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What is causs for lightheadedness since the echo came out good?

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Practicing since : 1966
Answered : 4499 Questions
Age 65. Mvp. No problem for 17 yrs. Last bout was 17yrs ago when hormones dropped. Now 3 wks ago heart pounding , many pvc';s, went to metoprolol for hbp . has beta blocker in it, not helping the pvc's.they are all day and all nite as soon as i sit up in bed. Recently got echocardiogram....said came out "fine" and just a "trivial" amount of valve leakage. Heart nurse told me that. Waiting to see heart doc. Today i got a bad spell of lightheadedness lasted maybe 4 seconds. Felt strong. Got shorter and smaller one a wk ago. Beta blocker not helping pvc's. Doc said to double up on metoprolol, but heart beat already too low at 54 beats, afraid bb will make it go slower. What is causing the lightheadedness since the echo came out good? And why won't the pvc's go away? Thanks. XXXXXXX
Posted Fri, 13 Dec 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Anantharamakrishnan 2 hours later
Brief Answer: Need more tests / follow up Detailed Answer: Hi friend, Welcome to Health Care Magic You need further investigations… HOLTER (24 to 48 hour ambulatory monitoring – for analysis of arrhythmia) / TMT (Treadmill exercise ECG – for ischemia) / LABORATORY work-up – may all be necessary for further assessment and assistance. The body's balancing mechanism is in the inner ear. ENT (Ear Nose Throat) specialists have special tests to confirm or exclude the contribution of the ear – to evaluate lightheadedness... If the ear is excluded, you have to be seen by a neurologist. / MRI may be needed. MRA (MRI angiography) shows blood vessels and is generally done at the same sitting. If there are no clues and if the problem is still bothering to the extent of interfering with life style, you may need advanced investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. There are several classes of drugs and several drugs in each class… Also there are advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. The treating doctor may suggest them depending on need, based on his assessment of the situation. Good luck Take care Wishing all well God bless
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