Heart Disease Expert Forum
Dizziness
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Dizziness

I am 27 years old. Last week I felt as if my heart skipped a beat. Afterwards, I felt as if my chest was tight, I had shortness of breath and felt dizzy as well. I saw an E/R doctor who took chest x-rays, listened to my heart, checked my oxygenation and blood sugar levels, and checked my blood pressure and did not find anything. A few days later, I visited my primary care physician. By this time, my only symptom was dizziness. She evaluated me with a possible virus which was causing congestion which was making me feel dizzy. She prescribed Allegra and Meclizine. It has been a few days, and I am still feeling dizzy. A few moments ago, I felt as if my heart missed a beat again and then beat one time really hard. It was as if I couldn't move for half a second and then my chest thumped really hard. Is this all related and should I be concerned?
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Dear James,

Thank you for your question. Dizziness can be caused by a variety of different things.  Blood loss and dehydration are more serious causes.  Neurological problems are a potential source with strokes and TIA's as potential causes.  Inner ear problems such as labrinthitis (an infection of the inner ear) and Mineniers disease ( a progressive degeneration of the inner ear) as possible causes. Migraines are a possible cause of dizziness.  Medication side-effects are common causes of dizziness with many different medications causing this complaint. Autonomic dysfunction, more common in older men, can lead to dizziness. Cardiac causes of dizziness are usually due to fast or slow arrhythmias.  A diagnosis of psychogenic dizziness should be made only after all other causes have been excluded.

The work-up for dizziness is guided by the symptoms and the suspicions of the doctor.  It may include an ECG or Holter monitor test for heart rhythms, a tilt-table test may be used to exclude autonomic dysfunction, scans (MRI, CT) can be done to evaluate possible neurological causes as well as other neurologic tests that can be used.  A good medication review and basic blood work is usually a good idea.

In summary, many things may cause dizziness and a good internist should be able to work through them to find the source.
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