Thank you for the query. As per history, you are a 46yrs old lady, with occasional dizziness, palpitations and pain in the left arm radiating to the jaw. I would like to enquire whether you suffer from any associated conditions like diabetes mellitus, hypertension, thyroid dysfunction or dyslipidemia. The palpitations (a sensation of racing heart) may be due to underlying sudden cardiac arrythmia like atrial fibrillation or paroxysmal supraventricular tachycardia. These may settle on their own. The pain in your left arm or jaw may well be a cardiac pain (stable angina), referred commonly to these areas. I would like to enquire whether you have any shortness of breath associated with this pain and whether the pain arises on exertion. Certain blood investigations are suggested (if you have not done them) like thyroid profile and lipid profile. Hyperthyroidism can often lead to arrythmia. It is advisable that you undergo a 12 lead ECG which will help in detecting any underlying arrythmia or ischemic heart diaease. In case an arrythmia is not detected on ECG, a holter monitor may be needed. In case you consume alcohol it is suggsted that you avoid it. A hemoglobin test is needed because, low levels can cause fatigue, dizziness and palpitations. Please do consult your cardiologist for a physical examination, investigations and prescription of medications. Hope this helps you out.