Early 2019 was the first time I experienced what I thought was a stroke or heart attack. My chest ached and a sudden pain shot up from my chest, through my neck and into my jaw. Everything went white and I woke up on the floor struggling to breathe, numb and tingling everywhere, unable to move, and had slurred speech. Paramedics arrived and stabilized me with oxygen and CO2. They tried to sit me up and my stats dropped and I nearly fainted again. A trip to the ER wasn’t of great help as they insisted I was having classic panic attacks. They sent me home with a Ziopatch heart monitor and no answers. The following Monday I met with cardiology. I had a near fainting episode in front of the cardiologist. My ECG read abnormal with lateral and interior infarct and prolonged QT. I was promptly hospitalized and went through various testing.
Lateral & Anterior Infarct
Another way of saying cardiac ischemia. My heart wasn’t getting the blood supply and oxygen it needed resulting in chest pain and the electrical abnormalities.
Prolonged QT interval
This is an incredibly dangerous thing to find on an ECG. The QT interval is the measurement of time on an ECG between the repolarization and depolarization of the ventricles. The longer it takes for the electrical impulses to tell the ventricles to contract and push blood out to the body, the more at risk you become for a fatal arrhythmia to occur. I do have some genetic variations, but not ones typically seen in Long QT Syndrome (LQTS). I’ve not been given the diagnosis of LQTS, just “prolonged QT interval.”
Postural Orthostatic Tachycardia Syndrome (POTS)
They finally did a tilt table test that confirmed Postural Orthostatic Tachycardia Syndrome. My prolonged QT interval doesn’t fit with this or anything else wrong with me. However, I imagine it’s a problem unique to me based on how my mother’s pregnancy went and that I had slow fetal growth. Each day is different. Today just happens to be a day where I am pale, lightheaded and struggling to be on my feet. I have fainted a total of nine times in the last year and have three to five near syncopal episodes weekly. And that is while taking medications to manage my condition.
POTS is complex. It involves the autonomic system overcompensating for lack of cardiac output upon postural change. At rest, gravity pools blood in the lower extremities. When someone stands up who has POTS, it’s as if the blood doesn’t move. Our veins and arteries are innervated by the sympathetic nervous system to create tone that maintains blood flow. Because of the autonomic dysfunction piece of POTS, there is a lack of tone. Thus, vasodilation. And we simply don’t have enough blood supply to fill veins when they are completely dilated. This creates what is called hypovolemia, or low blood volume. I stand up, my blood pressure drops and my heart doesn’t get the blood supply that it needs so my heart rate increases in an attempt to pump more blood. Diagnostic criteria for POTS is a HR change of 30+ BPM upon standing and 120+ BPM after standing for ten minutes. This condition commonly coexists with Ehler’s Danlos Syndrome. Theoretically because of the connective tissue in the venous system.
Fainting is typically a productive thing for the body to do. It’s a forced rest. The brain isn’t getting enough blood supply so you faint in order to restore blood flow to the head. My fainting becomes a problem when my QT interval is sporadically prolonged. This is still a puzzle my physicians are attempting to solve and I currently have a cardiac monitor implanted. So far, we are only seeing short bursts of sinus tachycardia where my heart rate suddenly goes from 75 to 150. That’s a good thing because the alternative is Torsades de Pointes, pauses, Vfib, Afib, and cardiac arrest.
I’ve never fainted alone. I’ve always been near someone who was able to help and there has usually been an EMT present or arrived quickly. Knowing that I have a monitor watching my heart for the next three years and I have doctors who hear me and have worked diligently to figure my case out helps me relax. I lean on Isaiah 40:31 quite literally.
“…but they who wait for the LORD shall renew their strength; they shall mount up with wings like eagles; they shall run and not be weary; they shall walk and not faint.” ESV
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