Any cardiologists here? Syncope question

I had a crash in March and broke my ankle, scapula, and four ribs. I think I may have blacked out during the ride. I was alone and riding fairly easily. I later learned from the police report that I ran a stop sign and hit a car that was coming from my right to left. The only syncope symptom that I have from that encounter is a fleeting tunnel vision close-up of the left front quarter panel of what I thought was a white vehicle which was proven correct when I later saw the police report. I did hit my head in the accident as there was slight helmet damage, and when paramedics got to me I did not know the date, month, or president, but 30 minutes later in the hospital I had my full faculties back. I had no other concussion like symptoms and had a negative scan of the head. My heart rate monitor during the ride had me in the lower endurance zone, with no peaks, etc.

So far the cardiac work up has included a normal EKG, normal echocardiogram, and normal chemical stress test. I am scheduled for a cardiac MRI. I had a three week heart rate monitor patch with no cardiac symptoms but the doctor said that there were six strange beats where it seemed as if the upper chamber and lower chamber of the heart were out of sync.

Based on this, it appears as though the $64,000 question is whether I actually had tunnel vision that was due to passing out and my view of that car was what I actually saw before passing out, or if, since I did have slight head trauma, that is the only memory that I have of the event and what really happened is that I was just for some reason not paying attention, and ran the stop sign with the car already coming.

I know that it is extremely rare to pass out while exercising. And what are the odds that I blacked out at the precise moment that I encountered a car at an intersection? I have no pre-existing heart condition. There were no nutritional or hydration issues in play. This was an easy 45 minute ride. I am 64 years old and ride about 5000 miles per year. So it looks like either I blacked out, or just for whatever reason was not paying full attention at an inopportune time.

The only other thing that I think might be relevant is that six years ago while driving I rear ended a car in my commute to work. The only memory I have of that event is the police officer rousing me after opening my car door. My airbag had deployed. I thought at the time that I might have just fallen asleep behind the wheel, but I have no sleep issues and this was a first thing in the morning accident after having a full night of sleep. So maybe I blacked out then as well.

Any feedback would be appreciated. Thank you.

Am a doctor, though not a cardiologist.

I would suggest that all these questions you’re asking should really be directed at the physicians already involved in your care as they will have all the exact details from your history and investigations.

If you’re asking ‘was it possible that I had cardiac syncope?’ - the answer, as always, is ‘it’s possible’ though given the negative findings from your workup thus far it does seem unlikely.

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Not a doctor, but I know you can get tunnel vision during exercise without passing out. I know I have, usually when it’s hot, even when I’m drinking water.

Am also a doctor but not a cardiologist. i would agree you should ask these questions of your treating doc for the reasons mentioned above. Having said that, I will also agree many things are possible as also mentioned above. One of which would be that you likely sustained a mild traumatic brain injury ie concussion which could account for your difficulty with knowing exactly what happened. Even in the absence of a TBI, recall is pretty tricky for accidents like this.

The only answer here is to talk to your treating physician. For bumps and bruises, I dont mind giving advice, but for the important stuff, its impossible to chime in without an exam.

For the docs here, there’s been cases where online advice has put people in medical-legal limbo. Its typically agreed that theres no doctor-patient relationship from an online forum discussion, but I think we’d all agree we’d rather not have to take time out of our day to prove that in court.

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I’m not even convinced you ran the stop sign.

Drivers are often FOS and will say anything to worm their way out of responsibility.

Some police officers are also FOS and will run with anything that gives them the least amount of paperwork.

We’re you wearing a heart rate monitor when this happened?

Thanks. I’m just impatient for answers. Part of me wants it to be I just screwed up and ran a stop sign because I’d rather not have a heart condition.

Yes, see end of first paragraph of my post. Thanks.

Yes, see end of first paragraph in my original post.

Thanks. I was just trying to crowdsource some info. I appreciate your liability concern.

[quote=“mrussotto, post:3, topic:72341, full:true”]
Not a doctor, but I know you can get tunnel vision during exercise without passing out. I know I have, usually when it’s hot, even when I’m drinking water.
[/quote] Thanks. I was fully hydrated, andit was around 50 degrees.

@mh5 Thanks, I’m thinking the same. I’ll likely never know if the glimpse of the car I saw was in real time before the hit or my only memory from having hit my head.

(not a doctor)

Depending on your bike computer (and whether it survived) you may be able to tell whether you ran a stop sign or not from analyzing the ride file. The memory loss isn’t surprising for a crash of that severity though.

If you are able to determine the moment of the crash fairly precisely (ie when your speed dropped to zero maybe) the thirty or so seconds of heart rate data right before and right after the crash might have some clues for your doctor

Matt, the heart rate data at crash time is pretty unrevealing.