I’ve been experiencing syncope for several years (technically pre-syncope as I’ve always been able to prevent complete fainting).
But it’s getting g worse.

I’ve had 3 cardiologists do workups and all the tests that I see listed at Mayo and my heart always passes with no real problems. The one heart issue that does stick out is I have a low resting heart rate (50ish) and I can’t get my exercise heart rate into the range I was accustomed to a few years ago.

The symptoms hit me when I stand after sitting, usually after taking some steps. Will hit me when walking up the jet bridge when deplaning, when walking up stairs. Once I get through the episode the exertion no longer causes the symptoms. It does not happen every time I stand up.

My current cardiologist has concluded I have a problem with the signal of the vegus nerve. He put me on fludrocortisone (0.1 mg 2x daily). I’ve been on that for 30 days and it has had no positive effects.

Is there something else I should have checked out? Is there another type of specialist I should see?

Med history: I’m 66, 6’1” and 240. I’ve recently developed an essential tremor in right hand. Peripheral neuropathy that causes numbness in feat (I’ve Had this for 15 years). I have a synovial cyst at L4L5 that causes tremendous pain and will be removed for second time this month with probable lumbar fusion.