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My Daughter Had A Sudden Episode Of Feeling Lightheaded To
Posted on
Wed, 8 Apr 2020
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Wed, 8 Apr 2020
Answered on
Last reviewed on
Question : My daughter had a sudden episode of feeling lightheaded to the point of almost fainting. After laying down, she started to feel better.
She is 16 years old and weighs 109 lbs.
She was standing and her mother was helping to apply a "charcoal face mask" makeup. This was the first time she used the product.
She began to have visual disturbances which clouded her vision for several seconds, then her vision became clearer.
She then started to feel faint, and her mother help her to the bed to lay down
She seemed to be hyperventilating, but returned to normal breathing a few minutes later
Minutes after the incident, we obtained the following readings (lying down):
At 11:30 PM: 95.7 degrees, 99% SpO2, 71 bpm, pressure 97/58 and 89/64 (two cuffs, sequentially, and respectively)
At 11:45 PM: pressure 93/56, 66 bpm
She has these episodes at least once or twice a year.
We had her to drink some water in case of dehydration.
For reference, I (her dad) have a history of hyperthyroidism, which has been fully under control for many years, and am now being treated for an enlarged aorta sinuses of Valsalva.
I would would appreciate your clinical opinion regarding my daughter's episode.
She is 16 years old and weighs 109 lbs.
She was standing and her mother was helping to apply a "charcoal face mask" makeup. This was the first time she used the product.
She began to have visual disturbances which clouded her vision for several seconds, then her vision became clearer.
She then started to feel faint, and her mother help her to the bed to lay down
She seemed to be hyperventilating, but returned to normal breathing a few minutes later
Minutes after the incident, we obtained the following readings (lying down):
At 11:30 PM: 95.7 degrees, 99% SpO2, 71 bpm, pressure 97/58 and 89/64 (two cuffs, sequentially, and respectively)
At 11:45 PM: pressure 93/56, 66 bpm
She has these episodes at least once or twice a year.
We had her to drink some water in case of dehydration.
For reference, I (her dad) have a history of hyperthyroidism, which has been fully under control for many years, and am now being treated for an enlarged aorta sinuses of Valsalva.
I would would appreciate your clinical opinion regarding my daughter's episode.
Brief Answer:
Appears to be vasovagal syncope, proper hydration is the treatment
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern. I really appreciate your elaborated history and clinical evaluation.
To me it appears to be vasovagal syncope.
The points in favour of vasovagal syncope are
1) Age of the patient
2) Prodromal symptom - blurring of vision
3) Symptoms - Dizziness, transient altered consciousness, Tendency to fall but without any abnormal movement or injury
4) History of similar episodes in past
5) Brief episode and stable vitals
Vasovagal episodes can be precipitated by morning shower, prolongs standing, pain, anxiety, fear, fasting, dehydration, crowded places etc
The other close differential here is Orthostatic postural hypotension(OPH) . But it is unlikely as OPH episodes are usually not preceded by visual blurring or other Prodromal symptoms.
I don't think that it has any relation to the firts time used makeup as there is similar past history without any exposure to makeup.
Hyperventilation itself can present with these symptoms but as the hyperventilating episode is preceded by symptom of dizziness it appears that hyperventilation is due to the syncope not causing the syncope.
As thyroid levels are in well controlled level thyroid disorder as a cause of this episode is highly unlikely.
Although it is quite clear from history that this is a vasovagal episode still i would like to get one tilt test done. This is non invasive test and can be done easily on opd basis. Here we check blood pressure and heart rate after creating a situation that provokes vasovagal episodes(pre and post) . In your case there is not much difference in vitals as all the readings are taken after the episodes.
I won't get overly worried as the episodes are not too frequent and vasovagal syncope is a benign condition. Teach her to take plenty of fluids to maintain proper hydration and whenever she gets these Prodromal symptoms tell her to lie down immediately.
I hope this helps.
Please let me know if you have any more doubts.
Regards
Appears to be vasovagal syncope, proper hydration is the treatment
Detailed Answer:
Hi
Thanks for asking on this platform
I have gone through the details and do understand your concern. I really appreciate your elaborated history and clinical evaluation.
To me it appears to be vasovagal syncope.
The points in favour of vasovagal syncope are
1) Age of the patient
2) Prodromal symptom - blurring of vision
3) Symptoms - Dizziness, transient altered consciousness, Tendency to fall but without any abnormal movement or injury
4) History of similar episodes in past
5) Brief episode and stable vitals
Vasovagal episodes can be precipitated by morning shower, prolongs standing, pain, anxiety, fear, fasting, dehydration, crowded places etc
The other close differential here is Orthostatic postural hypotension(OPH) . But it is unlikely as OPH episodes are usually not preceded by visual blurring or other Prodromal symptoms.
I don't think that it has any relation to the firts time used makeup as there is similar past history without any exposure to makeup.
Hyperventilation itself can present with these symptoms but as the hyperventilating episode is preceded by symptom of dizziness it appears that hyperventilation is due to the syncope not causing the syncope.
As thyroid levels are in well controlled level thyroid disorder as a cause of this episode is highly unlikely.
Although it is quite clear from history that this is a vasovagal episode still i would like to get one tilt test done. This is non invasive test and can be done easily on opd basis. Here we check blood pressure and heart rate after creating a situation that provokes vasovagal episodes(pre and post) . In your case there is not much difference in vitals as all the readings are taken after the episodes.
I won't get overly worried as the episodes are not too frequent and vasovagal syncope is a benign condition. Teach her to take plenty of fluids to maintain proper hydration and whenever she gets these Prodromal symptoms tell her to lie down immediately.
I hope this helps.
Please let me know if you have any more doubts.
Regards
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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