What causes palpitations and episodes of passing out?

Question

Hello doctor,

I had palpitations and episodes of passing out intermittently for a few years. I have had blood tests, an ultrasound, and an ECG (electrocardiogram) done, but so far, I have no answers as to what is causing it. Is there anything that can be done to help manage the symptoms at this point, or do I just have to put up with it and hope they find a cause and treat it?

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns.

The probable cause in your case is a cardiac arrhythmia. Firstly, were these episodes witnessed by others? Are there any tonic-clonic movements, similar to those seen in seizures? Additionally, are there any precipitating events, such as stress, urination, or passing stool? This is to rule out the possibility of vasovagal syncope. Given the likely possibility of a cardiac arrhythmia and recurrent syncopes, one option is electrophysiological studies, which can help determine the cause.

Otherwise, we may need to wait and observe until the episode of arrhythmia recurs and is captured on an ILR (implantable loop recorder). However, if you are currently experiencing symptoms and the ILR shows no abnormalities, then it is unlikely to be a cardiac arrhythmia. If you are symptomatic now, the ILR should be interrogated; if you are asymptomatic, electrophysiological studies would be an option. Otherwise, a wait-and-watch approach is advised.

I hope this helps, and feel free to reach out if you have any doubts.