Think I'm having heart problems

    About 13 years ago when I was just 20 years old I was having a
  problem with my heart beating irregularly.  I went to the ER repeatedly
  having problems and was treated for anxiety over and over, even though
  I have a strong family history of heart disease...sister, father, aunts, uncles, grandparents, etc.  By the time I would get to the ER, I'd usually feel better and my EKGs were normal.  Finally, one day while visiting a friend in the hospital, I started having that crazy feeling in my stomach/chest and they immediately did an EKG and diagnosed atrial fibrillation.  I then had a 24 hour EKG which showed bradycardia
  tachycardia syndrome (42 to 175 bpm)...finally someone believed me and I was started on a beta blocker.  
    Through the years, usually pre-menstrually or on the first day of menses, I would awaken short of breath with my heart racing and feel somewhat weak.  I always passed after a few moments.  Now, in the last month, I'm awakening almost nightly with shortness of breath, extreme nausea, profuse sweating, usually cold sweats, and when I try to stand up I'm very dizzy to the point that I cannot stand.  The nausea is overwhelming.  Sometimes I feel a fullness in the epigastric region, sometimes I don't, sometimes a squeezing or tight sensation in the epigastric region and sometimes nothing but the extreme nausea and dizziness.  I've called the ambulance 3 times in the last month, and when they get here, my symptoms are usually subsiding and the EKG is normal, but my blood pressure is somewhat elevated (normally low 110/65, etc, but it's usually around 160/100, 135/105, etc when they're here, but by the time I get to the ER it starts coming down.  They treat me for anxiety at the ER, but I believe something is really wrong with my heart.  My cholesterol is elevated (hereditary) despite healthy eating, I'm very thin,
  but it seems as though no one is taking me seriously; it's like years ago before they caught my arrythmia on an EKG.  The nurses make me feel like I'm just a nuisance, and I'm afraid that one night I'm really going to have a heart attack and no one is going to take me seriously.  Anyway, the only test that has come back abnormal is an EEG, my 24 hour EKG was normal, but I wasn't symtomatic that day.  So, about a week ago, I woke up, soaked in cold sweats, kept sweating profusely, all the blood was drained from my face, I was so pale, very short of breath, a heaviness in my chest and so nauseated and dizzy that I crawled to the bathroom thinking I may vomit, but I didn't.  It finally passed after about 15 minutes and the next day it felt as though someone had crushed my chest.  I actually didn't go to the hospital because I figured they'd just treat me for anxiety again, but now I think I may have had a heart attack.  I'm so afraid that I will have a bad one now and that when I get to the ER, they will just ignore me thinking I'm a nut or something.  Please, can
  someone tell me what I should do?  Thank you, Victoria
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Dear Victoria:
I am not sure what your symptoms may be due to.  One possibility is that it is a recurrence of the previous atrial fibrillation, or perhaps some different arrhythmia [heart rate disturbance].  You may need to wear an EKG monitor for several days to catch the arrhythmia while you are having symptoms.  Alternatively, your symptoms may be due to some other cardiac, medical or psychiatric condition, and all these possibilities should be explored fully.
You should tell your primary doctor about all your different symptoms.  Referral to a cardiologist, other medical subspecialist, or psychiatrist can then be obtained.  I wish you the best of luck.
Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.