Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
197 Doctors are Online

Vomiting, dizzy spells and fainting. ECG is normal. What could this indicate?

User rating for this question
Very Good
Answered by

Practicing since : 1998
Answered : 1306 Questions
I am an EMT. Just attended an elderly patient with fainting & vomiting, dizzy spells. His ECG is normal, then he suddenly has a 20-30second run of rsr conplexes in V1 & V2 which accompanies his symptoms (pale sweaty dizzy vomiting). This self resolves and the symptoms dissipate. What could this indicate?
Posted Sat, 18 May 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 1 hour later
Dear Sir
Thanks for writing to XXXXXXX

The symptoms mentioned by you are signs of low heart output (sweating/ dizziness /pallor).

The First possibility is that he had a Ventricular Tachycardia, where the rsr' complex in V1-2, would have accompanied a prolongation of duration of QRS complex and increase in the heart rate. It will also be showing either absence of P waves or the P waves will lose their 1:1 relationship with QRS complex. In this condition the pumping of heart reduces markedly due to 1. inability to fill properly due to short diastole (or period of relaxation or filling phase) 2. loss of atrial contribution 3. ineffective ventricular contractions.The most common cause for VT is anginal/coronary heart disease. A dilated dysfunctional heart (with decreased pumping) also predisposes to this condition.

Second less common possibility is that he had a supraventricular rhythm which may be irregular (like atrial fibrillation, with no P waves, irregularly irregular) or regular (Atrial flutter/ AV node dependent tachycardias) with rate related prolongation of QRS. These rhythms usually do not produce signs of low heart output (sweating/dizziness/pallor) unless patient has underlying "decreased heart pumping" (systolic failure) or marked relaxation abnormality/ diastolic dysfunction (as in aortic stenosis/ hypertrophic cardiomyopathy).

These rhythms may resolve spontaneously on their own.
If you can upload the ECGs, I would be glad to discuss more on this issue.
Sukhvinder Singh
Above answer was peer-reviewed by
Share on Facebook
Share on Twitter
Share on Google+
Question is related to

The user accepted the expert's answer

Ask a Cardiologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor