Unconscious for the 3rd time during dialysis. Please help!

[jo]

Hi,

My mom passed out and was unconscious for about 2 minutes today towards the end of the session. This is happening to her for the 3rd time. The doctors have no idea why this happens often, but one of the nurses think it could be a vaso vagal syncope and so her blood pressure drops too low and makes her pass out. Does anyone know what's causing this? Anyone else had similar experiences? 10 mins before this happened, her BP on the machine showed 135/58. She was laying flat at that time as that's the only way the techs could pull fluid off of her because of BP fluctuations throughout the treatment. After 10 mins, she wanted to sit as the treatment was almost ending and she sat on the dialysis chair. Within 2 minutes, she passed out. Once this happened, the techs made her lay flat and gave her about 600 mL of water back. She regained consciousness but the BP raised to 213/78 within 10 mins again. Our family is very worried because of this. She is very scared of dialysis because of this happening once in a while. What should she do to prevent this? Passing out starts with an urge to pass stool, lightheadedness, sweating, etc., Kindly help us out. Thanks.

[jeannea]

To me, these are unusual BP readings. The two numbers are not usually that far apart. Does she have any other medical problems? I would consider having her see a cardiologist. Do you have a BP monitor at home? You can get one at your pharmacy. You don't need the most expensive model. Take her blood pressure morning and night and write it down. She can do it herself with an automatic BP monitor.

[jo]

To me, these are unusual BP readings. The two numbers are not usually that far apart. Does she have any other medical problems? I would consider having her see a cardiologist. Do you have a BP monitor at home? You can get one at your pharmacy. You don't need the most expensive model. Take her blood pressure morning and night and write it down. She can do it herself with an automatic BP monitor.

She was on coumadin for 6 months to treat a blood clot in her heart and the doc said it's ok to stop on February 2015. We took her to the ER 3 days ago when her BP at home went to 247/76. That was the very first time at home she had a blood pressure over 200. Many times during dialysis, she has seen BP's of over 200. At the ER, they did a EKG and other blood tests and said that there is nothing wrong with her heart. But, they found she has got a urinary tract infection and put her on antibiotics. They gave her nitro to bring her BP down and sent us home when the BP dropped to about 180/78 saying that the BP will drop even further with Lisinopril. And, the pass out has happened today. Do you think there is something wrong with her heart? I am very worried.

[PrimeTimer]

Seeing a Cardiologist would probably be very helpful. They could perform an Echocardiogram (that's sort of like an ultrasound) of your mother's heart, basically watching it in motion and looking for any problems, such as enlargement or faulty heart valve or perhaps atrial fibrillation. My mother had congestive heart failure caused by enlargement of one side of her heart. She also had a blood clot embedded in the walls of her heart and altho they didn't think the clot would ever break off, they kept her on Coumadin the rest of her life. They also had her on water pills (to help lighten the workload on her heart) and she was also on Coreg. She was very petite and other than the heart problem, she was physically fit. She did quite well for many years. But, how they discovered her heart problem was by an Echocardiogram and another type of picture where they used dye and watched her heart in motion. Since your mother has kidney disease, I don't know if she should have the dye injected into her but an Echocardiogram may be all they need to do to determine if she has a heart problem. And the nurse that you said who mentioned "vasovagal syncope" might be right. Hope she does better, she's lucky to have you helping her through all this. Also, if she has insurance, they should cover the cost of an automated BP cuff/monitor for your home use. It runs on small batteries and also takes your pulse. The nurse can show you how to use it, it's very easy.

May also want to read up on "Starling's Curve" in relation to the heart.

[jo]

Seeing a Cardiologist would probably be very helpful. They could perform an Echocardiogram (that's sort of like an ultrasound) of your mother's heart, basically watching it in motion and looking for any problems, such as enlargement or faulty heart valve or perhaps atrial fibrillation. My mother had congestive heart failure caused by enlargement of one side of her heart. She also had a blood clot embedded in the walls of her heart and altho they didn't think the clot would ever break off, they kept her on Coumadin the rest of her life. They also had her on water pills (to help lighten the workload on her heart) and she was also on Coreg. She was very petite and other than the heart problem, she was physically fit. She did quite well for many years. But, how they discovered her heart problem was by an Echocardiogram and another type of picture where they used dye and watched her heart in motion. Since your mother has kidney disease, I don't know if she should have the dye injected into her but an Echocardiogram may be all they need to do to determine if she has a heart problem. And the nurse that you said who mentioned "vasovagal syncope" might be right. Hope she does better, she's lucky to have you helping her through all this. Also, if she has insurance, they should cover the cost of an automated BP cuff/monitor for your home use. It runs on small batteries and also takes your pulse. The nurse can show you how to use it, it's very easy.

May also want to read up on "Starling's Curve" in relation to the heart.

Thanks. They did the echocardiogram along with an other test, I don't remember the name, through which they found the blood clot. May be we will meet with a cardiologist again. What triggers the vasovagal syncope?

[jo]

@PrimeTimer: Is it hard to do a kidney transplant in case they find something wrong with the heart? Or are there exceptions to a few medical problems in case of a kidney transplant?

[jeannea]

The doctors look at the whole picture before you can get a transplant. There is a lot of testing. There are tests for the heart. They need to know if your body can survive having surgery and anaesthesia. If she can find out what's wrong and get treatment, she has a better chance than if she continues having problems. There are no guarantees.

[PrimeTimer]

@PrimeTimer: Is it hard to do a kidney transplant in case they find something wrong with the heart? Or are there exceptions to a few medical problems in case of a kidney transplant?

jo, those are very good questions but unfortunately, I don't know the answers. I think jeannea is probably right, tho. There is a "Transplant Discussion" section on this site, maybe someone there has been through the same thing and can answer your questions. Sure hope they find out why your mother is having these problems so she can get back on track. Bad enough she has to do dialysis and then suffer these terrible episodes of passing out! I think you are doing the right thing by asking questions and learning all you can on her behalf.     

[PrimeTimer]

Seeing a Cardiologist would probably be very helpful. They could perform an Echocardiogram (that's sort of like an ultrasound) of your mother's heart, basically watching it in motion and looking for any problems, such as enlargement or faulty heart valve or perhaps atrial fibrillation. My mother had congestive heart failure caused by enlargement of one side of her heart. She also had a blood clot embedded in the walls of her heart and altho they didn't think the clot would ever break off, they kept her on Coumadin the rest of her life. They also had her on water pills (to help lighten the workload on her heart) and she was also on Coreg. She was very petite and other than the heart problem, she was physically fit. She did quite well for many years. But, how they discovered her heart problem was by an Echocardiogram and another type of picture where they used dye and watched her heart in motion. Since your mother has kidney disease, I don't know if she should have the dye injected into her but an Echocardiogram may be all they need to do to determine if she has a heart problem. And the nurse that you said who mentioned "vasovagal syncope" might be right. Hope she does better, she's lucky to have you helping her through all this. Also, if she has insurance, they should cover the cost of an automated BP cuff/monitor for your home use. It runs on small batteries and also takes your pulse. The nurse can show you how to use it, it's very easy.

May also want to read up on "Starling's Curve" in relation to the heart.

Thanks. They did the echocardiogram along with an other test, I don't remember the name, through which they found the blood clot. May be we will meet with a cardiologist again. What triggers the vasovagal syncope?

I found this link on Vasovagal Syncope. It's not all that uncommon. In your mother's case, maybe it is triggered by the fear, hell and stress of dialysis. 

http://heartdisease.about.com/od/syncopefainting/a/Vasovagal-Cardioneurogenic-Syncope.htm

 

[jo]

Thanks.