Vomiting, Dizzy Spells And Fainting. ECG Is Normal. What Could This Indicate?
Thanks for writing to XXXXXXX
The symptoms mentioned by you are signs of low heart output (sweating/ dizziness /pallor).
The First possibility is that he had a Ventricular Tachycardia, where the rsr' complex in V1-2, would have accompanied a prolongation of duration of QRS complex and increase in the heart rate. It will also be showing either absence of P waves or the P waves will lose their 1:1 relationship with QRS complex. In this condition the pumping of heart reduces markedly due to 1. inability to fill properly due to short diastole (or period of relaxation or filling phase) 2. loss of atrial contribution 3. ineffective ventricular contractions.The most common cause for VT is anginal/coronary heart disease. A dilated dysfunctional heart (with decreased pumping) also predisposes to this condition.
Second less common possibility is that he had a supraventricular rhythm which may be irregular (like atrial fibrillation, with no P waves, irregularly irregular) or regular (Atrial flutter/ AV node dependent tachycardias) with rate related prolongation of QRS. These rhythms usually do not produce signs of low heart output (sweating/dizziness/pallor) unless patient has underlying "decreased heart pumping" (systolic failure) or marked relaxation abnormality/ diastolic dysfunction (as in aortic stenosis/ hypertrophic cardiomyopathy).
These rhythms may resolve spontaneously on their own.
If you can upload the ECGs, I would be glad to discuss more on this issue.
Sincerely
Sukhvinder Singh