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Experiencing light-headedness, racing heart and shortness of breath. History of high BP. Could this be perimenopausal?

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Internal Medicine Specialist
Practicing since : 1996
Answered : 961 Questions
I am a 48 year old woman who has in the last week experienced lightheadness, racing heart, and shortness of breath. It has not been everyday, nor all day, but enough to be concerning. I am not overweight (5'10" 145 lbs), have a failry healthy diet and exercise regularily. I do not have any history of high blood pressure, even though I do smoke. Could this be perimenopausal? Or something more serious? The symptoms do not seem to be related to activity but i think our being execerbated by the anxiety they are causing.
Posted Tue, 16 Oct 2012 in Menstruation and Miscarriage
Answered by Dr. Prasad Akole 3 hours later
Thanks for sharing your concerns here.

Before we say it is peri-menopausal, we should be sure it is not of cardiac origin.

Your symptoms can occur due to many causes.

I hope you do not mind answering a few questions which would help me help you better

How many times in a day does the heart seem to be racing fast?
Do you feel heavy beating (palpitations)?
Do you feel dizzy? Did you have a blackout?
Is there sweating, chest pain, nausea during the episodes?
Do you feel any missed beats?
Is there swelling at the ankles/ feet? Do you have cough, fever?
As you say, it occurs at rest, is the shortness of breath also at rest and gets better when the fast heart rate stops?

If answers to most questions are positive, it may be a cardiac rhythm disorder – arrhythmia.

You will be required to see your physician, get thoroughly evaluated and get an EKG, Xray chest, CBC, 2-D Echo, holter and other appropriate tests.

Some arrhythmias/ heart conditions can be XXXXXX So it is advisable to get checked and be sure.
An EKG may be normal in between episodes. So one done during symptoms will be better.
Otherwise a continuous Holter monitoring would be needed

If the evaluation is inconclusive or rules out cardiac cause, you may see your gynaecologist to ask about menopausal evaluation.

I hope I addressed your concerns.
I would be glad to answer any more doubts you may have.

Take care and please keep me informed of your progress, test results etc.
Good Luck!
Thank you!
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