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fainting (again) (Read 8740 times)

beadbabe

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fainting (again)
Aug 17^th, 2007, 1:57am

Hi there
I have recently had another weird incident which I think is related to a faint. I went deaf for a while after standing up. I have been told that is it vasodepressor related. I don't really understand this. I have also read on patient.co.uk that there is a 30% mortality rate in a five year period if you have a non-cardiac faint, even higher if it is cardiac related. This is doing nothing for my anxiety and so is it really true I have a one in three chance of dying now because I have fainted. RLR - what do you know of this?

All the time I have had these ectopics people have said well have you ever fainted. Now the answer is yes unfortunately so my longheld back-up plan about not worrying because 'not to worry because you have never fainted yet' has fallen apart. And now this one in three chance of dying in the next three years.

What causes vasodepressor problems? Are there any serious causes? Could it be related to neurological problems I have? (ie. internuclear ophthalmoplegia).

Ectopics are still awful and happening a lot - I noticed on the plane they were really bad the other day. But I got to thinking about you saying about digestion affecting it, because digestion goes to pot when you are airborne what with the air pressure!

bead

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Stu M Senior Member Offline Keep Smiling :0) Posts: 148 Northants - UK Gender:	Re: fainting (again) Reply #1 - Aug 17^th, 2007, 3:01am Hi Beadbabe, Im really sorry you are getting so anxious over this, and can understand fully, but have no answers unfortunately Im sure RLR will have some ideas on the matter. Try and keep calm........if you can. Stu
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RLR

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Re: fainting (again)
Reply #2 - Aug 17^th, 2007, 4:42am

Okay, we've held discussion before regarding material you've read somewhere and on this particular occasion, I'm going to ask you to please kindly refer me to the specific source that you obtained literature regarding the mortality rate associated with fainting. I would like to review it from a professional standpoint and share my thoughts with you. By specific, I mean don't simply lead me to a website wherein I must sift though countless material to try and locate the actual material you read. Please copy the the actual http page link so I can access it quickly.

Secondly, I will tell you very plainly here that there is no substance of truth to that data. Otherwise, millions of folks would be facing a tremendous increased risk of death from merely fainting. I know of no such research data even suggesting that vasovagal syncope, which incidentally is what we're referring to here, is associated with subsequent mortality. This is only a consideration in the presence of certain types of heart disease and very specific associated criteria.

Once again, great care must be taken when reviewing medical literature and research. There is a tremendous amount a background knowledge that must be taken into account when looking at research of this nature. Generalizations are by far the greatest confound and simply cannot be placed into the equation. Some portion of medical students suffer from a form of this type of generalization to such a great extent that it's commonly known as medical student syndrome. It occurs because they are bombarded with so much medical information that separation of concepts can be difficult and the saturation of exposure causes them to believe that sickness and disease is literally everywhere, including within them. They begin making comparison of patient symptoms to their own and often believe themselves to have similar illness or disease. All of this passes as logic eventually takes over and experience stabilizes their perceptions.

You're not going to die. So take a deep breath and relax. We'll talk more. Please forward the specific link to the research literature you referred to and we'll discuss it at length.

Best regards and Good Health

Best Regards and Good Health

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angiebaby Gold Forum Member Offline Posts: 261 england Gender:	Re: fainting (again) Reply #3 - Aug 17^th, 2007, 5:13am That is so very interesting to me RLR as i can so relate to that information. I also have the feeling quite frequently that i am going to pass out upon standing or moving quickly. I have put this down to my neck, the vaso things, and as yet i have never fainted. Thank goodness as this is a fear of mine since my operation.xx
Back to top	Angiebaby.x It take a minute to get anxiety and a lifetime to get rid of it!! IP Logged

beadbabe

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Re: fainting (again)
Reply #4 - Aug 17^th, 2007, 6:18am

hi rlr
Thanks for your words. I knew you would know - and I found it surprising and of course have worried about it now!

here is the aforementioned document - http://www.patient.co.uk/showdoc/40024510/

The offending phrase is the last statement under the heading prognosis just before the references.

I have used this website before because my GP has referred me to it before re anxiety.

bead

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saab

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Re: fainting (again)
Reply #5 - Aug 17^th, 2007, 2:49pm

I read the article, followed some of the links and found this (I have edited it to give the main facts, but not changed any wording, my summary is in italics):

Department of Medicine, University of Pittsburgh, Pennsylvania, USA.

OBJECTIVE. To determine whether syncope, independent of underlying comorbidities, is associated with increased mortality or other cardiovascular outcomes.

PATIENTS AND METHODS. A prospective cohort study of patients with syncope and a group of patients without syncope matched with respect to age, gender, site of care (inpatient/ outpatient) and a cardiac disease index at an urban university medical center. Overall mortality, cardiac mortality, cardiovascular outcomes, and occurrence of syncope within 1 year of study enrollment were compared between the groups with Kaplan-Meier rates and Mantel-Cox statistics.

RESULTS. The characteristics of 470 patients with syncope and the matched patients without syncope were similar except that the patients without syncope had more cardiac diseases than those with syncope (P = 0.002).

Patients with and without syncope had similar rates of 1-year overall mortality.

In multivariate analyses, syncope was not a significant predictor of overall or cardiac mortality, but male gender, age > 55 years, and congestive heart failure were.

- syncope is not necessarily a predictor of death, from heart problems or anything else.

One-year rates for other cardiovascular outcomes (myocardial infarction, congestive heart failure, cardiac arrest with survival, and cerebrovascular events) in patients with syncope were similar to those in patients without syncope.

- after a year the mortality rate for people with serious heart problems was the same; ie no worse if you had syncope

CONCLUSIONS. Syncope itself is not a risk factor for increased overall and cardiac mortality or cardiovascular events. Underlying heart diseases are risk factors for mortality regardless of whether the patient has syncope or not. The major focus of the evaluation of patients with syncope should be to identify and treat underlying heart diseases.

-having syncope does not make a heart attack or death (from heart or anything else) any more likely

I think the article is wrong - they have got the statistics/figures wrong. It is easily done and probably goes unnoticed, because not everyone is like us, looking up stuff on google all the time! If there was such a massive link between fainting and sudden death we would have heard about it. Also, I know plenty of adults who have fainted - they have not died, so the statistics have not been borne out in my experience anyway. Also, the study group was about 440 people - not exactly a massive group.

Please don't worry about this. Carry on addressing the anxiety and deal with the medical stuff as it arises. I am struggling a bit at the moment too as my daughter has a health problem that won't go away and I am 'catastrophising' about it - made worse by looking stuff up on google. I hope you feel better soon. Best wishes.

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RLR

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Re: fainting (again)
Reply #6 - Aug 17^th, 2007, 3:17pm

Okay, I've quickly reviewed the article and it's much as I had anticipated. The simple reason that literature like this can be so misleading with regard to your specific concerns is that the numbers game can quickly be taken as a generalization. The actual truth suggested here is that the mortality for all non-cardiac related causes includes those that involve accidents subsequent to fainting. In other words, if you happen to be driving your car at the time you faint, or fall from a ladder, or are swimming in your pool, and are subsequently fatally injured, then it represents a non-cardiac mortality factor in the view of this research. Get the idea?

So the common misconception that readily forms here is that death subsequent to all non-cardiac related syncopal episodes can be as high as 30%, when in fact the direct relationship of vasovagal syncope and mortality without aggrevating factors (like being killed in a car accident) is virtually non-existent. Your presumption was that the mortality was strictly associated with the syncopal episodes themselves and that the presence of syncope contributed directly to an increased mortality rate. Not true whatsoever.

Take a deep breath and relax. Here's the scoop; When you suffer from anxiety and even simple chronic stress, it can lower or disturb vagal tone. Vagal tone is necessary for the body to overcome changes in position wherein gravity may pose a factor to sufficient perfusion, or blood to the brain and upper body. So when you stand up quickly, depressed vagal tone will result in dizziness and if not recoverable via sitting down to restore balance, it can potentially proceed to a vasovagal syncope (fainting.)

In your case, this is all that's happening and it's not a prelude to cardiac mortality or any other mortality risk. You're going to be just fine.

Best regards and Good Health

Best Regards and Good Health

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beadbabe

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Re: fainting (again)
Reply #7 - Aug 18^th, 2007, 12:41am

Hi RLR
Thanks for setting the record straight and saab for having the patience too to read through the footnotes. The article is clearly wrong, isn't it.

Having read your reply RLR, I wonder if what you have said accounts for my strange symptoms the last couple of days, I am noticing adrenal rushes as I move about or get up and down. I am thinking that I don't feel particularly anxious but my body feels a lot more out of synch and more ectopics and palpitations than ususal. I am finding the adrenaline rushes a bit spooky and frightening. Is it adrenaline (it feels like a sort of prickly surge in my stomach) - is this related to the heart's actions or is it the body telling the heart to speed up. I haven't experienced this very often before. Maybe once or twice but these past couple of days it is all day long.

Thanks to you again!

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