Dizziness episodes

[Scroogega]

I recently had surgery to replace one heart valve and repair another.  Medtronics products were used for these.  In the days following the surgery my cardio decided that I should have a pacemaker implanted.  They used a Medtronics Model KDR901.  On the day I was to be discharged from the hospital I had an episode of extreme dizziness but nothing showed up on the monitors as being wrong with my heart, blood pressure, etc. This was 14 months ago.    

Since I have been home I have had several similar episodes - one every two weeks or so.  They start with what seems to be pressure buildup in my head, then my vision goes out of line - double vision. and I am very dizzy, and cannot walk without holding on to a wall or other object.  They vary in intensity and duration.  The longest is about 15 minutes, the shortest was about 30 seconds.  On only one occasion did I begin to sweat heavily.  I went to the emergency room on that occasion.  They thought that I was having an occular migrain and I was put on Depacote.  I really think they were incorrect.  They episodes have continued.

The pacemaker clinic has adjusted the pacemaker several times. i.e. turned off the wire in the lower chamber, turned it back on, changed the interval between the firing between the two chambers, etc. The episode continue.  They say I am now 100% dependent on the pacemaker.  My doctor seems to be unable to come up with any solutions or ideas.

Any suggestions to causes or solutions.  I prefer a real answer to the question rather than a "soft" version.  Please answer as directly as necessary.

[Cleveland Clinic]

scroogega,

thanks for the post.

Unfortunately, I have no specific answer hard or soft. Since there is no specific change in your pacemaker during your episodes, it is doubtful that they are related to your pacemaker.  An event monitor that would record your pacemaker rhythm at the exact time of your episode could help confirm this.

I would be interested in a followup echo to make sure that there was no specific cardiac finding. If this were all negative, I would look into other causes of your symptoms such as migraines, TIAs, or vertigo.

The symptoms you describe are somewhat nonspecific and could be caused by a number of things.

good luck

[DottyCece]

I have a story similar to yours.  I have had a mitral valve replacement and pacemaker implant for sick sinus syndrome...actually two surgeries in 11 months...they ahd to redo the valve.  Anyway, I have been plagued with dizziness peiodically and even had a syncopal episode.  They immediately were concerned about a possible clot so I had a CT Scan of my head, neuro assessment etc.  That was ruled out.  So they only thing left were arrhythmias or inner ear disturbances.  I do have arrhythmias even with the pacer that could contribute.  I was treated with a drug for inner ear disturbance.  But interestingly, the dizziness will go away but them return.  I have less episodes at present, the most recent a couple of months ago.  I also have heart failure and few other things going on as well.  Are you dehydrated in any way?  Are you on beta blockers or other drugs?  So many of them cause dizziness.  Anyway, I understand you concern.  I still wonder what caused all of this but I am doing okay so have learned to cope with it.  I know when the dizziness comes on to hang on to something or sit down...so far it  has been fine.

[Erik36]

Don't rule out the possibilty of migraines. They can cause these symptoms. Try treatment of migraines to rule it out.


Erik

[Scroogega]

Dotty, it helps to know someone else has had similar instances.  I also wondered if there might be an inner ear thing going on.  Seems that I have burning mild pain on the left side of my head that is very similar to infected sinuses.  Sometimes this preceededs one of the episodes.  It seems to have begun after surgery and I wondered if something might have been brought on by the tube from the ventilator being in place for a couple of days.  

Eric - thanks.  I am being treated by a neurologist for migrains using Depacote.  It does not seem to have helped but he is feels it is the cause.  I go back in a couple of weeks for evaluation.  I am still skeptical but will keep looking at this.  My only concern here is the old axiom that says - If all you have is a hammer then every problem starts looking like a nail.

[Erik36]

Depacote may not be the best drug for migraines. Look further into it.

[jdm]

From one who's had them over 40 years your condition sounds like migraine.  Since I have been taking attenolol for tachycardia I have noticed that the visual portion of the attacks sometimes is missing.  In place of extreme visual disturbance when the attacks start I now sometimes get extreme dizziness. ( sometimes both ) Even though I know what is happening I frequently get a severe anxiety reaction to the abrupt dizziness and this can cause perspiration.  I know that beta blockers are prescribed for migraine but probably in higher doses than I take.  In my case they (seem) to have changed my migraines somewhat and not for the better.  It's scary when this kind of thing happens abruptly.  Migraines medicines have side effects for me and don't seem to change much anyway.  So I just suffer through the episodes which happen several times a week.  It seems sometimes that so many medicines just make things different but not better-and sometimes worse.  good luck.