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What Causes Fainting Followed By Chest Pain, Memory Loss And Shortness Of Breath?

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Posted on Thu, 23 Jun 2016
Question: My son is 16 years old, he has had 8 fainting bouts since August of 2015. He passes out and then has immediate chest pains, shortness of breath, and confusion on average of about 1.5 to 2 hours each time. He has also suffered from severe short term memory loss since these bouts occurred. He has had an MRI and EEG which showed nothing. He was seen by a cardiologist who found nothing. He was diagnosed with PreCordial Catch Syndrome when he was 10 years old. He has ADD and has been taking Adderall 20 mg XR since 5.5 years old. Six months ago his choloresteral, sugar levels, etc. were all normal. Since these bouts his choloresteral has now doubled (well over 300+), he had a glucose level of 106 (pre-diabetic), his red blood cell has greatly increased also. No one can seem to figure out what is going on. My personal physician suggested he may have Addison's disease but has not been tested. He also had a 24 hour urine test when he had his last bout last week and everything came back normal except one high reading that the endroconologist said was okay since everything was normal. Need advise on what to do. He used to be a straight A student but due to his short memory loss now, he cannot retain information fails tests, forgets homework and turning it in etc. All these bouts happen at rest time and not during excertion. He was also diagnosed with asthma last December during these bouts, which he never had before.
doctor
Answered by Dr. Diptanshu Das (3 hours later)
Brief Answer:
A tilt table test needs to be done.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone very carefully through your query and understand your concerns. I would need to ask specifically if a Tilt Table Test has been performed. If not, visit a cardiologist who can perform this test (needs the setup of a tilt table). If the results come positive, it would indicate vasovagal attacks due to sick sinus syndrome. I would also insist you for a 24 hours Holter ECG Monitoring, in case it has not been done too. Contact me back with the reports and I would guide you further.

About his ADD, you need to visit a psychologist who could deliver cognitive behavioral therapy (CBT). It would enable him to accept his limitations and to better adapt and deal with his limitations.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (1 hour later)
Drs. Das:
XXXXXXX had a 24 Holter monitor when he was 10 years old and wore it for a complete month. He had two monitor flare ups but nothing else. The was done by a pediatric cardiologist. The determination was the Pre-Cordial Catch Syndrome. Could this actually have been the Sick Sinus Syndrome but misdiagnosed? XXXXXXX had various attacks from age 10 to last year when he just turned 16 years old lasting in duration about the same amount of time as the current attacks and some much shorter. In July 2015 he had a dehydration issue and then just before all the fainting spills started, etc. he had a moderate dehydration in August 2015 with required two iv bags given by the hospital, an elevated blood pressure and a heart rate of over 100 (they gave him a pill to reduce his heart rate). He often has higher blood pressure readings according to his pediatrician now of about 130/80+ which she says is high for a teenager.
A cardiologist did a EKG and Echocardiogram in December 2015 and said everything looked fine. He administered a fit test and said that he had only 80% lung capacity and diagnosed him with asthma, which he never had before. Could the cardiologist misdiagnosed the Pre-Cordial Catch Syndrome almost 7 years ago?

Please advise.

Thank you.
doctor
Answered by Dr. Diptanshu Das (6 hours later)
Brief Answer:
Get the tilt table test done.

Detailed Answer:
Thanks for writing back.

Precordial catch syndrome is not a diagnosis. The 'diagnosis' of precordial catch syndome is not something that is being misdiagnosed since it is just a composite name of the symptoms (it is analogous to the 'diagnosis' of fever when you have high temperature). The underlying cause is not definitely known but could possibly relate to the outer covering of the lungs.

I would insist you to go for a tilt table test. I feel that could give you an actual diagnosis.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Diptanshu Das (17 minutes later)
Thank you for you response. My son's endrocolonolgist is pointing that he has schizophrenia and not a medical condition. My son displays absolutely no positive points of that diagnosis. It's disheartening that because she cannot figure anything out that he must have a chemical imbalance because he had adhd. Thus diagnosis does not explain the 8 bouts of fainting, and all the other medical syptoms that occuring.
doctor
Answered by Dr. Diptanshu Das (2 hours later)
Brief Answer:
Tilt table test needs to be done.

Detailed Answer:
Thanks for writing back. An endocrinologist is not the right person to be able to diagnose schizophrenia; you need to visit a psychiatrist for the same. Moreover, schizophrenia IS a medical condition. The DSM-5 (the primary index book of XXXXXXX Psychiatry Association) classifies all psychiatric or psychological ailments (including ADD or ADHD) to have organic (physical) basis. On a personal note, I do not think your endocrinologist is pointing to the right direction but for confirmation you would need to visit a psychiatrist.

Once again let me emphasize on the significance of tilt table test. I am quite certain that you should get this test done.

Regards
Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3877 Questions

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What Causes Fainting Followed By Chest Pain, Memory Loss And Shortness Of Breath?

Brief Answer: A tilt table test needs to be done. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone very carefully through your query and understand your concerns. I would need to ask specifically if a Tilt Table Test has been performed. If not, visit a cardiologist who can perform this test (needs the setup of a tilt table). If the results come positive, it would indicate vasovagal attacks due to sick sinus syndrome. I would also insist you for a 24 hours Holter ECG Monitoring, in case it has not been done too. Contact me back with the reports and I would guide you further. About his ADD, you need to visit a psychologist who could deliver cognitive behavioral therapy (CBT). It would enable him to accept his limitations and to better adapt and deal with his limitations. Regards