Discussions By Condition: I cannot get a diagnosis.

Prolonged presyncope attacks during rest

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: pmbruun
  • November 28, 2009
  • 01:10 PM

Over the past year, I have been experiencing attacks where my blood-pressure suddenly drops.

I get dizzy and nearly faint, but do not loose consciousness. Attacks happen unexpectedly, with no immediate cause, typically while at rest - sitting or lying down. Duration is 10-30 minutes, and lying down Getting legs up, etc does not help at all. I get extremely pale with blackness under my eyes.

Attacks started in February 2009. During March-April they occurred approx. 1 time each week, then rate dropped to approx. once per month.

Severity varies. During the severe attacks I also experience chest pain.

Last attack yesterday was typical:

I had been home from work for about 1 hour doing dinner preparations. I lay down on couch because I was feeling tired. After 5-10 minutes, at 7pm, I experienced sudden severe dizziness, tingling in fingers, etc. There were no external causes, I was not getting up or changing position, no events, no disturbing thoughts.

I have been through numerous tests, which have ruled out numerous obvious causes:
- ECG: Normal.
- Blood tests: Normal. No signs of heart attack. Not diabetic.
- MR Heart scan: New scanner captures working heart. All normal.
- MR brain scan: Normal.
- EEG: No epilepsia.
- Work (cycle) test: Normal.
- Tilt test: No response with or without Nitro.

Only positive test was breathing-test: 3 deep cycles per minute, holding breath. This caused hypotension while holding breath, and my sensations matched those occurring during attacks, confirming the cause to be acute hypotension.

However, due to this I have specifically payed attention to my breath during attacks, and breathing is slow and normal. Also, I usually recover quickly after hyper-ventilating - not so after these attacks.

What is worrying me is the duration of the attacks. Thet are not orthostatically induced, and the symptoms do not go away by getting legs up, pressing blood out of legs.

Also, after each attack, I am shaken for 30-60 minutes, and I feel weak for 1-2 days before really recovering.

I have no diagnosis, but after the breathing test, doctors have given up finding the cause. They did give me this advice: "Do not sigh" - seriously.

Other factors:
- I am a tall male - 192cm and somewhat overweight 107kg.
- I am somewhat overworked/stressed
- I have always been susceptible to Vasovagal episodes (blood, etc), and orthostatic dizziness, so I know the feeling of presyncope, but this is very different: No trigger, long duration.
- I am drinking water and tea in sufficient quantities. Drinking during/after attacks does not help.
- I am not taking any medication. No drugs or alcohol.
- I have never smoked.

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