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What causes fainting inspite of having normal cardiac tests?

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Posted on Wed, 11 May 2016
Question: to doctor XXXX
it is XXXXXXX I am so sad because four doctors told me that I am dying because I didn't go to the doctor when I felt faint. the particular reason it is so upsetting is that I knew my dad died young because he was born with a problem with his heart. his hear was actually on his right side not left. but every one else in my family have died in their 80's and 90's. which when I was happily running my school I thought would be the case for me too. heavens knows why I took the advice of a personi didn't respect. I should have done my norm of ringing the doctor for everything that was wrong. doctor pope said to me that we like our patients to live long lives but if they don't go to the doctor when they are feeling faint they can't expect to live long. I showed my physiarist the medication that you suggested and he said that he didn't take advice from a cardiologist. all he did was reduce the veneflaxine a little. by one tablet. all I can do is accept I am dying although you are the only person who believes otherwise which is why I am mailing you again. I don't understand what I am dying of just because I didn't go when I felt faint a few times. I guess I really should have gone because my worse fear was dying young like my dad but never thought I would. I am only 63. I am so scared.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
My answer as follows:

Detailed Answer:
Hello dear XXXXX!

Welcome back on HCM!

I completely understand your clinical situation and would reassure you that you are not dying from any cardiac disorders.

As I explained to you before, there are several causes of fainting. The fact that these episodes occurred a long time ago and didn't repeat (which means that whatever was the cause, it resolved spontaneously), means that it was a clinically non-significant cause.

Your performed cardiac and brain tests also reassure that you have a normal heart and brain. If a disorder affecting the heart or brain would be the cause of these past episodes of fainting, these episodes would repeat, until you had gone to the doctor.

So, just relax. Nothing would have changed in your body if you had gone to the doctor at that period of time.


There is no obvious medical cause for to XXXXXXX You are going to live as long as other healthy individuals.

Regarding your father's medical history, I would explain that it is normal in such individuals to have a shorter lifetime span than others. But your performed cardiac tests have excluded any similar cardiac disorder. So relax. You have not inherited any potential life-threatening cardiac disorder.

The only problem you have is the psychological fear that you are dying.

I understand your doctor, that he can not rely on a cardiologists medical opinion on psychiatric disorders. But I would recommend changing your psychiatrist and consulting with another psychiatrist.

The fact that he reduced the dose of venlafaxine, would not be the best thing to do. It should be switched to another drug, as it doesn't seem to be effective in your case.


You should try to think about other things, like theater, cinema, musical plays, go out and make some shopping, jogging in the fresh air, etc..

You should try to be in touch with your children and create a possible new relationship. Loneliness is not really helpful for your psychological health.

Hope you will find this answer helpful!


Best wishes,

Dr. Iliri




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)
hello again
thank you for your answer. firstly I would say that the feeling faint episodes did continue for several times. I should have seen the doctor and can't think why I didn't. I am cross with myself.
my children won't let me be in touch with them sadly. especially when I had such a good rapport with them at one time. I am in this supported living house and I really hate it. I feelthat it was so unlike me not to go to the doctor i.e. when I felt faint several times... so out of character because before that I used to go for everything even little things. I don't understand when I read your comments why those doctors have said I am dying. thy seem very certain about it. I can't do those things you suggested because I am too scared to go out.
alo I don't know why I have been ill for ten years.
I knew my dad would have a shorter life span because of his problem he was born with. but I feel I have mesed up my chances of a long life which I should have had
doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
My opinion:

Detailed Answer:
Dear XXXXXXX

There is no reason for you to XXXXXXX early. I reassure you about that.

Even though the episodes of fainting kept repeating, if it was a serious medical cause underlying them, I can assure you that you would have had further problems, which would oblige you to see the doctor. But this didn't happen.

From the other hand your actual performed tests have excluded any possible serious life-threatening disease affecting the heart and brain.

So relax! I really do not understand why these doctors can say something like that. All your tests say the opposite: that you are going to live a normal life like all other healthy persons.

Coming to this point, if you turn back to your questions, and read what you have written, you would understand that the only problem in you is a persistent thought that you didn't go to the doctor and you are going to XXXXXXX for this. But this is not reality, just an irrational obsession.

I can reassure you of that.

I am not a psychiatrist and I can not treat you for your psychological problems. I can only make suggestions, which you should discuss with your attending physician. I have a lot of information on antidepressants and their uses. Besides, many of cardiac patients suffer from depression and anxiety and take antidepressants or other drugs used in mental disorders.

That is why I recommend you to consult with another psychiatrist. Venlafaxine is not the only drug for these problems and it doesn't seem to be effective in your clinical situation.

Regarding your family, I would recommend making another try to reach them. You should try to get out of the house and be independent. Soon, you will understand that there is nothing to worry about. You can walk on the streets alone, go to theater and cinema and nothing bad will happen. You should try to release yourself from this obsession. You are the only person who can help yourself. Just try to repeat yourself every moment that you are a healthy normal person.

There is a lot of XXXXXXX out there and a normal life that you are missing, because of this virtual cage, in which you have put yourself. It is time to move on.

I am always at your disposal, whenever you need me!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
you are right if I re read my questions it all comes down to the unusual; practice of me not going to the doctor about something.

however although I understand what you sre saying that I would have had further symtons if it had been something bad a lot of things have happened to me which are depressing and make me feel I haven't long to live. firstly I lost my job that I loved. I had been teaching since 1974 and I got so much XXXXXXX from my work, secondly my partner left me because he thought I was dying. thirdly I have ten years when I have missed all family events, my sons 30th birthdays, my son's wedding, mu niece's wedding and she has two children now I havn't met and they must be about 10 now. none of my friends talking to me. being in this place which I never would have expected, neither of my sons talking to me and yes I have made enormous efforts, what can I do when my eldest son won't answer my emails or phone calls. I have had horrible Christmases in instutions and I used to be really good at planning and having wonderful Christmases, my youngest son has nothing to do with me. and I could go on. yes I did have a life with XXXXXXX an d I loved it but for some reason even if it isn't the feeling faint episodes something has gone really wrong. I haven't even been able to help my daughter in law with the children like my mu did for mre. I didn't see XXXXXXX at all in the first year of his life. and only a few times since. my left hand feels permanently numb although I can move it. I am so scared because it does feel like I must be dying. my brothers are both very well and fit . I no longer drive which I really enjoyed and haven't been on an aeroplane to anywhere since I was 50 and the staff bought me a trip to oslo. people just don't want to know me. I used to have a wide circle of friends and have lot them all. I bought my son a good bye present... a holiday at butlins . I have sent other goodbye presents to others which they will get this week, I haven't shared mothers day with my boys for ten years. all I have in my room are pictures of my grand son whoch have been sent o me. the only contact I have with my youngest son is looking at a web site which has his award winning photos on. he has blocked my emails and I have no phone nuber for him. I have written to him but he has told me that he doesn't read my letters just bins them.
I used to sing all the time and enjoy life so much but it is very long time since I have done that. I know you are an expert and I know iu haven't got the same as my dad had and I know two tests n my heart were okay but I wish he had done more. I can't get out of my head the doctors words " we hope out patients will live long lives but if they didn't go to the doctor when threy felt faint they can't expect to. the other g.p. said he didn't know what was wrong with me. the male g'p said I hadn't got very long and the last doctor in that practice said that most people go to the doctor when they feel faint nd she didn't know what would happen to me. sincerely you are the only one who believes I will be okay. I am cross with myself anyway because my normal practice was to go to the doctor about everything and at least if I had gone when I felt faint several l times I would feel easier now. I really don't know how to cope with the situation I am in. I used to be such a happy person but now I am as someone said to me a miserable old sod. I don't know how to cope, you say go out but I feel so scared I bought a theatre ticket for a comedy play on in Windsor and didn't go. I couldn't feel confidnt. all my old friends are having their grandchildren round for tea and sleepovers . there are tenants in my lovely home that I fought so hard to keep when I was on my own with the children. my best friend said to me that I can't have looked after myself as well as I thought and I was dying and that she had lost a lot of her friends! another said people die younger than you. you said about changing physiarist but the one I have got is reputed to be the best . and most people have said that. he did offer me seeing someone else who may think of something that he hadn't but there isn't anyone else with the sort of knowledge and research he has done. I have a nasty cough which doesn't seem to clear. my worse fear in life was dying young like dad not necessarily with the same problem but I really feel that I am. I feel that I have lost everything precious to me. I used to get loads of cards at Christmas but now I only get two or three.
I understand what you are saying about being the only person who can hep myself and the cage I am in. but I have tried so hard to help myself by seeing counsellors and a physc therapist. nothing has worked. my son says I am just wasting money.
so you see although I understand exactly what you are saying I feel that I can't put it into practice. even the company you are employed by stopped me asking any more questions until my new subscription was paid as they said I asked more questions than the avearge user and banned me for that short time. they said it was a potential abuse of the system. I understand what thy mean, in my old life I may have asked just one question like perhaps about the headaches I got and that would be all. and I guess many people only have one question to ask. I know that I am repetitive and that must be hard for you and frustrating but I am sure you must understand that I feel so scared when doctors have said those things to me and it wasn't only one as you can see. all the doctors at the practice have said the same sort of thing. if it was just one I would feel that they must be mistaken but all of them it is very scary. I don't really know how you can help except you ARE the only one who sees things differently. and you must be more qualified than the average g.p. I never thought I would be stuck in this poky room fearing death. it is ten wasted years buti don't seem to have been able to do anything about that. you say about being the same as the average individual but I am not am I? I haven't my job. my family life. my own home any more. none of the things that were precious to me seem to remain. I feel in a hopeless position. I have a friend who has bone cancer but she lives a better life than me. you must wonder what you can do to help me and I wish that I could just move o n and get rid of this virtual cage. but I honestly don't know how. I suppose I need you to tell me how, I am amazed that this should happen to me.
doctor
Answered by Dr. Ilir Sharka (7 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Dear XXXXXXX

I am really touched by your words!

This is a virtual site and I wish I could really help you if you were my patient in my clinic.

But the only way to help you is my giving some advises.

It is up to you to believe in my words and practice in your everyday life some of my advises.

I assure you that you have no cause to be dying soon. You will live like normal persons. The only fact that your friend with bone cancer lives better than you, is that she is not afraid to live as it was the next day of the rest of her life.

Nobody knows how long we are going to live. We can be OK, and then going to work we can have an accident. We can have accidents at home too (gas intoxication, an earthquake, electricity shock, etc.). But we should live our lives, as it was the next day of the rest of our lives.

This means that it is important to live and do not care how long. The only thing that matters is how we spend our life, with emotions, happiness, friends, beloved persons.

You should know that it is really selfish, to think about yourself all the time and of the fear of dying. Persons around us need some attention. We should hear the others, pay attention to their problems, sorrows and then they will hear us and our problems.

You should be more opened to the world out there and to other persons. That is why you have some some of your friends. Because you should try to hear them time after time and not think about your irrational fear.

The only person that can really help you is you! You are the only person, who can take the courage to move on and go out without fear. You are the only one to condition your life. Nothing is lost forever.

There is always hope until there is life. And you are alive. You have been alive for ten years, waiting to XXXXXXX But you are still here. And you can get back what you have lost. Tomorrow is another new day. And the day after tomorrow too.

You are the only one who can make the change.

A good therapy would also be really helpful. I have seen a lot of patients like you, with problems like yours. And psychiatric drugs can make miracles. You should only consult with a good psychiatrist.

Regarding the head numbness, there is nothing to worry about. Your brain MRI was OK, so any possible disorders which could explain this numbness have been ruled out.

Try not to think about it!

Hope you will find this answer helpful!

Wishing a nice weekend,

Dr. Iliri

p.s.: Try to go out this weekend. It is not so cold any more.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka (2 hours later)
hey,,, doctor Iirri where is your clinic? I would love to see you in person and really get down to serious discussion with you but I guess from various comments you have made that it isn't in England.
I think I need to accept that not going to the doctor when I was faint is irrelevant to how I am now. it is just it lingers in my mind that all the doctors here think it is.
you did pull me up by saying I was selfish, one member of staff here said that I abuse the staff here by saying I am dying. my friend with bone cancer has been told she can live up to ten years unless it goes into a major organ so she has a job unlike me and is working full time to fund her next holidays. in my ten wasted years in mental hospitals and here in this horrid house she has travelled to china and lots of other places and I am happy for her. I wish however that a doctor had said to me that I have another ten years (given the possibilities of an accident etc) my financial adviser who was also a very good friend was killed in a car crash. so I know that life is unpredictable.
I never used to be scared of life . I lived happily and was content. now my daughter in law travels on a regular basis to her own country and her parents have seen far more of the grandchildren than me. I do feel neglected by friends, and family and I do feel sorry for myself because of the loss of the good life that I had. I haven't been out at all since Wednesday but I will take your advice and go somewhere for lunch today. I am afraid that I remain in a muddle. some one has suggested a hypotherapist I don't know if that is how you spell it but putting you into a state of altered concoiusness to find out what the trigger point was and working from there. what are your thoughts on that?you say you have seen similar people with problems like mine.. is it always the right medication that does the trick? I saw my physiarist last Monday when he said as I told you that he wouldn't take advice from a cardiologist which you understood but I didn't. to me things are worth a try if they might make me feel better. he did say would I like to see a different physiarist who may think of something he hasn't/. but the problem is that the one I am seeing doctor vassos is supposed to be the best. I just want my old life back and that is impossible. I shall venture out for lunch with trepidation! thank you for your patience with me and my repetition. I really wish those doctors had never said anything. but I keep saying to myself that you are far more experienced than any of them. XXXXXXX
the numbness wasn't in my head. it is my left hand which feels numb all the time although I can move it.
it is hard to explain how much I delighted in life when I was bringing up my boys and when I was teaching leading to me running my own school. I lapped life up and was a real " party girl" doing fun things most of the time.
my first secretary when I was a head can't believe that I am here. she used to call me a worry wart because I went to the doctor for everything... you see because of the doctors here I still believe that I was wrong not to go to the doctor when I felt faint a few times. I just wish that I could be less "selfish" and get it out of my mind. I said you were the only one who believed I am not dying but there is one member of staff here that thinks you are so right and she says where is the evidence that you have something terminally wrong with you. that those doctors who have told me these things should give me some evidence for their point of view, I didn't tell you about doctor XXXXXXX at the surgery. apparently when I was in hospital a short time some of my blood tests were abnormal. so I asked her which ones I needed re doing at the surgery and she said it isn't worth you having them done as you are dying! when I read your answers they make me feel positive and then all I have lost and the reactions of the doctors and my boys make me think differently again. I can't keep asking you the same questions and soon must close the discussion and do the review. I would be interested to know why my left hand feels numb, why I have a cough that won't clear, and I still don't know how to get out of this cage. when I am rarely out like last Wednesday I went to dandos for lunch I get on
well with other people and always interact with them. you said about how you live your life but I did have someone that I loved very much and we had a wonderful time together for 8 years until I fell ill at which point he left me. I still love him but there is nothing I can do as he is with someone else now. that is one of the things that I meant when I said to you that I feel that I have lost the things that were precious to me.
doctor
Answered by Dr. Ilir Sharka (11 hours later)
Brief Answer:
My answer as follows:

Detailed Answer:
Dear XXXXXXX

Unfortunately my clinic is in Albania, far from England, and the only way to discuss with you about your problems is this site.

I would like to review all your blood lab tests and give another second opinion, if you have them.

I really am surprised by such nonprofessional reaction of my colleges. We doctors in medicine usually do all in our power to keep patients alive. And when they are in serious risk of death, we make frequent repeated tests to closely monitor their medical situation, in order to do whatever we can to help them.

The numbness in your hand can be psychological or related to a nerve compression. No one of these disorders is lifethreatening. A nerve conduction study (electroneurography) would help determine possible peripheral nerve disorder. Other central nervous system disorders (like possible stroke, demyelinating disorders, inflammation or a tumor) have been excluded by your brain MRI.

I understand that you have lost your beloved person. But you can still find another one. There is always hope for a change, until we are breathing. And there is a lot of fish in the sea. You should just try to think about it, go out and make some new friends. Life is full of surprises.

I understand that your psychiatrist seems to be the best in your place, but you can try to consult with another one, just for a new opinion. I really insist that some changes in your therapy could still make a difference in your clinical situation.

I strongly encourage you to go out and try new experiences. You should let yourself be more opened to the world and its possibilities. And maybe, going out, talking with new persons, will help you create e distance from your bad thoughts, and even forget about them for at least some minutes. This would be a big progression.

Hope to have been helpful!

Best wishes,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

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What causes fainting inspite of having normal cardiac tests?

Brief Answer: My answer as follows: Detailed Answer: Hello dear XXXXX! Welcome back on HCM! I completely understand your clinical situation and would reassure you that you are not dying from any cardiac disorders. As I explained to you before, there are several causes of fainting. The fact that these episodes occurred a long time ago and didn't repeat (which means that whatever was the cause, it resolved spontaneously), means that it was a clinically non-significant cause. Your performed cardiac and brain tests also reassure that you have a normal heart and brain. If a disorder affecting the heart or brain would be the cause of these past episodes of fainting, these episodes would repeat, until you had gone to the doctor. So, just relax. Nothing would have changed in your body if you had gone to the doctor at that period of time. There is no obvious medical cause for to XXXXXXX You are going to live as long as other healthy individuals. Regarding your father's medical history, I would explain that it is normal in such individuals to have a shorter lifetime span than others. But your performed cardiac tests have excluded any similar cardiac disorder. So relax. You have not inherited any potential life-threatening cardiac disorder. The only problem you have is the psychological fear that you are dying. I understand your doctor, that he can not rely on a cardiologists medical opinion on psychiatric disorders. But I would recommend changing your psychiatrist and consulting with another psychiatrist. The fact that he reduced the dose of venlafaxine, would not be the best thing to do. It should be switched to another drug, as it doesn't seem to be effective in your case. You should try to think about other things, like theater, cinema, musical plays, go out and make some shopping, jogging in the fresh air, etc.. You should try to be in touch with your children and create a possible new relationship. Loneliness is not really helpful for your psychological health. Hope you will find this answer helpful! Best wishes, Dr. Iliri