Question Title: Light-headedness/Ringing in Ears

Forum: The Heart Forum
Topic: Palpitation

I suffered an MI 4.5 years ago and in June '96 I had a defibrillator implanted. Often, I experience light-headedness, ringing in my ears and pressure in my chest. The only medications I am currently taking are: 81mg of aspirin (daily) and 1,000 IU Vitamin E (daily). I have noticed that I have excessive amounts of gas following these episodes, which relieves the pressure when released. Do you think this is symptomatic of a serious problem that I should discuss with my cardiologist?

Thank you for this wonderful forum!

Bill

The symptoms you describe could likely be due to cardiac causes. Light-headedness, for example, might result from a rhythm disturbance of the heart (more common in persons who have suffered a heart attack), or might be due to decreased blood flow to the heart. Such blood flow problems, or ischemia, might also cause the chest pressure your describe. I would be interested to know if the defibrillator has fired over the past year or two, and how often. Certainly, the defibrillator should be able to identify and treat (with a mild electrical shock) life-threatening arrhythmias that may or may not be taking place during the episodes of light-headedness.

A simple solution to your question would be to interrogate the device. The latest generation of defibrillators have excellent capacity to stores numerous episodes of rhythm abnormality, allowing the physician to better gauge the extent and frequency of problems. Your device, implanted in 1996, is likely to be quite adept in this capacity, and should be able to provide your doctor with a thorough record of recent arrhythmic events, if any have taken place. If your problem is indeed due to arrhythmias, it may be helpful to prescribe a medication that reduces the frequency of these events (an anti-arrhythmic medication such as a beta blocker, amiodarone, sotalol, and others, depending on the precise underlying problem), or better program the defibrillator to recognize and treat any such episodes. If arrhythmia is not responsible for your symptoms, then one must reassess the chest pressure complaints, and determine whether there is a problem with decreased blood flow to the heart muscle. A stress test or a coronary angiogram would thus be indicated. Regarding the gas, I'm not sure whether this is related, although it might signal a state of heightened vagal tone (a component of the nervous system that regulated gastrointestinal activity). I hope this advice has been helpful. We'd be happy to see you here (Cleveland Clinic Foundation, Desk F15, a 800 CCF-CARE), with one our capable electrophysiologists. Best of luck.

Information in the Heart Forum is for general purposes. Specific diagnoses and therapies can only be provided by your physician.

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