Vasovagal Syncope

Cranddi

My wife has stage 4, early 5 Alzheimer's. She's had 3 fainting spells in the last 3 months. Bloodwork, MRI's, Echocardiograms, Holter monitors, medication changes have found no cause. The most recent ER doctor theorized that it's vasovagal syncope brought on by her damaged brain trying to deal with the stress and confusion of life. Has anyone else had experience with this in their LO? I've been there to catch her all 3 times, but I don't want to push my luck. FYI - following up with a cardiologist on Tuesday.

​fesk

Hi Cranddi. I am sorry you and your wife are having this issue.

My mother used to have this issue. For her, it turned out to be an interaction between her blood pressure medicine and other medications she was taking. It had nothing to do with her Alzheimer's.

Have you been taking and monitoring her blood pressure? Is there any pattern to when this happens? Recommend having her sand up slowly from a seated position too.

Cranddi

https://alzconnected.org/discussion/comment/223478#Comment_223478

fesk,

Thanks for the reply. I've been monitoring her BP at her PCP's request. He reduced her Metoprolol from 25 mg 2x daily to 1X. It's been very consistent 130's over 70's. It's happened at 10am, 11am and 2pm. First 2 times while seated and the last time while standing, never getting up from a seated position. Her Rivastigmine was stopped 5 weeks ago after the 1st two episodes and she's currently only on Metoprolol 25mg, Lansoprozole 15mg, Mirtazapine 15mg, Rosuvastatin 20mg and Sertraline 25mg.

SDianeL

my husband had 3 episodes with dizziness, nausea and sweating. They never found the cause. All 3 times his BP was very high. He was about stage 5-6.

Jgirl57

Cranddi, yes my HWD/Alz has “vasovagal syncope collapse” . The recommendation was to go off BP medicine and his BP has remained ok. One of the triggers for my hubby is heat ( he often wears a sweat shirt after getting out of bed) and the other is walking /changing directions; at times he would have profuse sweating and vomiting . The cardiologist completed an Echo study and found decreased heart function. He is now stage 6 and our life is simplified and mostly stay at home with small errands during the week. I did get him a cane to use for stability and try to ease him to the floor when it happens . Episodes have decreased the last year with our decreased activity. Hugs to you as you navigate this .

ImMaggieMae

Cranddi, I had dizziness, sometimes extreme when standing up quickly, that started with my PCP prescribing Metoprolol for heart arrhythmia. The arrhythmia was only occasional and my new cardiologist took me off of the Metoprolol and increased my BP medication slightly. That drug made me feel awful and I had been on it for over a year. (I don’t have dementia.)

Joe C.

My wife had this well vasovagal well before there was any indication of ALZ and continuing into mid stage. Her trigger was always pain such as menstrual cramps, back pain and constipation. Interesting enough she has not had an episode in several years since she was in about stage 6. If you can figure out what her trigger is it will help you be on alert of a possible episode.

​fesk

My mother's triggers seemed to be after a shower and also in the bathroom after a BM. It was recommended not to move her quickly after she went to the bathroom. I can say after they took changed her BP med, the problem resolved. Sounds like reading everyone else's comment that's a good place to start adjusting which your doctor seems to be doing.

Please keep us posted.

rplourde50

What is her resting heart rate? We discovered my DW has bradycardia. Resting heart rate was under 50 bpm. Got a pacemaker installed. That's helped.

Cranddi

https://alzconnected.org/discussion/comment/223542#Comment_223542

Her resting heart rate is around 72 and was steady when monitored for 10 days. Thanks for sharing your thoughts.

Iris L.

This can be problematic while straining at the toilet. Be aware. An emeritus member fainted on the toilet and had to be resuscitated by her DH.

Iris

Cranddi

The Cardiologist reviewed the Echo and the 10 day monitor results and concluded that there didn't appear to be any evidence of heart issues involved in her episodes. He agrees with the ER doctor's diagnosis of vasovagal syncope. Unfortunately, her triggers seem to be anything outside of her normal routine. So, we'll move forward, staying as active as possible, within the limits of her comfort zone as she clings to me for support. The fainting episodes (and hospitalization) seem to have expedited her decline. It's so damn painful to watch this once strong, vibrant woman slowly losing her ability to function in this world.