Regarding your heart palpitations, I would explain that a cardiac arrhythmia could be the cause of palpitation followed by fainting, but it would not explain the other symptoms that you experienced (warm tingling in your chest,neck and face and the narrowing vision).

Usually cardiac arrhythmias are associated with other symptoms like shortness of breath, changes in your blood pressure, blurring vision or bright lights, dizziness, etc.

Anyway, an ambulatory 24-48 hours ECG monitoring is needed to exclude possible cardiac arrhythmia.

Sometimes a cardiac arrhythmia can trigger epileptic seizures, but generalized ones (with complete loss of consciousness and convulsions).

As I mentioned before, you should also go ahead with your EEG and brain MRI too, to be sure that everything is ok (your heart and your brain). A possible seizure could mimic all this clinical scenario.

I would also advise to closely monitor your blood pressure.

Besides, a consult with the endocrinologist to examine better your thyroid gland function is necessary too. Thyroid gland is a very important gland, which has strong influences on the function of many organs in the body, including the heart and the brain.
Further tests (fT3, fT4, echography and scintigraphy of the gland) are necessary to establish the diagnosis.

It should be properly treated.

Hope to have been helpful!

I am at your disposal for further questions, whenever you need!

Best regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka 53 minutes later
and it's true that even most cardiac arrhythmias in and of themselves generally aren't life threatening, correct?


I'm sorry, this whole thing has brought on this GAD all of a sudden and I've never dealt with it before. I'm quite literally worrying myself to death over this whole scenario and looking for any positivity to set my mind at ease a little haha. I have a beautiful wife and 3 small children and the thought of not being around for them is terrifying. I'm just trying to get a handle on if this is potentially life threatening or something fairly minor and easily treatable. Thanks so much again
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
Most of cardiac arrhythmias are not life threatening.

Detailed Answer:
Hello again!

I understand your concern.

You don't have to worry so much about this.

It is very important to be calm.

Most of cardiac arrhythmias are not life threatening and can be treated, especially in case of a normal cardiac structure.

Only some of them (ventricular arrhythmias) can be life threatening.

In your case it doesn't seem to be any severe cardiac arrhythmia underlying your symtomatology.

From the other hand cardiac arrhythmia and anxiety are closely connected.

As anxiety could raise the blood levels of chatecholamines (adrenaline and noradrenaline), which induce the heart to beat faster and even cause ectopic heart beats.

These ectopic heart beats are quite normal during anxiety and physical stress. There is nothing to worry about them.

Anyway a cardiac ultrasound and an ambulatory 24-48 hours ECG monitoring are necessary to examine better the structure and the electric function of your heart.

Meanwhile, I would advise you to relax, take a deep breath with your eyes closed and don't think about anything else.

Regarding GAD, you should discuss with your doctor the possibility of starting a long term preventive therapy, like an antidepressant (SSRI class, etc), which are better than ativan.

I would not recommend taking ativan for prolonged periods of time as it can cause tolerance (you need higher doses to have the same effect) and dependence (you feel worse when you don't take it).

Psychotherapy would be also very useful, to help you manage your anxiety.

Hope to have been helpful!

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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