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What Causes Dizziness And Fluttering Sensation In The Chest?

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Posted on Wed, 5 Apr 2017
Question: Hello Dr,
I'm writing on behalf of my adult son. His name is XXXXXXX 28 years, 6' tall, approx 230lbs. My son has recently lost 20 plans, planning on losing more going forward. He is a Golf Pro at a nearby Golf and Country Club.
Approx 2.5 months ago he noticed some heart palpitations and a little dizziness. He continued to have minor flutters in his chest combined with mild dizziness.
3 days ago his work sent him home after getting out of his vehicle and having to steady himself on the outside of the vehicle till the dizziness stopped. He thought he was passing out. he went to the ER with palpitations and dizziness. They ran IV fluids, did a 12 lead EKG, all normal, his bp was within normal ranges, heart rate normal, BMP within normal, HGB 15.6 HCT 46.3
He has been healthy although had severe ear trouble i.e. ear tubes twice as a young child, also allergies such as hay fever, dust, dust mites for which he had allergy desensitization shots all at about age 9.
We thought hard about familial heart problems concluding there were none.
Then, my husband remembered his mother (our sons grandmother) had been diagnosed with HOCM in her 70's following a dizzy spell. The hospital released him wo a referral to a cardiologist or an ENT referral despite the fact that we requested them.
My son just located a doctor (in fact, a member of his Golf & COuntry Club who has done a thorough exam, sending him for an echocardiogram this Friday morning, assigned a cardiologist and is also doing an MRI next Tuesday. In case there is nothing to see he is suggesting an ENT and a Neurologist.
Do you think these symptoms line up with Hypertrophic Obstructive Cardiomyopathy? Given his age, quite excellent health, very athletic walking golf courses daily...can you pls advise? Also, my husband and his brother were both checked to see if he had an enlarged heart but they had echoes and showed no signs?
doctor
Answered by Dr. Rishu Saxena (46 minutes later)
Brief Answer:
Presyncope with dizziness most likely its not HOCM.

Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query,
I am Dr Rishu Saxena and will answer your query
As per your query unfortunately the first symptom of presentation in 85% of patients with HOCM is death ,In most of the patient HOCM is accidentally diagnosed while doing Echo.Only 10-15% of patients presents with breathlessness as primary symptom.Dizziness with Palpitation are very rare for a patient presenting with HOCM.
Though not asked yet,
The symptom your son is are having are palpitations with Presyncope.A heart palpitation is the sensation that your heart has skipped a beat or added an extra beat. It may feel like your heart is racing, pounding, or fluttering. You may become overly aware of your heartbeat.There can be many causes of palpitations.
Most of the time palpitation is usually associated with some pathological or physiological problem with the heart
To rule out the cause of palpitations i would like to suggest you some of the baseline tests of cardiology like -
24 hour holter monitoring-A small device would be attached to your body for 24hours.It will keep a record of your heart beat (both rate and rhythm) for a perioid of 24 hours.You can also note the time during which you feel palpitations and the rythm at that time could be seen on computer monitor during interpretation of the test.It is the basic and most important test for you.

7 days loop recorder- In case faulty heart beats are not recorded in holter ,A device called loop recorder would be attached to your body for 7days and it will keep a record of your heart beats for 7 days!

Tread mill test -some times the faulty heart beats are precipitated only when the heart is under stress,Tread mill test is designed for that,You will be made to run on a tread mill under monitored condition.Any arryhtmia precipitated can be observed on computer recordings.

2d echo -This test will rule out any abnormality in cardiac function,pumping system of heart and will help to find out if all valves of heart are functioning normally or not.Asymetrical hypertrophy of septum is seen in HOCM(Gold standard test for HOCM).
Presyncope is a state of lightheadedness, muscular weakness, blurred vision, and feeling faint. Presyncope is most often cardiovascular in etiology.
Carotid artery doppler -To rule out if blood supply to brain is normal
Apart from this Thyroid function test should be done.A increased in level of thyroid hormone can cause palpitations.

If these tests are normal complete Neuorological and E.N.T evaluation of patient should be done.
In case of any other query feel free to ask.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Causes Dizziness And Fluttering Sensation In The Chest?

Brief Answer: Presyncope with dizziness most likely its not HOCM. Detailed Answer: Hello, Thanks for choosing HealthcareMagic for your query, I am Dr Rishu Saxena and will answer your query As per your query unfortunately the first symptom of presentation in 85% of patients with HOCM is death ,In most of the patient HOCM is accidentally diagnosed while doing Echo.Only 10-15% of patients presents with breathlessness as primary symptom.Dizziness with Palpitation are very rare for a patient presenting with HOCM. Though not asked yet, The symptom your son is are having are palpitations with Presyncope.A heart palpitation is the sensation that your heart has skipped a beat or added an extra beat. It may feel like your heart is racing, pounding, or fluttering. You may become overly aware of your heartbeat.There can be many causes of palpitations. Most of the time palpitation is usually associated with some pathological or physiological problem with the heart To rule out the cause of palpitations i would like to suggest you some of the baseline tests of cardiology like - 24 hour holter monitoring-A small device would be attached to your body for 24hours.It will keep a record of your heart beat (both rate and rhythm) for a perioid of 24 hours.You can also note the time during which you feel palpitations and the rythm at that time could be seen on computer monitor during interpretation of the test.It is the basic and most important test for you. 7 days loop recorder- In case faulty heart beats are not recorded in holter ,A device called loop recorder would be attached to your body for 7days and it will keep a record of your heart beats for 7 days! Tread mill test -some times the faulty heart beats are precipitated only when the heart is under stress,Tread mill test is designed for that,You will be made to run on a tread mill under monitored condition.Any arryhtmia precipitated can be observed on computer recordings. 2d echo -This test will rule out any abnormality in cardiac function,pumping system of heart and will help to find out if all valves of heart are functioning normally or not.Asymetrical hypertrophy of septum is seen in HOCM(Gold standard test for HOCM). Presyncope is a state of lightheadedness, muscular weakness, blurred vision, and feeling faint. Presyncope is most often cardiovascular in etiology. Carotid artery doppler -To rule out if blood supply to brain is normal Apart from this Thyroid function test should be done.A increased in level of thyroid hormone can cause palpitations. If these tests are normal complete Neuorological and E.N.T evaluation of patient should be done. In case of any other query feel free to ask.