Hi there
Can you enlighten me RLR? so I have a morning without ectopics (well maybe I did have some but didn't notice, but who cares - I felt fine!) and then this happens to frighten me.

I was going round the shops when I started to feel all sweaty and weak and a faint came on. I didn't go out cold because I did lie down before that happened. (I have only had this two or three times in my life out of the blue, if you ignore occasions where it was related to having vaccinations or horrible things). As I lay there I was completely sweating and clammy at the same time ( which I never get like). My pulse was pretty slow (don't know what as I didn't take it).

I kept trying to get up again (cos I didn't want to be lying on a shop floor forever) but each time I took a few steps the same thing happened. It wasn't panic because actually when I was lying there I was mentally thinking straight, although perhaps a bit blank really.

The only other factors I can think of that might relate are that I had my period for the last couple of days, and was a bit crampy (not really bad though), and was feeling a bit warm going round the shops. I was actually enjoying myself though, but while I was paying it all happened.

do you think this could be related to my heart and should I be worrying about there being something wrong they have missed. What about long QT syndrome - would that show up on ecgs? I am worrying because whatever you read, if you have palpitations and fainting it needs to be investigated. Panic and anxiety don't normally cause fainting, do they? Because they raise blood pressure. I wasn't aware of palpitations at the time of the event.

thanks for listening

Neither panic nor anxiety raises blood pressure. Stress can raise blood pressure and is oftentimes associated with anxiety, but you should realize that panic disorder and intense anxiety most always cause downward fluctuations in blood pressure. By contrast, when persons become stressed or fearful, a corresponding increase in vascular tone is experienced, along with an increase in heart rate in most cases. These factors alone will increase blood pressure. A good example is white-coat hypertension associated with visiting the doctor. While anxiety may be present, it has little effect upon blood pressure because patients are actually stressed by the fear that something terrible may be discovered during the visit. This drives blood pressure upward and sets in motion the fight or flight response.  

Fainting, or syncopy, is quite common with both panic disorder and anxiety disorders. Rapid changes in vagal tone can produce a corresponding brief drop in blood pressure. The body responds with an adrenaline increase to boost heart rate and cardiac force, which can produce sweating and nausea. Nowhere is this syndrome more described than in patients who have been suddenly frightened by a horrific event or sudden tragedy occuring in their presence, even the sight of something grotesque. Just ask the average medical student about their first response exposure to the surgery ward. These events all can cause a dramatic change in vagal tone and subsequently, fainting.  

Interestingly enough, persons with severe abdominal cramping have also been known to faint. Again, this is due to rapid changes in vagal tone and blood pressure.  

It's important to realize that diagnosis of something like this can be quite difficult in the absence of direct observation and evaluation, but based upon your description only, this does not sound like your heart. I'm uncertain where you may be trying to make the connection, but I see no correlation between your symptoms and heart disease. As I've stated numerous times, the symptoms associated with benign palpitations are not related to the heart itself, but rather vagus nerve stimulation. The heart is only responding to nervous stimulation. The ectopic beats you feel do not represent a problem with the heart of any nature.

You must learn to remove the association between benign palpitations and heart disease. It would be similar in the instance where diabetes type II can cause blurred vision. A trip to the opthamologist for correction of your vision will only afford you a referral to an internist to address the underlying problem of diabetes. Regardless of how many times you visit an opthamologist to correct your vision problem, the underlying cause has nothing to do with your eyes. People experiencing benign palpitations seek out a cardiologist because the symptom is affecting their heart, but the underlying condition is related to an anxiety disorder in most cases. So the cardiologist and his diagnostic tests will always return a negative result because heart disease is not the cause of the palpitations. No matter how often you return to the cardiologist for benign palpitations, the results will always indicate a healthy heart and absence of disease because the underlying cause is mere stimulation of the vagus nerve.

Best regards and Good Health