Cardiovascular Disease Prevention Expert Forum
Lightheaded, several tests, need guidance.
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Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.

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Lightheaded, several tests, need guidance.

I am a 33 yo white mail. About 15-20 pounds overweight.

9 months ago I experienced crushing chest pain with a little bit of sweating, and was pale. Went to ER.

They got me on all the machines, BP was high. Everything else looked ok. Chest x-ray also looked ok. They told me it stress.

The next day I started to experience what I would call “slight lightheadedness”.

Later, my Primary told me to see a cardiologist. The cardiologist had me take a few tests including a nuclear stress test. That one came back abnormal. EKG and ECG tests all good. The doctor said it was “not urgent”. He put me on 81mg baby aspirin. He said he didnt want to do a catheter due to my age. He recommended a CT scan.

He said the hospital would call me.

Call never came. I called the hospital/cardiologist several times over the next few months and no response. So, I figured, whatever.

I let it go for a few months, the lightheaded feeling came and went. Some days good, some days not good.

I finally called my primary care. He ordered blood tests. Cholesterol came back normal, some of my vitamins were a little low. He sent me to a another cardiologist.

New cariologist said "these results indicate you can't walk a block without haveing severe angina, is that the case?"

No-I walk multiple miles a few times per week. No pain.

So, he ordered the CTA of the carotids. He knew I was concerned with the abnormal stress test results. This time I got a call.

Calcium score was 0, and the rest of the test was normal (they did the contrasting warm liquid one). The cardiologist said I was in the clear and to come OFF the aspirin. He also said the lightheaded was due to dehydration.

I have been off the baby aspirin for a week now.

Today I was sitting in my office and my left outer calf started throbbing with pain for about a minute. It happened again later in the evening. Is this an issue?

Any issues with coming off the 81mg Aspirin?

What about the lightheaded feeling?

Should I get looked at for PAD?
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469720_tn?1388149949
Hello
It seems unusual for a relatively healthy person to have recurrent lightheadedness from dehydration. There are signs of dehydration and you did not mention any of those. Having said that, it appears that all of you cardiac work up is negative. I tell patients that unless there is some contraindication like history of bleeding episodes, that one baby aspirin a day is apporpriate. The evaluation for PAD is simple and begins with a physical exam and additional testing as necessary. Based upon your walking tolerance, it is unlikely that PAD exists. Best of health
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