Syncope/Presyncope advice

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FredW

Premium Level User
Joined
Dec 16, 2015
Messages
263
Location
Rochester Mills, PA
OK fellow aortic stenosis folks, I would like some feedback. For those of you who are, or were, symptomatic with your stenosis, can you help me identify if my episode today was serious enough to call my cardiologist about? Here is what happened:

For the past few months I have been what I call mild stenosis symptoms: slight dizziness when I get up, mild heart (chest) pain, fatigue, shortness of breath. My cardiologist knows of these symptoms. In the past few weeks, the dizziness has become more frequent, the fatigue more predictable - every time after eating and lying down, the mild chest pain more often. My next appointment and echo test is in July. This afternoon, I was changing hooking up my belly mower on my mid-range tractor and when I crawled out from under it and stood up, I became instant dizzy. Recognizing that I may have gotten up too fast, I tried to just hold still until it passed. It normally does. Feeling like the garage walls were moving, I reached out to hold on to the side of the garage door and totally missed it. It felt like somebody moved the wall on me :) I staggered out the door and fell on my butt outside the garage. While on the driveway, I thought: "Wow! I haven't even been drinking." I then felt nauseous and thought I was going to throw up. I have a fairy good ability to stop that, for it makes me sick to throw up :) so I stopped that. I then just laid there for a few minutes wondering if I should try to extract my cell phone out of my pocket. My wife was out shopping and I was home alone, so I figured I would wait to see if I got better. This all happened with about a minute or two. I got better, slowly got back up. found the door frame I missed earlier to hold on to something and stood there thinking: "What was that?"

I cut grass for two hours and came in to do research on syncope. From what I read, I think this is called a presyncope for I did not loose consciousness. There may be many reasons for this spell. I was not hydrated well for I had been working outside for the past few says sweating more than drinking water. I had been dealing with some stress this morning. I didn't sleep well the night before, and I had just eaten. Also, my beta blocker has been doing a fine job of getting my resting heart rate down to the high 40's.

My question for those of you more experienced than I is was this a classic syncope (or Presyncope) and should I call my cardiologist and tell him about it or wait until my appointment in July to tell him?

Thanks in advance
 
I would drop the dime and make the call. This may or may not indicate a worsening of your symptoms, but stenosis patients who ignore the cardinal symptoms (shortness of breath, chest pain, syncope) put themselves at greatly increased risk. It is most definitely worth the conference, and the doc may want to get you in for that echo sooner than July.

Also, unless you are some sort of an athlete, a resting heart rate in the high 40's is not usual. My resting heart rate, before my valve surgery, was down around 45 - 48 bpm. We attributed it to 30+ years of running and jogging. Man, were we wrong. I actually had brady/tachycardia. This is a syndrome in which the patient's resting heart rate is too low, yet their heart rate goes too high under exertion. When I was running, my heart rate would go up to the 160's or higher - and I was already in my mid to late 50's.

When I had my valve replacement, my heart rate would not regulate post-op. It would go slow, then fast, then beat extra times, then just stop. . . . . . for up to 20-30 seconds before re-starting. The doc's said that given time, they thought they might be able to regulate my heart rate with medication, or they could simply implant a pacemaker. I told them to just put in the pacer. What a difference! It keeps my resting heart rate at 60 bpm or higher (at least it did until my ventricular lead began to fail - see my other thread), and once we got all the adjustments right, life became very "normal."

Get it checked out. Life is too short as it is, without taking unnecessary risks as patients.
 
I agree that it's wise to contact your cardio. After I saw mine for the first time, he told me to let him know if I had any dizziness or lightheadedness. I think yours would want to know, too.
 
If nothing else, maybe they'd want to ease up on those beta blockers! It seems odd that they'd be intentionally trying for a heart rate in the 40s. I agree give them a call. You don't sound like a hypochrondriac worrier. You sound like the guy who puts it off too long. Your doc needs info to treat you appropriately.
 

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