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Dr. Andrew Rynne

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Feeling dizzy, lightheaded and shortness of breath. ECG normal. Should I consult cardiologist?

Answered by
Dr. Piyush Ostwal


Practicing since :2005

Answered : 349 Questions

Posted on Wed, 16 Jan 2013 in Hypertension and Heart Disease
Question: Hello:
I am 49 year old, caucasian female, former collegiate and professional athlete, still a runner (though slowing with age :); I have light headedness often, shortness of breath often in day activities, though not brought on by running, often minor dizzy spells for a short time upon laying down or standing, blood pressure low when sitting, episodic odd warmth feeling in my left arm, and have recently had a normal ECG (today); I am cold all the time. No anemia, T4 test normal. Referring to cardiologist. Thoughts? Thank you.
Answered by Dr. Piyush Ostwal 2 hours later
The light headedness and dizzy spells are due to the low blood pressure in upright position leading to reduced blood supply to the brain. Since you have shortness of breath also so possibility of a heart disease is very likely. The history of heart disease in family makes it further more likely. The symptoms indicate that heart is not able to pump to the required capacity.
The symptoms of heart are often associated with left arm because of the common nerve supply between the two regions.
You have been rightly referred to the cardiologist. He will be able to evaluate and prescribe you medications.
Hope that answers your query. If there are more queries, I will be happy to answer.
Good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Piyush Ostwal 4 days later
Hello Again:
Thank you for your feedback on your last correspondence.
Since then, my blood work from last week came back this afternoon. Elevated bilirubin (17) and a low alanine aminotransferase level was noted.
I don't know what this all means in conjunction with what I reported earlier to you. Could you give me any feedback on these reports? Do these readings increase alarm or not?
I am scheduled for XXXXXXX 4 cardiologist appointment but I am also on a stat waitlist if anything opens up earlier.
Today was particularly bad--perhaps the worst-- for dizziness (once that really left me grabbing for guidance) and only some shortness in breath (not nearly as bad as other days) and no discomfort at all in my left arm, thankfully. While waiting for my XXXXXXX 4, are there things that I should conclude that I go to an ER rather than wait till XXXXXXX 4 ?
Lastly, what should I expect at the cardiologist appointment ? For example, what other tests might be ordered to help figure out what is going on ?
Thank you for your time and insight. Hope you are having an enjoyable holiday season.
Answered by Dr. Piyush Ostwal 8 hours later
Thanks again.
Seventeen (17) value of bilirubin is way too high. I believe you meant 1.7, and in that case it is slightly on the higher side. It does not explain the recurrent dizziness though.
At the cardiologist appointment you are likely to undergo cardiac Echocardiography (to see the structural problems of heart) and exercise stress test (the function of heart while you are doing exercise in the laboratory).
The recurrent episodes of dizziness does puts you at risk of injury from falling and need ER consultation if it is getting worse.
Good luck. Not many holidays in my place of work but yes new year brings new hopes !
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Piyush Ostwal 7 hours later
Yes, you are right.... Bilirubin was at 1.7 not seventeen-thought I had a decimal in there. Thanks for the information about what to expect at my referral appointment. The lightheadedness/dizziness and other symptoms are still with me this morning, but will wait to see cardiologist unless it gets worse.

Would you be willing to let me know what the low alanine aminotransferase level I received on my blood work means ?

Thank you for considering this again. This will be my last question.

PS: By the way, I am a child and family therapist/college professor. This is the first year I am not "on call." I do actually get to go through the holidays without a page! Hope for you in the New Year! Bye.
Answered by Dr. Piyush Ostwal 1 hour later
Low alanine aminotransferase has really no meaning in your case and it is just a part of the normal variation. The higher values are more often significant.
Good luck.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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