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What Causes Dizziness Along With Chest Tightness And Palpitations?
Question: I am 33 years old, 167 lbs, and have no past medical issues. Off and on for the last four months, I have been experiencing light-headedness, chest tightness, and palpitations. Three months ago I had an EKG test that came back normal, but otherwise I have not seen a doctor about it. Yesterday morning, I woke up abruptly and sat up quickly, which caused the room to spin for several seconds and it felt as if I had too many drinks (I haven’t had any alcohol in a month). I finished college in December and have been looking for work. I have a history of anxiety (I am not taking any medication for it) so all of this may be stress related, but it is unlike anything that stress has caused in the past. What are your thoughts?
Brief Answer:
I would not consider anxiety this early
Detailed Answer:
Hello sir and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Based on your description, anxiety does not seem likely, of course I am not ruling it out yet, but I have a few other conditions that need to be ruled out before considering anxiety. Let me list them for you:
+Orthostatic/postural hypotension: It is a sudden change in blood pressure with a change in posture or position. You will have to visit a medical centre and get your blood pressure measured around the same time of day that this happened, and get your blodd pressure measured at different positions or postures. (i.e. supine position, then seated position and then standing position)
+Check your hemoglobin level: Anemia can also cause such a presentation, along with the symptoms of palpitations, etc.
+Blood glucose profile: Low blood glucose (hypoglycemia) can easily cause this presentation and I would thus request you to get your blood glucose measured at the same time of the day, that this happened.
Also, please write back to me with information like:
-What time did you wake up?
-What time did you get out of bed (i.e. at what time did you experience this spinning sensation)?
-When was your last meal (time approximately and how many hours prior to this episode) and what did you have? Quatity as well if possible?
-Family history of chronic diseases (e.g. diabetes, hypertension, cardiac abnormalities, etc.)
-List of current medications you are on
+Blood pressure related abnormalities: Please report to a medical center to get your blood pressure measured at three different times of the day, on three different days
+Nutritional deficiencies: E.g. vitamin,etc. Need to consider this if other possibilities are ruled out and check parameters
+Repeat EKG for more recent information
I look forward to hearing from you in order to help you further. Please do not hesitate to write to me with any further information or clarifications you have sir. I would be more than happy to help you.
Best wishes.
I would not consider anxiety this early
Detailed Answer:
Hello sir and welcome.
Thank you for writing to us.
I have gone through your query with diligence and would like you to know that I am here to help. Based on your description, anxiety does not seem likely, of course I am not ruling it out yet, but I have a few other conditions that need to be ruled out before considering anxiety. Let me list them for you:
+Orthostatic/postural hypotension: It is a sudden change in blood pressure with a change in posture or position. You will have to visit a medical centre and get your blood pressure measured around the same time of day that this happened, and get your blodd pressure measured at different positions or postures. (i.e. supine position, then seated position and then standing position)
+Check your hemoglobin level: Anemia can also cause such a presentation, along with the symptoms of palpitations, etc.
+Blood glucose profile: Low blood glucose (hypoglycemia) can easily cause this presentation and I would thus request you to get your blood glucose measured at the same time of the day, that this happened.
Also, please write back to me with information like:
-What time did you wake up?
-What time did you get out of bed (i.e. at what time did you experience this spinning sensation)?
-When was your last meal (time approximately and how many hours prior to this episode) and what did you have? Quatity as well if possible?
-Family history of chronic diseases (e.g. diabetes, hypertension, cardiac abnormalities, etc.)
-List of current medications you are on
+Blood pressure related abnormalities: Please report to a medical center to get your blood pressure measured at three different times of the day, on three different days
+Nutritional deficiencies: E.g. vitamin,etc. Need to consider this if other possibilities are ruled out and check parameters
+Repeat EKG for more recent information
I look forward to hearing from you in order to help you further. Please do not hesitate to write to me with any further information or clarifications you have sir. I would be more than happy to help you.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your follow-up, Dr. XXXXXXX
Here are the answers to your questions:
- I woke up at approximately 9:00AM.
- I got out of bed at 9:00AM as well. When I awoke and sat up, the spinning started immediately, so got out of bed quickly in case I needed to vomit. I did not vomit and have not felt like I have needed to since this episode or for the four months that I have experienced the head and chest issues.
- My last meal was approximately 13 hours before the episode. I had a 3/4 bowl of shrimp scampi, consisting of shrimp, tomato sauce, and spaghetti squash. I had several cans of soda that day, which is more than I normally have, but not by much.
- I am not currently taking any medication except Advil on occasion. Starting about a month ago, I was prescribed 10 day's worth of amoxicillin, which I completed to treat a possible case of strep throat.
To add to my original message, while the spinning happened once, the light-headedness comes and goes and sometimes it worsens at random times during the day. The same is true with the chest pain. Today in particular, I've noticed a throbbing sensation on my left temple that also comes and goes. None of this has caused severe pain or discomfort, but it has negatively impacted my productivity on the days when it has surfaced.
My dad has COPD brought about by smoking. My sister might be anemic. She had an episode with rapid heart rate caused by exercise and she saw a doctor, but I am unsure if she diagnosed with it or not. She made her doctor aware that she was born with a heart issue that I believe involves a valve that does not fully close. Although, I can't say what the outcome of that situation was. My aunt has diabetes and my grandmother had kidney cancer years ago (both are related by blood). Everyone else is good.
Thanks again, XXXXXXX
Here are the answers to your questions:
- I woke up at approximately 9:00AM.
- I got out of bed at 9:00AM as well. When I awoke and sat up, the spinning started immediately, so got out of bed quickly in case I needed to vomit. I did not vomit and have not felt like I have needed to since this episode or for the four months that I have experienced the head and chest issues.
- My last meal was approximately 13 hours before the episode. I had a 3/4 bowl of shrimp scampi, consisting of shrimp, tomato sauce, and spaghetti squash. I had several cans of soda that day, which is more than I normally have, but not by much.
- I am not currently taking any medication except Advil on occasion. Starting about a month ago, I was prescribed 10 day's worth of amoxicillin, which I completed to treat a possible case of strep throat.
To add to my original message, while the spinning happened once, the light-headedness comes and goes and sometimes it worsens at random times during the day. The same is true with the chest pain. Today in particular, I've noticed a throbbing sensation on my left temple that also comes and goes. None of this has caused severe pain or discomfort, but it has negatively impacted my productivity on the days when it has surfaced.
My dad has COPD brought about by smoking. My sister might be anemic. She had an episode with rapid heart rate caused by exercise and she saw a doctor, but I am unsure if she diagnosed with it or not. She made her doctor aware that she was born with a heart issue that I believe involves a valve that does not fully close. Although, I can't say what the outcome of that situation was. My aunt has diabetes and my grandmother had kidney cancer years ago (both are related by blood). Everyone else is good.
Thanks again, XXXXXXX
Brief Answer:
Need you to work with me towards establishing a D
Detailed Answer:
Hello once again XXXXXXX
Thank you so much for the elaborate and detailed response to my queries, it helps a great deal.
Let me highlight a few facts from your query and what they point towards:
+13 hour gap from your last meal
+Small dinner
+Symptoms matching a sudden onset of lightheadedness, spinning feeling, etc.
+Positive family history of diabetes
Based on the details provided I strongly suspect low blood sugar (may or may not be related to diabetes) and/or anemia. I would thus request the following:
+As soon as you experience any of these symptoms again report to a medical centre immediately and get your blood glucose measured and blood pressure
+If at all you are not able to get to a medical center for the tests then take a glass of water mixed with sugar (3-4 tablespoons) or a chocolate (large one) immediately and wait for a few minutes to see if your symptoms improve
I would however strongly recommend you try your best to report for a blood glucose check, but if there is absolutely no chance then consume either the above mentioned items.
I would also like to ask if you have experienced any of the following symptoms:
+Frequent urination (polyuria)
+Increased thirst (polydipsia)
+Increased appetite (polyphagia)
+Change in weight
I hope you find my response helpful and informative XXXXXXX Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
Need you to work with me towards establishing a D
Detailed Answer:
Hello once again XXXXXXX
Thank you so much for the elaborate and detailed response to my queries, it helps a great deal.
Let me highlight a few facts from your query and what they point towards:
+13 hour gap from your last meal
+Small dinner
+Symptoms matching a sudden onset of lightheadedness, spinning feeling, etc.
+Positive family history of diabetes
Based on the details provided I strongly suspect low blood sugar (may or may not be related to diabetes) and/or anemia. I would thus request the following:
+As soon as you experience any of these symptoms again report to a medical centre immediately and get your blood glucose measured and blood pressure
+If at all you are not able to get to a medical center for the tests then take a glass of water mixed with sugar (3-4 tablespoons) or a chocolate (large one) immediately and wait for a few minutes to see if your symptoms improve
I would however strongly recommend you try your best to report for a blood glucose check, but if there is absolutely no chance then consume either the above mentioned items.
I would also like to ask if you have experienced any of the following symptoms:
+Frequent urination (polyuria)
+Increased thirst (polydipsia)
+Increased appetite (polyphagia)
+Change in weight
I hope you find my response helpful and informative XXXXXXX Please feel free to write back to me for any further clarifications, I would be more than happy to help you.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. XXXXXXX
- Polyuria is a possibility. If I had to estimate it, I would say at the very minimum I urinate 5-6 times in a day. The average would probably be 7-8.
- My thirst level has not changed.
- My appetite is the same or possibly a little lower since starting the Paleo diet in July 2014.
- Since July, I have lost approximately 9-10 lbs. About half of that was lost due to the diet. The foods I cut out are corn, peas, beans, dairy (except milk and butter), grain, and potatoes (except sweet potatoes). The other half of the weight was lost after I stopped drinking alcohol in September 2014.
To elaborate on the alcohol, I had been a consistent drinker for 12 years and a heavy drinker for about 7 years. I quit in September when the chest issues started. At that time, my consumption was the worst it had ever been and I was consuming approximately 8-12 beers per night on 5-6 days per week. Since September, I have gotten drunk 5 times and each day that followed I had similar chest discomfort and light-headedness (no spinning though).
Your prompt responses are very appreciated, Dr. XXXXXXX I have also been satisfied thus far with the quality of your responses.
Thank you, XXXXXXX
- Polyuria is a possibility. If I had to estimate it, I would say at the very minimum I urinate 5-6 times in a day. The average would probably be 7-8.
- My thirst level has not changed.
- My appetite is the same or possibly a little lower since starting the Paleo diet in July 2014.
- Since July, I have lost approximately 9-10 lbs. About half of that was lost due to the diet. The foods I cut out are corn, peas, beans, dairy (except milk and butter), grain, and potatoes (except sweet potatoes). The other half of the weight was lost after I stopped drinking alcohol in September 2014.
To elaborate on the alcohol, I had been a consistent drinker for 12 years and a heavy drinker for about 7 years. I quit in September when the chest issues started. At that time, my consumption was the worst it had ever been and I was consuming approximately 8-12 beers per night on 5-6 days per week. Since September, I have gotten drunk 5 times and each day that followed I had similar chest discomfort and light-headedness (no spinning though).
Your prompt responses are very appreciated, Dr. XXXXXXX I have also been satisfied thus far with the quality of your responses.
Thank you, XXXXXXX
Brief Answer:
Info supports suspected diagnosis
Detailed Answer:
Hi XXXXXXX
I am glad you found my response helpful. I would also like to apologise for the delay as I was in the OT for quite some time.
All the new information now also helps contribute to my suspecting diagnosis XXXXXXX Alcohol intake, especially in large amounts for a long time can cause some amount of damage to the insulin production, resistance and tolerance.
Almost 60 % of chronic alcoholics (from your past) develop either diabetes or glucose intolerance. So I would urge you to go ahead with the investigations suggested in my last response sir. Please do keep in touch with me and keep me updated on any developments. I am always here to help you XXXXXXX so please do not hesitate to keep in touch with me.
Best wishes.
Info supports suspected diagnosis
Detailed Answer:
Hi XXXXXXX
I am glad you found my response helpful. I would also like to apologise for the delay as I was in the OT for quite some time.
All the new information now also helps contribute to my suspecting diagnosis XXXXXXX Alcohol intake, especially in large amounts for a long time can cause some amount of damage to the insulin production, resistance and tolerance.
Almost 60 % of chronic alcoholics (from your past) develop either diabetes or glucose intolerance. So I would urge you to go ahead with the investigations suggested in my last response sir. Please do keep in touch with me and keep me updated on any developments. I am always here to help you XXXXXXX so please do not hesitate to keep in touch with me.
Best wishes.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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