lightheadedness daily...

I have been experiencing lightheadedness for the past 2 months.  Just recently, I have had a numerous test done with a cardiologist, including a 24 hours heart moniter.  Along with that, I have had blood work to check for anemia.  My heart was pronounced strong from the tests, but I do have a slow beat (anywhere from 40-60).  My doctor said that my dizziness occurred at times when my heart rate was the normal average of 60 and when it was low at the 40's. My doctor said that the heart looks fine, but if I want to wear a moniter for a week, it was my decision. Should I be concerned about this low rate.  Although they say it is fine, I'm still dizziy.  Next week, I'm going to have a EEG and a CAT scan as a precaution.  If those come back fine(which my doctor expects), should I go back to the cardiologist for the heart moniter.  Also, in my blood test, they asked if I have any allergies because I guess they could see I do through the test....Could it be allerigies?

[Cleveland Clinic, MD]

Dear Scott,

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.

It sounds like your doctor is working this up in a good manner and I would continue with this plan.  I kind of doubt it is related to allergies.