Some things that can cause this sensation: 1)Coronary artery problems -- get an angiogram done. I had exact symptoms, waking me every 2 hours, had 99% blockage in left anterior descending artery. 2) Diabetes 3) Coronary Microvascular blockage in small arteries (not main ones)--in brain, heart. 4) medications, such as antipsychotics, or ECT treatment. 5) Deep brain stimulation, Vagus nerve stimulator 6) Ear implants 7) Tumor in brain or ear 8) infection in brain or ear Tests needed: 1) Angiogram 2) Blood profile, including blood sugar 3) CMD usually manifests itself first when people start having problems doing routine daily tasks. NHLBI also lists other steps for diagnosing CMD. These include: •Stress Test - may be ordered to see if the heart is getting enough blood during exercise. •Angiogram - may be ordered to determine if the arteries of the heart are blocked. •Electrocardiogram (EKG) - could be done to assess blood through the arteries and heart. •A diagnosis of CMD may be given if there are no blockages and further tests rule out problems like: •heart valve disease •muscle problems •throat problems •vascular dysfunction •coronary artery spasm According to the NHLBI, once CMD is detected, it may be treated with drugs. These may include: •ACE (angiotensin converting enzyme) inhibitors to help keep blood vessels open •nitrates such as nitroglycerin to relax blood vessels and help with chest pain •blood pressure drugs including calcium channel blockers and beta blockers •statins to help lower cholesterol •aspirin and anticoagulants to thin the blood and keep clots from forming Causes and prevention NHLBI reports the causes of CMD are still largely unknown and can vary from patient to patient. But the agency recommends adopting a heart-healthy lifestyle, which includes: •no smoking •exercising •following a heart-healthy diet •keeping cholesterol and blood pressure at healthy levels CRF says there is some suggestion that hormones may play a role in the development of the condition. That would help explain the reason that many more women have CMD than men. According to the NHLBI, studies suggest that people with CMD have no higher risk of suffering a heart attack or dying from cardiovascular conditions than other heart patients.