36f w/ palpitations/dizziness/fatigue before having bm. what could be the cause? ekg, stress echo normal except pfo. no meds or other sign. pmhx.

Vagal: Youth be stimulating your vagus nerve. The result is usually a slow heart rate and lowering of the blood pressure. To make the diagnosis you may need to wear an event monitor or have a tilt table test. If this happens frequently the answer may be more fiber or a stool softener.

Autonomic system: Abnormal activity of the autonomic nervous system can cause dizziness, palpitaitons, chronic fatigue. It typically is not a priamry heart proble. Another association can be pots. (postural orthostatic tachycardia syndrome). Discuss with your doctor about diet/exercise/medications that can help.