Syncope often result of arrythmia

Dear Dr. Gott: I was interested in your advice to the man who “loses consciousness after eating,” because I, too, “lose consciousness” (which I am told is “syncope”) at inappropriate times. Not after eating, and without those alarming consequences, but several times while working at my computer, and once while seated and holding a half-consumed glass of wine at a cocktail party. It is never for more than a split second; I didn’t spill the wine, but I have hit my head against the computer screen.

In my case, I have always had an irregular heartbeat (arrhythmia?), which has never bothered me, and recently was told that I have a “leaky mitral valve” (severe mitral regurgitation) of which I was previously unaware and has also never bothered me, but for which I am now taking Monopril. I have been given an overnight “sleep test,” which disclosed sleep apnea, too mild for treatment, then a “tilt-table” test, and am now wearing a Holter monitor similar to what you describe.

If the results indicate that the syncopes are not heart-related – i.e., they are essentially negative, as they have been for the first three weeks of the experiment – should I, too, consider an allergist? Or are my symptoms and history too different?

Dear Reader: Syncope is commonly the result of an irregularity in the heartbeat. Testing between the syncopal episodes may be unrevealing. In such cases, doctors usually prefer to use an event monitor. This is similar to the Holter monitor you are wearing, except that it stays in operation for a month or more. If you feel lightheaded, you can trigger the machine to record your heartbeat; if you faint, trigger the machine when you can, because many of these devices have a “memory” and can print out your pulse pattern after the event.

It sounds to me that you are obtaining appropriate medical attention. Let me know what the doctors find.

Dear Dr. Gott: My 13-year-old daughter has been complaining for a couple of years now that her chin gets to hurting mostly when she’s running as in gym class or playing sports. She insists that it hurts even when she thinks of relaxing those muscles. Once in awhile she says it hurts when she’s just sitting still.

Dear Reader: I suspect your daughter is experiencing overuse syndrome.

During adolescence and its phenomenal growth spurt, many young women experience muscle/joint achiness after violently exercising. Teeth-clenching is one such example. But simple muscle tension is a more prevalent disorder.

Based on my 30-year experience with adolescents, I recommend that you refer your daughter to one of her school’s trainers. If this approach is unsuccessful, then a referral to an orthopedic sports specialist would be in order.