DIZZINESS AND ENLARGED LEFT ATRIUM

FOR THE LAST FEW YEARS I HAVE HAD THIS STRANGE FEELING IN MY CHEST. IT FEELS LIKE MY HEART FLUTTERS OR MAYBE EVEN SKIPS A BEAT.IT HAS BEEN MORE FREQUENT LATELY. NOW I AM GETTING DIZZY ALL THE TIME AND FEELING LIKE I AM GOING TO PASS OUT IF I STAND UP OR BEND OVER. I AM CONSTANTLY LOSING MY BALANCE & I ALSO HAVE A PROBLEM WITH DAILY HEADACHES. I GET OUT OF BREATH ALOT. IF I WALK UP A FLIGHT OF STAIRS MY HEAD FEELS LIKE IT'S GOING TO POP AND MY HEART IS THROBBING AND I CAN'T CATCH MY BREATH. I HAVE FELT TINGLING AND NUMBNESS IN MY FINGERS AND ARMS (NEUROLOGIST TOLD ME IT MAY BE CARPEL TUNNEL). I WENT TO MY DOCTOR AND AT FIRST HE THOUGHT IT MAY NE NEUROLOGICAL(I HAD A SUBARACHNOID HEMMORAGE IN 1998 AND I ALSO HAD SPINAL MENINGITIS AND SEIZURES AS A BABY) BUT AFTER HAVING AN MRI AND AN MRA, THAT HAS BEEN RULED OUT. ON MONDAY MY DOCTOR DECIDED TO DO AN EKG WHICH CAME BACK SHOWING THAT I HAD AN ENLARGED LEFT ATRIUM AND WHEN THEY CHECKED MY BLOOD PRESSSURE LAYING DOWN AND THEN STANDING UP, IT DROPPED. MY DOCTOR SENT ME TO A CARDIOLOGIST THAT IS SENDING ME FOR AN ECHO AND CHEST XRAYS AND MORE BLOOD WORK NEXT WEEK. I AM A LITTLE WORRIED, DO YOU KNOW WHAT THE PROBLEM COULD POSSIBLY BE? I KNOW I SHOULD WAIT UNTIL THE TESTS ARE DONE BUT I AM STRESSING MYSELF OUT SO BAD OVER THIS I CAN'T EVEN SLEEP OR GET MYSELF TO RELAX. CAN YOU OFFER ANY SUGGESTIONS FOR NOW PLEASE?

[CCF-M.D.-MJM]

Hello Spunkier,

That is quite a battery of tests.  It is difficult to make the diagnosis without a thorough history and physical plus the tests you mentioned. I imagine you are also heading for an upright tilt table test as well.

In the end my guess is that you have orthostatic hypotension (ie when you stand up, your blood pressure enough to cause symptoms).  I do not think you need to get too worked up over the long term consequences of this, although I recognize it is having a significant impact on your daily life now.

The echo will ensure that you have normal heart function -- and I will be bet that you do.  I would also check a holter monitor to make sure there are no arrhythmias being missed, but again, this sounds pretty classic for orthostatic hypotension.

Orthostatic hypotension or in its extreme form postural orthostatic tachycardia syndrome (POTS) is difficult to treat and involves increasing fluid and salt intake as well as some behavioral changes like not standing up too quickly.  If you end up with this diagnosis, it is important to make sure you control it and not it controlling you.  Learn your limitation and realize this disease and these symptoms will not kill you -- I say this because many people with diagnosis continue to worry that their real diagnosis is missed and are convinced they are dying.

This a bit long winded on my behalf and probably premature since you don't have a diagnosis yet, but these are issues I wanted you to be aware of.

Good luck and I hope this helps.

[SPUNKIER]

I FORGOT TO ADD IN MY EARLIER POST "DIZZINESS AND ENLARGED HEART" THAT I AM A 30 YR. OLD FEMALE