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Dr. Andrew Rynne

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What causes lightheadedness and dizzy spells?

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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2254 Questions

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Posted on Mon, 4 Aug 2014 in Hypertension and Heart Disease
Question: Hi I have been experiencing light headness, dizzy spells for almost two years now with nurmours blood tests, ct and MRI's all coming back normal.... On the advise of my nurologist I had a 24 hour heart holter test done. results back today said
average HR was 56 bpm lowest was 35 at 3.19am highest was 86 at 9.18am.
Occassioanl ventricular etopic beats with 6 couplets and 1 triplet
frequent supraventricular ectopic beats with 677 couplets and 190 runs longest being 7 heats with heart rate 70-110bpm.
79 Pauses greater then 2 seconds longest being 2.8 due to a compensatory pause following a low atrial run.

I had another blood test today and have an echo for next week then wait to see cardologist. I dont understand what any of this acutually means?. what are the possible problems?. and what are possible treatment options.... I am quiet stressed about all this and worried my BP was high tonight at 160/93 I do have high BP but tonight I feel quiet ill and so tired
doctor
Answered by Dr. Benard Shehu 2 hours later
Brief Answer:
Kindly upload your Holter monitoring report....

Detailed Answer:
Hi there,

I have gone through your medical history and understood your concerns.

The Holter monitor results are indicative for possible problems with heart rhythm (arrhythmia). What you are feeling may be due to ventricular pauses greater than 2.5 seconds.

If i was your doctor i would probably stop verapamil and will put you on diuretics for BP control.

However, to get final conclusions, I ask to have the report of your Holter monitoring test, so I can analyze it myself and come back to you with answers to your questions!

Thank you!
Dr.Benard
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Benard Shehu 1 hour later
I just uploded the report, how would the coveram go maybe i should go back on it
doctor
Answered by Dr. Benard Shehu 2 hours later
Brief Answer:
Stop Verapamil;restart Coveram&HCTZ...

Detailed Answer:
Hi there,

Thank you for uploading your Holter monitoring report.

I have gone through it and noticed that you had one episode of dizziness which coincide with sinus pause (followed by a junctional escape beat).

At this point, I advise to stop taking Verapamil, and restart taking Coveram, and hydrochlorothiazide.

You can discuss this further with your cardiologist!
Dr.Benard
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Benard Shehu 9 hours later
I have stoped the veraoamil and am back on coveram not the hydrochlorthiazide as dont have it at home but still had the coverram. so what does all of the report mean?. what is the mostly likly reason... and fix do you think it will be medication or could it be a pace maker I feel to young to need a pacemaker and dont want to go through that if it can be avoided... also I do 3 hours of quiet strenious excerise on a sat or tap and jazz dancing that i love can I continue to do this is excerise good or bad for someone with that i have?. anything I should be changing what I do/eat etc it could be months until i get in to the cardologist.
doctor
Answered by Dr. Benard Shehu 45 hours later
Brief Answer:
If no more pause,no need for pacemaker

Detailed Answer:
Hi back,

That's great. Continue with Coveram, no problem for hydrochlorthiazide. This is a diuretic helping to lower your blood pressure.

Please bare in mind that it will require 2 - 3 weeks to evaluate if stopping verapamil will improve symptoms. If after 3 weeks, there will not be any pause present in your Holter monitoring, then, this resolves your problem, and you do not need pacemaker.

Dr.Benard
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Benard Shehu 1 hour later
I was getting alot of 180/90 type BP readings on the verapamil but even after two days back on coverram my readings are now 124/75 average HR on my BP monitor gone from 78 to 68 Bpm... I was wondering if it was worth while suggesting to my GP to re do holter and see how it goes plus I have the Echo booked for this thus I went back on coverram on sat would it be to early to re do holter on monday next week?. I have been suffering dizzy spells for nearly two years the nurologist thought vestibular migraine but order the holter to test for heart problems. I am thinking the medication caused the holter readings and my problem is migrains
doctor
Answered by Dr. Benard Shehu 26 hours later
Brief Answer:
Can schedule on Monday next Monday...

Detailed Answer:
Hi back,

Thank you for following up.

Yes, you can schedule Holter on Monday next week. Usually, the re-evaluation is done after 10 days. So, until Monday next week, it will pass enough time for re-evaluation.

Let's see the reports first before running into final conclusions. If the problems will persist, then, suggest pacemaker to adjust the heart problems. Once again, wait for the results first!

Dr.Benard
Above answer was peer-reviewed by : Dr. Raju A.T
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