New Health Issue with 10Yr Old Daughter

I'm afraid that I have nothing to offer but words of encouragement. Another responder talked about prayer, and I couldn't agree more. God has a wonderful way of answering our prayers--we never know when or how, but he always answers them. It sounds like you are doing all you can, and all of the right things. How lucky for your daughter that she was with your sister at the time. Having a loving relative who is also knowledgeable in the medical profession must have been very soothing and comforting for her in what might have been a very scary time otherwise.
My prayers are with you and your family during this time. Please keep us posted as to your progress.

Hi H.,
I am not sure if this is the same, has a condition called nuerocardiogenic syncope which is basically a vasal vagal response. When he is passed out, it does appear to look like a seizure (slumped, gray complexion, eyes rolling back, some shaking, sweating). In fact, he was first seen by the first seizure unit by MGH before he was referred to a cardiologist. It onset in adolescence but he only recently sought medical treatment after an episode on the plane, where I was with him and witnessed it. Standing still for long periods of time, become dehydrated, lack of salt in diet can trigger it for him. He does normally have low blood pressure and his blood pressure was fine after the event. He is on a daily beta blocker and we are told that he is totally healthy, not more prone to heart attacks, future heart problems etc. This is a non-life-threatening condition that he has to live with. The only danger is that when he passes out, he can't typically ward it off and he has fallen down the stairs, into a coffee table etc. Hopefully, the beta blockers will prevent this in the future.

Good luck - hopefully your daughter experienced something very minor and manageable such as this (although it looks very scary to watch).

I work in Cardiology and the best advice I have to give you is to ask all of these questions to your doctors, and don't be afraid of asking too many. It is their job to give you all the answers and explain your daughter's condition to you so you fully understand it. I wouldn't go by other peoples symptoms or experiences because it maybe very different from your daughters. Good luck.

I hope this spell turns out to just be a one-off thing with your daughter.

Cholesterol levels can often be controlled through diet and exercise. Your daughter's heart condition might limit her exercise options, and cholesterol levels are also hereditary. If you aren't already, replacing other oils with olive oil can help, as well as eating less meat and more fruits and vegetables. Hopefully your doctors can give you some detailed advice. Heart disease runs in my family and my father has had a lot of success with his heart problems by switching to a very strict vegetarian diet, but I think you'd want to talk to a dietician before doing this with a teenager. I know he bases his diet off of a book he read, and I can find out what it was if you are interested. These sites on cholesterol might be helpful, although their information is not that detailed:

http://www.nhlbi.nih.gov/health/dci/Diseases/Hbc/HBC_Caus...
http://www.americanheart.org/presenter.jhtml?identifier=4500
http://www.fda.gov/fdac/features/1999/199_chol.html

Good luck, I hope her doctors give you some good answers soon.

Dear H. - I am somewhat reluctant to respond just in case this episode is related to your daughter's current heart condition, but wanted to tell you about my vasal vagal episodes that began about the same time. I am a 42 year old Mom of two and continue to have these episodes, but now they're usually brought on by a fear of needles. When I was around 10 I started passing out. The episodes were short and my blood pressure plummeted and it would take a while to fully recover. The first time it happened was about an hour after I was bit by a dog, then when I was standing in front of an English Lit class giving an oral report - my most embarrassing episode, another time when someone next to me was talking about giving blood and most recently when I was being injected with contrast for an MRI. I had an EEG - nothing. I was told to make sure I was getting enough salt in my diet and eating properly. I am 5'3" and weigh about 110. Anyway, I've learned how to manage these episodes and get myself in a safe place when I can feel them coming. I always have a dizzy sensation just before these episodes so I can sense it happening, but I can't stop it. I hope this helps. S.

Hi, H.- my name is K., i'm sorry that your daughter has to go through somethin like that...i know it can be scary for any mom as well for a child to experience such things...well, what i say is to keep up the good work with bearing with the doc's, cause i know it can be discouraging...but after they give you one opinion get a second and a third...because you never know, what one might think another might know for sure...you can never be to careful when it comes to your kids....also if you are saved or believe in god- pray and ask him what you should do..not in that order, ask him first!!! And pray with your husband and find out what god says about it...it could never hurt, just help.... Sorry that i couldn't give alot more information, but god bless you and your family and stay encouraged!! K.

Hi H.,

I am not familiar with the particular condition mentioned above, but as a nurse I would suspect that your daughter's "spell" would more likely be related to her cardiac condition as opposed to a neurological condition.

A vasovagal reaction, as I'm sure your sister has told you is a relatively common occurence. It occurs when the vagus nerve is stimulated (that can occur with coughing or "bearing down" to move your bowels etc.) When the vagus nerve is stimulated the heart rate slows down causing a transient drop in blood pressure which subsequently diminishes blood flow to the brain resulting in "fainting" or syncope. This reaction is usually self limited and the patient has returned to normal within a few minutes.

An EKG gives a picture of the electrical activity of the heart. This electrical activity usually corresponds with the mechanical act of the heart pumping so certain things can be predicted by it. There are three major components of each "heart beat" which are represented on the EKG. The first waveform on the normal EKG is called the "P" wave. The P wave indicates the electrical activity which begins each heart beat. The P wave is intitiated in the right atria. (The heart has four chambers two on top (the atria) and two on bottom (the ventricals). The atria are the collecting chambers and the ventricals are the beating chambers.)

The next waveform on the EKG is the QRS. This is the largest most obvious waveform on the EKG and it represents the actual "heartbeat" and usually corresponds with the pulse. The final waveform is the T wave. The T wave indicates that the heart has recovered from the previous heart beat and is ready to begin another heart beat.

The QT is measured from the end of the QRS to the beginning of the T wave. This called the refractory period as the heart is not ready for another heart beat yet. If an electrical impulse hits during the refractory period it could potentially cause a serious heart dysrrythmia because the heart has not fully recovered.

Naturally, if this period is prolonged there is more opportunity for an electrical impulse to fall at the wrong time.

A borderline QT is often simply the result of a slower heart beat (bradycardia) This can occur in athletes. Therefore it is important that doctors check (as I am sure they have) the QTc. The c stands for corrected, so it is the corrected QT. The QT is corrected via a mathematical calculation (the QT divided by the square root of the r-r)
(more information then you need!)

Anyway, many things can cause a prolonged QT. Most commonly it is the side effect of certain drugs. So a diagosis of borderline QT really doesn't give you much information in and of itself.

It is possibly that your daughter fainted seconary to another condition called orthostatic hypotentsion. This occurs when a person changes positon too quickly and their blood vessels don't contract fast enough so blood pressure drops, temporarily decreasing blood flow to the heart. This can simply be a side effect of a normally low blood pressure combined with a little dehydration.

I hope I have been able to educate you a little and prepared you a little for your conversation with your daughter's cardiologist. Best Wishes and God Bless.

J. L.

Hi, sorry to hear about what daughter's episode. I bet you haven't been able to stop thinking or worrying about it since! My son was born with a rare syndrome which included a variety of complex and rare congenital heart defects. He had open heart surgery at 8 months and is doing wonderfully now (he's 3).

I'm not familiar with your daughter's diagnosis but we did have a little experience with the boderline prolonged QTs. I don't know how much you know about them but they can be very dangerous. Our son had a brief period of that during one of his hospitalizations for intestinal issues (shortly after intestinal surgery, not cardiac - go figure!). The issues seems to have gone away on its own though. He was just basically continuously monitored (not hard since he was already stuck in the hospital) and they just made sure the meds they gave him didn't exacerbate the issue.

I would recommend that you ask for a 24-hour Holter monitor. It's a study that would record your daughter's heart activity for a 24 hour period. It might catch something that the ECG/EKG/EEG missed. My son has them done twice a year (more often if he has some kind of episode). Has your daughter ever had one done? It doesn't hurt the kids, they basically wear a bunch of leads that attach to a little unit that looks like a beeper. You bring it back to the doctors the next day and a day or two later you get the results. It records everything - daytime activities (running, playing) and sleeping too.

Also, does your daughter have a local cardiologist? We have two for my son - one at Children's and one in Worcester/Fitchburg (she has two offices). It saves a lot of money, time and stress to have someone local to work with. I can pass on her contact info if you're interested. She's absolutely wonderful, intuitive, and thorough. She catches things all of the time that other doctors miss and is used to working with both Children's and UMASS.

Good luck to you. I hope you get some comforting answers. I've learned that there seems to still be a lot of unknowns and everyone is different. Oh, and you might find it helpful to keep a little log somewhere of anything out of the ordinary that you notice so whenever you speak to the doctors, you can easily remember all the little details. Even just a little notebook for your purse so you can write down things like if she's tiring easily, dizzy spells, etc. Just include the date, time and what the activity was that she was doing when the incident occurs. You may start to notice a trend after a while. Then again, you may never have to write a thing because it's just as likely that nothing will ever happen again!!

And as the other moms said, pray pray pray!! God has given my son so many miracles it's astounding! (Once people meet my son they're amazed that he has so many life threatening issues and that he's been through so much in such a short time. It's hard to believe that it's the same kid!) And you'll find peace and strenghth from God too.

Good luck,
T.