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What meds are best for pre-syncope caused by obstruction?

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  • What meds are best for pre-syncope caused by obstruction?

    Hi everyone,

    Before I even start the rest of my post, I know that the answer is to talk to your Dr., but since he is at NASPE until next Monday when I see him, I will post and see what everyone else thinks so I will be prepared next week.

    I have HOCM, and was implanted with an ICD/pacemaker in February.

    I was feeling pretty good, being paced at 60 bpm about 50% of the time, and am taking 25 mg. of atenolol twice a day. I was having the occasional arrythmia, but feeling less short of breath and generally better until last week when I went to visit my family in New Orleans where it is much hotter and more humid than here in sunny California.

    (I was also taking antibiotics and guenafenesin for a sinus infection which may or may not enter into this), but anyway, while I was there, I started having much worse arrythmias and almost fainted several times. My ICD was quiet at least, so apparently the rhythms weren't dangerous, but I was feeling really bad.

    I called my doctor at home who wants me to have blood work done and who I will see Monday, but in the meantime over last weekend I almost fainted several times in one day. In a panic I called my dad's cardiologist who is also a friend of our family and treats my dad's HCM. He felt sure that my symptoms were being caused by obstruction and not arrythmias since my ICD didn't go off and due to the weather and other circumstances. He advised me to drink alot of water and to be very careful, advice which I took to heart and which really did help.

    In the meantime, though, I still am having terrible palpitations. I am sure my meds need some tweaking and I am thinking about asking for Verapamil. Up until now, the only thing I have taken is atenolol, which has been ok, but is obviously not entirely taking care of the problem.

    Any thoughts or words of advice?
    Daughter of Father with HCM
    Diagnosed with HCM 1999.
    Full term pregnancy - Son born 11/01
    ICD implanted 2/03; generator replaced 2/2005 and 2/2012
    Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

  • #2
    Re: What meds are best for pre-syncope caused by obstruction

    This may be stupid advice but maybe you should get your icd/pacemaker checked out and make sure it is still running the same way as when you had it installed. Perhaps something has gone haywire or something. I hope you can get in asap and get everything checked out. I am sorry you are not feeling too well Cyn...

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    • #3
      Re: What meds are best for pre-syncope caused by obstruction

      PS Your baby is adorable!!!

      Comment


      • #4
        Re: What meds are best for pre-syncope caused by obstruction

        Hey Kathy,

        No, your suggestion isn't stupid...the doctor who installed the ICD is who I am seeing next week when he returns from the same conference Lisa is at. They do check the device every 3 months, and I am due and will do that next week.

        And thanks for the compliment about the baby. I am going to upload some new pics from the trip soon, so stay tuned...that one is old.
        Daughter of Father with HCM
        Diagnosed with HCM 1999.
        Full term pregnancy - Son born 11/01
        ICD implanted 2/03; generator replaced 2/2005 and 2/2012
        Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

        Comment


        • #5
          Re: What meds are best for pre-syncope caused by obstruction

          Hi, Cynthia!

          I have learned that much of my own dizziness is related to my blood pressure dropping too low. We keep it pretty low with the beta-blocker normally. And when I get dehydrated it drops pretty fast. We do have hot--and sometimes humid--weather here in Yuma and that has always made it worse. So I drink 3 to 5 liters of water daily in hot weather. Since you are not acclimated to the hot humid weather in New Orleans you probably lost fluids fast.

          I'm also wondering if sometimes I have a sodium depletion when I'm out for long in the heat because I'll feel dizzy and generally yucky at the same time as I crave chips. I usually find that eating something salty, drinking more water, and resting a bit will make me feel better. I'm going to check out this idea with my cardiologist tomorrow!

          Have you a way to check your blood pressure when you're feeling dizzy and having the irregular beats? That would give you more information to take to the doctor next week.

          Good luck--and always sit down before you fall down! (I've learned that the hard way!)

          Pat

          Comment


          • #6
            Re: What meds are best for pre-syncope caused by obstruction

            Sometimes guifenesin has sudafed in it. You should be careful with any decongestant. Many of them will make your heart race or act weird. Ask the doctor who prescribed it to you whether or not the one you used might've had the sudafed in it.

            Reenie
            Reenie

            ****************
            Husband has HCM.
            3 kids - ages 23, 21, & 19. All presently clear of HCM.

            Comment


            • #7
              Re: What meds are best for pre-syncope caused by obstruction

              I am hitting the road in a few minutes so ya caught me before NASPE!
              Great advise guys - I would check the device first and soon - if you had been traveling there is a chance that you were in a magnetic field that altered your programing - call your ICD clinic and ask to get checked out.
              Lets work on that one before you head off to more meds.
              Of course if it is not the ICD then lets look at the BIG picture and try to find the cause of the problem - this may mean an event monitor, blood tests and maybe some non cardiac work ups based on your history.
              Be well -
              If you need to get intouch with me - call the office and they will get your # to me on the road - I have a 4+hr drive ahead of me..WITH MY CELL PHONE!
              Take care,
              Lisa
              Knowledge is power ... Stay informed!
              YOU can make a difference - all you have to do is try!

              Dx age 12 current age 46 and counting!
              lost: 5 family members to HCM (SCD, Stroke, CHF)
              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
              Therapy - ICD (implanted 97, 01, 04 and 11, medication
              Currently not obstructed
              Complications - unnecessary pacemaker and stroke (unrelated to each other)

              Comment


              • #8
                Re: What meds are best for pre-syncope caused by obstruction

                Hi guys,

                Thanks for your suggestions. Pat - My Dad's doctor suggested exactly what you did...eating salt and drinking water. I am back in L.A. now and am definitely feeling better, but am off to the lab today to check my magnesium and to have a Chem 7, whatever that is. Also, I am hypothyroid so I am checking that out too.

                Reenie - As to the Guinefesin, it doesn't have any sudafed in it because I already know I can't take that, but I wonder if the Guenefesin alone has any affect. I have stopped taking it until I can get checked out. Also, sinus infection is now gone.

                Lisa - As soon as you are done with Dr. Cannom at your conference, I will see him Monday. I am off to have those labs done today so I will have them when he gets back. As I think I told you before though, I wasn't sure my symptoms were improved enough before, esp. the palpitations/chaotic heartbeat feelings. That is what was and continues to be really bothersome, so I will discuss with him.

                We are going on another very hot trip later this summer, and I would hate for this to happen again.

                By the way, I also asked for a pat down both ways and avoided the metal detectors, so that shouldn't be the problem, but who knows. I have been to lots of stores with them in the past few months.
                Daughter of Father with HCM
                Diagnosed with HCM 1999.
                Full term pregnancy - Son born 11/01
                ICD implanted 2/03; generator replaced 2/2005 and 2/2012
                Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

                Comment


                • #9
                  Re: What meds are best for pre-syncope caused by obstruction

                  Some thoughts.....

                  If you find change in the rythms, do not wait for the 3month check up. I had pacemaker installed 4weeks ago, and i have been to my packemaker tech. almost everyweek. Now (Knock on wood), I feel much better.
                  I have an excellent pacemaker tech who reads up on HCM and research papers on various adjustment techniques for our type of problem before my appointment.

                  I felt a lot of palpitations a week after my pacemaker. It turned out, I had the AF suppression feature ON since my doctors had thought I had A Fib. And it was responding to every PAC or PVC. Some times antibiotics and food/liquids increase your PACs and PVCs.
                  After they turned off the AF suppression for me, I have been feeling great. Also changing my Toprol dose changes premature beats, and it takes a week after the dose change for them to settle down.
                  Hope you feel better....
                  Ketan Thanki

                  Comment


                  • #10
                    Re: What meds are best for pre-syncope caused by obstruction

                    An update from the desert southwest, Cyn! It sounds like you're addressing everything which needs to be checked out and you'll have answers soon. Great!

                    Knowing that I drink lots of water, my doctor suggested today that when I know I'm going to be spending an extended period outdoors doing some exertion in the heat, I should eat some salty stuff the afternoon and evening before. Or drink Gatorade instead of some of the water while I'm in the heat. It sounds like there's some agreement here that sodium loss could at least contribute to increased symptoms.

                    Interesting . . . .

                    Keep us posted, okay???

                    Pat

                    Comment


                    • #11
                      Re: What meds are best for pre-syncope caused by obstruction

                      I've had some of the same experiences as you with the almost fainting and things like that. Being that I live in Florida I am constantly fighting the humidity and heat. We have already hit 95 twice this past week. A couple of those days I was out riding the Segway all day in a vest, lycra shirt, and black polyester pants. Needless to say the heat was getting to me. I'm hypoglycemic as well and have very low blood pressure and we are not sure anymore what is causing what.

                      To make a long story short I was working last night and guess I bent over to fast and next thing I found my self lying on the floor. It must not have been long becasue I jumped up real quick and everyone started laughing so for the moment I laughed it off. This morning I ended up at the Dr. office with a sprained shoulder. Fun! So I guess at this point any insight would be nice. I think I might give the docs up in Boston a call and see what's up!

                      Oh well, my two cents.

                      Mary

                      Comment


                      • #12
                        Re: What meds are best for pre-syncope caused by obstruction

                        Good morning Cindy,

                        #1 thanks again!

                        #2 You are familiar with Jamies story regarding syncope & pre syncope. Since she was started the Florinef 0.1mg............it hasn't been a problem...at all. This med helps keep the fluids up and appears to have helped tremendously. She's been on it for about 2 months now.

                        Jamies home from college and says hello and where is this picture of the baby????

                        Take care!!!

                        Karen

                        Comment


                        • #13
                          Re: What meds are best for pre-syncope caused by obstruction

                          Hi Karen,

                          I had forgotten about Jamie's situation. That is something to think about. I will discuss with the EP.

                          As to the picture, here it is again. For some reason, every time I post it, it works for that day, and then goes away. I wonder if it has something to do with being logged on to my ISP or not.

                          Anyway, here is a small one. We will see how long it lasts. This picture is a few months old. We just celebrated his 18 mo. birthday, and he is doing great.
                          Daughter of Father with HCM
                          Diagnosed with HCM 1999.
                          Full term pregnancy - Son born 11/01
                          ICD implanted 2/03; generator replaced 2/2005 and 2/2012
                          Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

                          Comment


                          • #14
                            Re: What meds are best for pre-syncope caused by obstruction

                            Hello,

                            I still can't see the picture?!? I'm clicking on the X under your name, but I can't open it. I'll wait till the kids get home from school.....they can educate me!!!

                            Thanks.

                            Comment


                            • #15
                              Re: What meds are best for pre-syncope caused by obstruction

                              Dr. Cannom should be home now...GO GET HIM! and tell him I said hello..
                              My goodness that man has a strong hand shake - he left ring marks on my hand!
                              Be Well and DRINK water!!!!
                              Lisa
                              Knowledge is power ... Stay informed!
                              YOU can make a difference - all you have to do is try!

                              Dx age 12 current age 46 and counting!
                              lost: 5 family members to HCM (SCD, Stroke, CHF)
                              Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
                              Therapy - ICD (implanted 97, 01, 04 and 11, medication
                              Currently not obstructed
                              Complications - unnecessary pacemaker and stroke (unrelated to each other)

                              Comment

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