Heart Block??? How would I know?

[JamesAA]

I'm 38, in decent shape and exercise regularly.   I had my heart checked out 2 years ago (EKG, echo, stress test).  Everything was normal.  I do get bouts of PVCs at times but my cardiologist told me that they are benign and that I should ignore them.  In bad times I can have a few hundred a day, but these bad periods only last for 1-3 weeks typically.

As of the last 6 weeks I've been getting this mysterious dizzy/lightheaded spells, that come out of nowhere.  I'll literally be feeling perfect then I instantly get dizzy/lightheaded, and will feel that way for 30-60 min on average.  

I've narrowed it down to anxiety, lack of sleep, or heart block.  Now I am a phobic person but the thing is I will get these spells at times I'm happy and not worrying.  

So I asked my cardio about heart block and he asked me what my resting HR was.  I told him 57-65 bpm.  Then he asked if my HR goes up when I exercise, and I said most definitely yes...up to 175 when I do sprints.  He then concluded that I do not have heart block based on that alone.  Is that true and can he be certain???  Is it really that simple to rule it out??

[spade22]

"Then he asked if my HR goes up when I exercise, and I said most definitely yes...up to 175 when I do sprints.  He then concluded that I do not have heart block based on that alone.  Is that true and can he be certain???  Is it really that simple to rule it out?? "

The key here is that there are 3 major classifications of heart block:1st, 2nd (type I and II), and 3rd degree heart block.  2nd degree type II and 3rd degree heart blocks require treatment and would present with symptoms (irregular HB, dizziness etc) and the arrhythmia's would occur during exercise - with the very serious forms of heart block, you would have difficulty exercising.

The lower forms of heart block, eg 2nd degree type I can be intermittent and dont prevent someone from exercising.  In fact, 1st degree heart block is reasonably common in young athletes.  I would disagree that a heart block can be ruled out from the ability of your heart to reach 175 bpm during exercise however, your cardiologist would be able to get a good idea of whether you have a heart block that requires treatment from your ability to exercise (in conjunction with other symptoms).

Michelle brings up some good points - what is your BP during the dizzy spells?  Wearing an event monitor and pushing the button when you feel this way would be a good way to determine if the events are cardiac in nature.  Also, have you had blood sugar and thryoid levels checked?

[MichelleP_3811]

Boy I have to say I would really take the doctors word over anything I have to say since I do not have a degree.  Even the doctors that pop on here once in a while will likely not be able to say for sure what is happening but if the medical community views your symptoms not likely to be heart block then it is likely you do not have heart block.  That said, from a few of your posts it does sound as though you are experiencing something.  Have you checked your blood pressure during one of these dizzy spells.  It could be a simple bp issue.  I know most pharmacies have bp monitors for use and considering your episodes last up to an hour I would think you could get to one and measure yourself or you can buy one fairly cheap to test.  That said, though it sounds like there is something going on, whatever it is does not sound like it is a major threat to the health of your heart.  I personally had svt, my heart would all of a sudden start racing at 230bpm sometimes for hours.  I would become lightheaded and have a hard time breathing and feel as though I would pass out and I was told that I didn't need to do a thing about it.  I needed to stop the episodes if they lasted too long but beyond that I was told my health was not at risk so if you have had all the heart tests and your heart appears to be structurally good then whatever you are experiencing is likely not a major threat to your long term health.  Of course no one can give you 100% assurance but your tests have proved you are generally in good health.   That said if these dizzy spells are new and/or worsening then maybe ask your doctor for an event monitor so you can get what your heart is doing during one of the spells captured.  This would give you a pretty good indication if the spells are heart related or something unrelated.  If this all comes back normal then it is really likely just a matter of getting your anxiety under control.  I do hope you can get to the bottom of this once and for all and find some peace.  Take care and keep us posted on how you are.