### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, im a 20 year old female. I just went and had a my second tilt table test today. the results of this one where scary. i didnt really walk out of the hospital assured that id be fine. my last TTT was feb of last year. i passed out after 8 min with a reading of 76/46. i was then diagnosed with NCS. all well and good. ive been on mididorine for 6 months and my cardio said he wants to meet again but wanted another TTT before to see how the new med was working. this time i made it all the way to the nitro admin. within the first few min after that i passed out with a reading of 78/46. i was slow to come around this time and they recorded what they called a second degree heart block. when i asked questions about it all the doctor said was not to worry, that i was too young for a pacemaker. but he didnt really answer any of my questions on it. im looking for some info on what exactly this is. how it will effect me at 20 and why on earth would i need a pacemaker. thank you.

### output:

Hi, If you are having recurrent syncope, then first medical and behavioral therapy is tried. If there is no response, then one can think of pacemaker. During giddiness or impending syncope, following maneuvers should be tried, Leg-crossing with simultaneous tensing of leg, abdominal, and buttock muscles, Hand grip, which consists of maximum grip on a rubber ball or similar object, Arm tensing, which involves gripping one hand with the other while simultaneously abducting both arms. Plenty of oral fluids and increase in salt intake may also help. Hope I have answered your query. Let me know if I can assist you further.