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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 60394
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Elderly fainting episode. breathing difficulty, not me

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hi elderly fainting episode. breathing difficulty
JA: How long have you had fainting? Have you used any medication for it?
Customer: not me father in his mid 70s. 3 episdes over last 15 years. last one yesterday.
JA: Got it. Have you seen a doctor about fainting?
Customer: 15 years ago no diagnosis
JA: Thank you so much for your time. Finally, is there anything else in your medical history you think the Doctor should know?
Customer: diabetes type 2
Customer: replied 9 days ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call.
Customer: replied 9 days ago.
Let me know if you need more information, or send me the service offer(s) so we can proceed.

Welcome to JustAnswer.
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Customer: replied 9 days ago.
ok so are you going to call
Customer: replied 9 days ago.
bit pricey foe a phone call. type instead

Thanks for the question.

I am writing the answer for you and will get back to you in 5 minutes.

Unless you wish to speak in person, you can ignore the request for a phone call automatically generated by the website, not by me.

Thank you.

Customer: replied 9 days ago.
ok thanks.

Following investigations need to be pursued for your father;

1) MRI with gadolinium contrast

2) Magnetic resonance angiography (MRA)

3) Tilt table test

4) Carotid sinus massage

5) Electroencephalography (EEG)

6) Stress cardiac test

7) Total creatine kinase (CK) and heart enzymes; done immediately after the fainting episode and would tell about the abnormal brain or heart activity that caused the fainting.

8) Following also may be done after the fainting episode; blood electrolytes and blood glucose.

These should be able to zero down the cause.

He should be evaluated for the following which are the commonest causes for sudden fall/fainting or syncope;

1) bradyarrhythmias; this is sudden slowing of the heart. it is mainly due to sinus and atrial node dysfunctions. Sick sinus syndrome is a prototype of these arrhythmias and is a major cause of fainting or syncope. 24 hour Holter monitoring, echocardiography, etc are the investigations done for it.

2) neurocardiogenic mechanisms; this is the fall of the blood pressure suddenly due to a sudden sympathetic failure (failure of the autonomic nervous system).

3) carotid hypersensitivity syndrome is an exaggerated response to carotid sinus stimulation. In some studies, almost 50% of cognitively normal people who had experienced non-accidental falls or fainting episodes were diagnosed with carotid hypersensitivity.

4) orthostatic hypotension is due to failure of the autonomic nervous system and related heart regulatory mechanisms.

I would be happy to assist you further if you need any more information.
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