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Suggest treatment for heart palpitations, dizziness and chest pain?

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Posted on Sat, 8 Nov 2014
Question: I've had ecgs, holter monitor for seven days, chest xrays, echocardiogram and ct angiogram scan ( results posted to you) and every test has said my heart is fine

However I suffer severe palpitations especially when I move suddenly which makes my eyes flicker too and when I lay down to go to sleep my heart feels like it drops or stops completely and I feel dizzy I suffer with severe chest pain and arm pain too
I have had many blood tests and the only thing wrong is my vitamin D is severely low at 12

I cannot sleep at night or move around much at day because of these sensations it's torturing me but my drs say nothing wrong and I'm being a nuisance what could it be ?
doctor
Answered by Dr. Sukhvinder Singh (1 hour later)
Brief Answer:
Dysautonomias need to be ruled out.

Detailed Answer:
Dear Madam
1. Since your ECG, 7 days Holter, ECHO, CT angiogram are normal, be assured it is not a structural or major electrical abnormality of heart.
2. Sudden palpitation on moving, intermittent dizziness, severe chest pain are problems which can have other causes.
3. Autonomic nervous system disorders may present like this which can explain sudden palpitation on standing and dizziness. Whenever we stand from lying down position, some blood tends to pool down in our legs and body activates certain neural mechanisms to prevent decrease in blood supply to heart. if these neural mechanism do not work properly we can have lower blood pressure no sudden standing, high heart rate no sudden standing or dizziness at time.
4. Pain chest may be a part of fibromyalgia syndrome. fibromyalgia itself has been proposed to be associated with dysautonomias.
5. I would advise you to calm down, relax and take an appointment with your neurologist for evaluation of autonomic nervous system. If your MD has not checked you for postural hypotension (by checking BP in supine position and in standing position thereafter) it should be done. Do get treated for low vitamin D levels by taking an appropriate prescription. Do take a lot of fluids and appropriate amount of salt. Avoid dehydration. Shake your legs well before you get up from recumbent posture.
6. You may also consult your physician who is treating fibromyalgia regarding association of fibromyalgia and dysautonomia.
Feel free to discuss further.
Sincerely
Sukhvinder

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Follow up: Dr. Sukhvinder Singh (39 hours later)
The palpitations have got worse tried to get in to see my gp but couldn't till next week
The pain is inbetween my breasts in my left arm back neck ear and jaw but like I said all cardiac tests have come back 'normal' but I don't believe them because I these strong heavy electric shocks are happening inbetween my breast and the make my eyes flicker when they happen and I can't move even my eyes or turn over without it happening

I have just read cymbalta caused palpitations and I am on 120mg a day and it says can cause cardiac arrest if palpitations are not resolved within a few days! I've been like this nearly a week! I'm now frightened beyond belief I cannot sleep for these electric shocks in my chest or move because they make my eyes flicker and make me short of breath now I've read on the leaflet they could kill me ! I know everyone says palpitations are usually benign nothing to worry about but mine don't feel the same as the ones I got last year which were like a flutter these like I say or jolts or shocks accompanied with all the pain shortness of breath and nausea
As soon as I mention the shocks the hospital says hearts fine it's been ruled out but I never had these symptoms in May when I had the ct angiogram and echocardiogram but they don't take me seriously

It actually feels like my heart needs restarting or shocking to make it stop
Should I go to hospital ? Is it true these types of palps can cause cardiac arrest?

doctor
Answered by Dr. Sukhvinder Singh (6 hours later)
Brief Answer:
please see details

Detailed Answer:
Dear madam.
1. Electrical shock like or sharp pain is not a characteristic of anginal heart pain. With your overall profile and normal tests it is highly unlikely that these are anginal pains.
2. Frequent palpitations when go on for a week can cause cardiac arrest is also not fully correct. However since your symptoms are bothersome and increased you should visit hospital. An ECG at hospital will help us in knowing the heart rhythm and possibly reassure you. Only a few causes of palpitation are dangerous enough to cause cardiac arrest and they do so in few minutes not in weeks.
Sincerely
Sukhvinder
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sukhvinder Singh

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Practicing since :1998

Answered : 1306 Questions

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Suggest treatment for heart palpitations, dizziness and chest pain?

Brief Answer: Dysautonomias need to be ruled out. Detailed Answer: Dear Madam 1. Since your ECG, 7 days Holter, ECHO, CT angiogram are normal, be assured it is not a structural or major electrical abnormality of heart. 2. Sudden palpitation on moving, intermittent dizziness, severe chest pain are problems which can have other causes. 3. Autonomic nervous system disorders may present like this which can explain sudden palpitation on standing and dizziness. Whenever we stand from lying down position, some blood tends to pool down in our legs and body activates certain neural mechanisms to prevent decrease in blood supply to heart. if these neural mechanism do not work properly we can have lower blood pressure no sudden standing, high heart rate no sudden standing or dizziness at time. 4. Pain chest may be a part of fibromyalgia syndrome. fibromyalgia itself has been proposed to be associated with dysautonomias. 5. I would advise you to calm down, relax and take an appointment with your neurologist for evaluation of autonomic nervous system. If your MD has not checked you for postural hypotension (by checking BP in supine position and in standing position thereafter) it should be done. Do get treated for low vitamin D levels by taking an appropriate prescription. Do take a lot of fluids and appropriate amount of salt. Avoid dehydration. Shake your legs well before you get up from recumbent posture. 6. You may also consult your physician who is treating fibromyalgia regarding association of fibromyalgia and dysautonomia. Feel free to discuss further. Sincerely Sukhvinder