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What Causes Dizziness?

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Posted on Mon, 20 Oct 2014
Question: Hi I have been experiencing light headed eposoides for the last 2 1/2 years. sometimes when walking I can start off ok then have a feeling like a stumble and then be ok again, also when standing to talk to someone I feel like I am swaying- had MRI and CT scans and saw nurologist who has tired various types of medication none have worked. I had a 24 hour holter done that was fine and a Eco fine and blood tests fine- he now wants me to have another holter and see carologist as i think he has run out of ideas could it be heart he suspects pauses wouldn't i experience other symptoms if so what
doctor
Answered by Dr. Benard Shehu (3 hours later)
Brief Answer:
Repeat holter monitoring& run tilt test...

Detailed Answer:
Hi,

I have gone through your medical issues carefully and noted that:
- you have a history of lightheadedness for the last 2 1/2 years
- have run holter monitoring and your doctor suspects cardiac pauses causes your symptoms
- no other serious problem noted

At this point, I can say that light headed and other problems you are having may be related to cardiac pauses (even if you don't experience any other symptom).

So I advise to repeat holter monitoring to exclude cardiac pauses and to run Tilt test to exclude other non cardiac causes to your problems.

Dr.Benard
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Benard Shehu (10 hours later)
What are cardiac pauses?. if it is what sort of treatment is available if it turns out to be this-- as my lightheadness is worse when moving and I dont get it at all when sitting when I repeat the holter next week should I go for a light 5 mins or so walk around block so it can get a more accurate reading of me when moving I know last time they said to do what i normally do in the course of a day. can you tell me more about the tilt test does the cardologist do this to?

I would have thought if it was cardiac I would have experience shortness of breath and/or other problems not just lightheadness I forgot to add before I also get alot of pain the neck my lightheadness seems to be worse when the neck pain is and gets better or goes away if I can eleivate the neck pain but not always... could it be hormonal the nurologist original diagnoise was vestibular migraines
doctor
Answered by Dr. Benard Shehu (21 hours later)
Brief Answer:
Cardiac pauses as a rule lasting from 2.0 seconds.

Detailed Answer:
Hi and welcome back!

Cardiac pauses or sinoatrial pauses when the sinoatrial node stop to generate the electrical impulse ( normally stimulate the Heart). Cardiac pauses as a rule lasting from 2.0 seconds to several minutes. It can be detected by holter monitoring.

In the case of cardiac pauses it's recomended to stop medication that can cause sinoatrial arrest (betablockers, verapamil ect.). If this is insufficient to avoid sinoatrial pauses and to relief symptoms (lighheaded, faint ect.) then pacemaker is indicated.

Tilt test is an examination that is done to evaluate the cause of unexplained fainting (syncope), vertigo, lighheaded. During a tilt table test, you lie on a table that moves from a horizontal to a vertical position. Your heart rate and blood pressure are monitored.

Yes your symptoms may be related to neck and head problems (neurological) however is highly recommended that you should run out cardiac causes first (cardiac pauses) with a second holter monitoring.

If everything is ok than your symptoms are most probably linked with neurological problems.

Hope this answered all your queries!
Dr. Benard
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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What Causes Dizziness?

Brief Answer: Repeat holter monitoring& run tilt test... Detailed Answer: Hi, I have gone through your medical issues carefully and noted that: - you have a history of lightheadedness for the last 2 1/2 years - have run holter monitoring and your doctor suspects cardiac pauses causes your symptoms - no other serious problem noted At this point, I can say that light headed and other problems you are having may be related to cardiac pauses (even if you don't experience any other symptom). So I advise to repeat holter monitoring to exclude cardiac pauses and to run Tilt test to exclude other non cardiac causes to your problems. Dr.Benard