DEAR DR. GOTT: My 15-year-old daughter had the H1N1 shot on a Tuesday morning. That afternoon, she passed out walking to one of her classes. Her pediatrician did not find anything wrong. On Wednesday, she broke out with a rash from her armpit to below her hip. Thursday, her heart was racing at 150 beats per minute. Her pediatrician then ordered an EKG for the following day. The EKG on Friday was normal, but my daughter said she was still having palpitations, so I took her to the emergency room. There, she had blood work done and another EKG. Everything was normal, so they sent her home with a 24-hour heart monitor. On the following Tuesday, she passed out again but for a longer period of time. Again, we went back to the emergency room, where nothing was found to be wrong. She was then referred to a cardiologist and a neurologist. The cardiologist said it was vasovagal syncope and recommended she take salt tablets. The neurologist ordered an EEG, but we haven’t heard anything back from him.

I am not convinced that vasovagal syncope is the problem because she is still having racing-heart episodes out of the blue. What other questions should I be asking her doctors?

DEAR READER: First, vasovagal syncope is the most common cause of fainting and occurs when the body reacts in an exaggerated way to certain triggers. These triggers cause a sudden drop in heart rate and blood pressure, which reduce blood to the brain, leading to a brief loss of consciousness. Because it is generally harmless, it typically does not require treatment.

Treatment may consist of blood-pressure medication (which blocks some signals that can lead to fainting), antidepressants, blood-vessel constrictors, certain exercises, avoiding prolonged standing, drinking plenty of fluids and finally, in severe cases, surgery to implant an electrical pacemaker.

I doubt this is your daughter’s problem because vasovagal syncope decreases the heart rate rather than increases it.

I believe the likely culprit is the H1N1 vaccine. According to the Mayo Clinic, you
should check with your physician immediately if you have chest pain, dizziness, fainting, fast heartbeat, feeling faint, dizzy or lightheaded, get hives, itching, shortness of breath, a skin rash and much more. These side effects are listed as having an unknown incidence rate, but clearly your daughter is having many of these reactions.

I urge you both to return to her pediatrician to discuss the possibility that she is having a reaction to the vaccination injection she received. If they will not consider it a possibility or don’t know how to help, consult another physician.