HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Persistent Chest Pain, Dizziness And Fatigue?

default
Posted on Sat, 2 Jul 2016
Question: I went to my doctor 1 month ago because I was very fatigued. Not normal for me. He suggested a sleep study. Because that is the latest jump on the bandwagon doctor phase, I am not scheduled until August.
I returned last week because of pain in my chest and dizziness. Recommend allergy tests due to my concerns of mold in the work space. Allergist stated my chest pain and fatigue was not due to mold.
Stated I have "impressive" allergies. Which I have know through out my 71 years. No sneezing, runny nose, or other allergy symptoms.
I was diagnosed with a leaky heart valve about 5 years ago and was concerned about the fatigue
because of that. Hench the first visit. Doc told me leaky valves don't cause fatigue.
2nd visit he said since I didn't have pains down my left arm or my jaw I don't have heart problems.
I am in a quandary. My family is worried and bugging me to go to a cardiologist. However, I live in a small town and have been unable to get into a doctor for a second opinion. My only step is to go to emergency. But yesterday the chest pain subsided. I am active as a furniture refinishing and I own a design studio. I am 71.. What do you suggest?
doctor
Answered by Dr. Ilir Sharka (23 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to chest pain and chronic fatigue:

1- Heart failure. Leaking valves are not a common cause of chronic fatigue, but heart failure (which is a progressed stage of many cardiac disorders) can be the cause of such symptoms. I would recommend performing a cardiac ultrasound and resting ECG to examine your cardiac function and structure.

2- Lung disorders can cause this symptomatology. A chest X ray study coupled with respiratory function tests (especially if you have shortness of breath) are needed for this purpose.

3- Metabolic disorders like chronic anemia, thyroid dysfunction, adrenal gland dysfunction, or electrolyte imbalances can lead to a similar clinical scenario. That is why I would recommend performing thyroid hormone levels, cortisol plasma levels, complete blood count and blood electrolytes.

4- Inflammation could lead to similar symptoms. I would advise performing PCR, sedimentation rate for this purpose.

5- Vitamin deficiencies like Vitamin D and Vitamin B12. It is important performing these vitamins plasma levels too.

6-Chronic allergies can lead to chronic fatigue.

All the above tests are not performed in the ER department, because no one of the above mentioned causes is an emergency.

So I would recommend consulting with your attending physician and discussing on the above issues.

If you have acute chest pain, triggered by physical or emotional activity, I would recommend going to the ER for a resting ECG, and some blood lab tests (complete blood count, cardiac enzymes, blood electrolytes) to exclude possible myocardial ischemia, which can be an emergent situation.

Meanwhile, I would recommend you to closely monitor your blood pressure in sitting and standing up position frequent times during the day. Low blood pressure or orthostatic hypotension can lead to fatigue and dizziness.

Hope to have been helpful!

Kind regards,

Dr. Iliri

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9539 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Persistent Chest Pain, Dizziness And Fatigue?

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome and thank you for asking on HCM! I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to chest pain and chronic fatigue: 1- Heart failure. Leaking valves are not a common cause of chronic fatigue, but heart failure (which is a progressed stage of many cardiac disorders) can be the cause of such symptoms. I would recommend performing a cardiac ultrasound and resting ECG to examine your cardiac function and structure. 2- Lung disorders can cause this symptomatology. A chest X ray study coupled with respiratory function tests (especially if you have shortness of breath) are needed for this purpose. 3- Metabolic disorders like chronic anemia, thyroid dysfunction, adrenal gland dysfunction, or electrolyte imbalances can lead to a similar clinical scenario. That is why I would recommend performing thyroid hormone levels, cortisol plasma levels, complete blood count and blood electrolytes. 4- Inflammation could lead to similar symptoms. I would advise performing PCR, sedimentation rate for this purpose. 5- Vitamin deficiencies like Vitamin D and Vitamin B12. It is important performing these vitamins plasma levels too. 6-Chronic allergies can lead to chronic fatigue. All the above tests are not performed in the ER department, because no one of the above mentioned causes is an emergency. So I would recommend consulting with your attending physician and discussing on the above issues. If you have acute chest pain, triggered by physical or emotional activity, I would recommend going to the ER for a resting ECG, and some blood lab tests (complete blood count, cardiac enzymes, blood electrolytes) to exclude possible myocardial ischemia, which can be an emergent situation. Meanwhile, I would recommend you to closely monitor your blood pressure in sitting and standing up position frequent times during the day. Low blood pressure or orthostatic hypotension can lead to fatigue and dizziness. Hope to have been helpful! Kind regards, Dr. Iliri