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What Does An Episode Of Dizziness And Palpitations Indicate?
Question: Hi, I am a healthy 33 year old male....I am approximately 6'4" 195 lbs. About 2 months ago I had an episode in Dicks sporting goods where I got extremely dizzy, lightheaded, heart started racing, pounding heart, felt like i was going to have a heart attack. I was taken to the ER where they did an EKG, advanced bloodwork and hooked me up to a heart monitor. Everything was perfectly normal, clearly all signs of a panic attack right. My primary care doc met with me a day later and once he found out how much I had been drinking during the summer months he thought it was me just going through some minor alcohol withdrawal which led to me having a panic attack. He prescribed me xanax as needed. My parents cardiologist who is also a good friend of mine also met with me and hooked me up to a 24 hour heart monitor. Nothing abnormal was found, great news I know. He also diagnosed me with panic attacks and gave me metoprolol, 25mg once a day. He claimed the panic attacks were adrenaline related, which i can believe because i am always going 100mph at my office. I am not a big pill popper so i thought i would try the xanax first since it was working. However, my body after these "panic" attacks, felt like it had been run over by a truck which led me to believe my cardiologist was right and it was adrenaline related. So i tried a cutting the 25 mg metoprolol pill in half and took it at 4pm. Took away all the symptoms that day until 3am came along and my heart felt like it was going to stop. My heart rate went down to 40 bpm to the point where i thought my heart was going to stop. Went to the ER again and they said everything will be fine when the metoprolol wore off and it was. All the bloodwork and EKG again came back normal with that ER visit as well. No enzymes were ever elevated in either my 1st or 2nd ER visit. The past 2 months I have stopped drinking, been working out and trying to eat healthier. The working out seems to help a little, at one point in time i had even stopped taking xanax for 2 weeks. Then these episodes came back. I am having some deep back pain in the middle of my back (not sure if it is adrenaline related). It's almost like i can feel my heart beat through my back. the reason for my question is I am not a person who panics very easily, I can normally handle a ton of stress and not even remotely freak out like this. I am still having these episodes where i have to take .25 mg of xanax a day. I am not depressed at all and have never been depressed so I'm not sure if lexapro or zoloft are the answers which my Primary Car Doc mentioned to me . However the fear of having these episodes when I go out is affecting me. I can't even relax when I'm on the golf course. I was never like this. I have done my research and it sounds like Panic Disorder. And now that I have this funky back pain, Im not sure what to think. I am a non smoker, I do not do any drugs and I smoke an occasional cigar. I use to drink a lot prior to these episodes. Probably 3-4 times a week and we use to get pretty tipsy at each setting.....to the point where I could drink 8-9 shots of crown on top of 5-6 scotches. Any take on why I am still having these episodes and what I should do? Im a former athlete so I don't let anything beat me. Even after these panic attacks I have gone out and done things, worked out, went for runs, etc... Just completely unsure what to think at this point. These episodes happen at all times....could be when I'm in the middle of a workout or when I am out on the town. However I did drink one night and it didn't happen that night but felt like it was going to if that makes sense. Hell, it even happened while i was nice and calm watching a movie! If its panic and me just being a sissy, feel free to just say so. but HELP! This is making me nuts!
Brief Answer:
Hi, One possibility is you are getting attacks of SVPT
Detailed Answer:
Hi, One possibility is you are getting attacks of SVPT--Supraventricular paroxysmal tachycardia--which can come as attacks in between which you are totally normal. Was your pulse fast when they did the EKG? Another possibility is MVP or mitral valve prolapse (common in 40% of people) --it can lead to similar symptoms.
One way to abort these attacks is to pinch your nostrils and blow hard through your mouth. This is called Valsalva's manouevre. Alternately feel the carotid artery inside the sternocleido mastoid muscle in your neck--(any doctor can show you) on any one side of neck and gently massage. This will also abort the attack. But never do it on both sides simultaneously. Personally I do not think they are panic attacks considering your personality. And instead of 25 mgs of Metoprolol, Verapamil 120mg SR or Propranolol 10 mg twice a day will keep you under control. You can revert back. Regards
Hi, One possibility is you are getting attacks of SVPT
Detailed Answer:
Hi, One possibility is you are getting attacks of SVPT--Supraventricular paroxysmal tachycardia--which can come as attacks in between which you are totally normal. Was your pulse fast when they did the EKG? Another possibility is MVP or mitral valve prolapse (common in 40% of people) --it can lead to similar symptoms.
One way to abort these attacks is to pinch your nostrils and blow hard through your mouth. This is called Valsalva's manouevre. Alternately feel the carotid artery inside the sternocleido mastoid muscle in your neck--(any doctor can show you) on any one side of neck and gently massage. This will also abort the attack. But never do it on both sides simultaneously. Personally I do not think they are panic attacks considering your personality. And instead of 25 mgs of Metoprolol, Verapamil 120mg SR or Propranolol 10 mg twice a day will keep you under control. You can revert back. Regards
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi Dr. XXXXXXX
During these episodes my pulse was normal during the ekg and heart monitor. It seems like they have ruled out SVPT. During these episodes my blood pressure normally goes to 135/85 to 145/90, and my pulse stays around 75-80 bpm. I did forget to mention that I do have a minor case of mitral valve prolapse, but as mentioned i never had episodes like this until 2 months ago. The mvp is so minor that you can't even hear it through a stethoscope. I have also stopped drinking all caffeine as well. One thing about me that I forgot to mention is that I go very fast throughout my work day because of how busy I am. I set my goals very high and do put a lot of pressure on myself. I also have acid reflux which I take 30mg of prevacid once a day. I also forgot to mention that in the past week or so, I have this fullness inside my chest where it feels like I have to keep making it gurgle, kind of like indigestion. This usually subsides after I stand up and go for a walk. So you want me to take the metoprolol? Maybe you misread my message, I only took half of the 25 mg pill of metoprolol (12.5 mg) and it dropped my heart rate down to 40 bpm and sent me in to bradycardia and put me in the ER. Are you sure I should take this medication again?
During these episodes my pulse was normal during the ekg and heart monitor. It seems like they have ruled out SVPT. During these episodes my blood pressure normally goes to 135/85 to 145/90, and my pulse stays around 75-80 bpm. I did forget to mention that I do have a minor case of mitral valve prolapse, but as mentioned i never had episodes like this until 2 months ago. The mvp is so minor that you can't even hear it through a stethoscope. I have also stopped drinking all caffeine as well. One thing about me that I forgot to mention is that I go very fast throughout my work day because of how busy I am. I set my goals very high and do put a lot of pressure on myself. I also have acid reflux which I take 30mg of prevacid once a day. I also forgot to mention that in the past week or so, I have this fullness inside my chest where it feels like I have to keep making it gurgle, kind of like indigestion. This usually subsides after I stand up and go for a walk. So you want me to take the metoprolol? Maybe you misread my message, I only took half of the 25 mg pill of metoprolol (12.5 mg) and it dropped my heart rate down to 40 bpm and sent me in to bradycardia and put me in the ER. Are you sure I should take this medication again?
Brief Answer:
Hi,No I did not suggest Metoprolol.
Detailed Answer:
Hi,No I did not suggest Metoprolol. I had suggested Calaptin (Verapamil) or low dose (10 mg twice a day) Propranolol. If it is due to MVP, the attacks will be aborted.
Sure, fullness due to gas and acidity can also give the same symptoms of pressure, palpitations, dizziness and light headedness. So first try an Omeprazole preparation with Domperidone twice a day for a week. If the attacks are due to this, you will find relief.
My second diagnosis will be MVP and I would think of panic attacks only after ruling out these two. Regards
Hi,No I did not suggest Metoprolol.
Detailed Answer:
Hi,No I did not suggest Metoprolol. I had suggested Calaptin (Verapamil) or low dose (10 mg twice a day) Propranolol. If it is due to MVP, the attacks will be aborted.
Sure, fullness due to gas and acidity can also give the same symptoms of pressure, palpitations, dizziness and light headedness. So first try an Omeprazole preparation with Domperidone twice a day for a week. If the attacks are due to this, you will find relief.
My second diagnosis will be MVP and I would think of panic attacks only after ruling out these two. Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks for the thorough diagnosis, it is much appreciated. However I cannot buy domperidone in the U.S.
Since my ultimate goal is to not take any medication, would diet and intense exercise help MVP and this fullness/acidity in my chest? Or would it be best to take the medication?
Since my ultimate goal is to not take any medication, would diet and intense exercise help MVP and this fullness/acidity in my chest? Or would it be best to take the medication?
Brief Answer:
Hi, sure! Diet and exercise will work beautifully.
Detailed Answer:
Hi, sure! Diet and exercise will work beautifully.
You can take plain Cap Omeprazole 20 mg as and when required (upto twice daily before food, in empty stomach), and also I am sure once you are re-assured that it is not serious---you will learn to handle it better.
Regards
Hi, sure! Diet and exercise will work beautifully.
Detailed Answer:
Hi, sure! Diet and exercise will work beautifully.
You can take plain Cap Omeprazole 20 mg as and when required (upto twice daily before food, in empty stomach), and also I am sure once you are re-assured that it is not serious---you will learn to handle it better.
Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you Doctor. So you think it is definitely not anything serious correct? I just want to make sure it is nothing heart related.
Brief Answer:
Hi, you have already seen a good doctor there.
Detailed Answer:
Hi, you have already seen a good doctor there. Only thing is MVP which is not serious in this scenario.
Wish you the best, Regards
Hi, you have already seen a good doctor there.
Detailed Answer:
Hi, you have already seen a good doctor there. Only thing is MVP which is not serious in this scenario.
Wish you the best, Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dr. XXXXXXX
Can Alcohol agitate my mitral valve prolapse? I drank the past couple days and my blood pressure keeps shooting up for no reason and I've been getting dizzy and sweaty. Im not hungover or anything like that.
Can Alcohol agitate my mitral valve prolapse? I drank the past couple days and my blood pressure keeps shooting up for no reason and I've been getting dizzy and sweaty. Im not hungover or anything like that.
Brief Answer:
Hi, yes alcohol can cause gastritis, leading to gas and bloating
Detailed Answer:
Hi, yes alcohol can cause gastritis, leading to gas and bloating and pressure on heart leading to palpitations even without a hangover. regards
Hi, yes alcohol can cause gastritis, leading to gas and bloating
Detailed Answer:
Hi, yes alcohol can cause gastritis, leading to gas and bloating and pressure on heart leading to palpitations even without a hangover. regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. XXXXXXX
I appreciate your response. I can handle everything pretty but this deep back pain is somewhat freaking me out and it's in the middle of my back. And I have an occasional sharp pain in my chest. I think all this stuff is giving me anxiety because I'm starting go get short of breath when doing my basic day to day activities. I don't have any heavy feeling in my chest or anything like that.
I appreciate your response. I can handle everything pretty but this deep back pain is somewhat freaking me out and it's in the middle of my back. And I have an occasional sharp pain in my chest. I think all this stuff is giving me anxiety because I'm starting go get short of breath when doing my basic day to day activities. I don't have any heavy feeling in my chest or anything like that.
Brief Answer:
Hi, I sense a mild cardiac anxiety here.
Detailed Answer:
Hi, I sense a mild cardiac anxiety here. But I agree with your concern. It is always good to be sure than sorry. So I want you to go back to your doctor, discuss all this (including options of Propranolol, Verapamil, anxiolytic) and also review your backache. Your Physician may want to conduct a few more tests to be hundred percent certain that there is nothing seriously wrong. After that you will be re-assured and hopefully free of your symptoms--wishing you the best, and regards
Hi, I sense a mild cardiac anxiety here.
Detailed Answer:
Hi, I sense a mild cardiac anxiety here. But I agree with your concern. It is always good to be sure than sorry. So I want you to go back to your doctor, discuss all this (including options of Propranolol, Verapamil, anxiolytic) and also review your backache. Your Physician may want to conduct a few more tests to be hundred percent certain that there is nothing seriously wrong. After that you will be re-assured and hopefully free of your symptoms--wishing you the best, and regards
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. XXXXXXX
What is cardiac anxiety? Is it caused by MVP? Or do you think this is some sort of general anxiety disorder? Im pretty sure my cardiologist did every test on, 24 hour heart monitor, echocardiogram, ekg, advanced bloodwork etc.. What other tests would they need do perform?
What is cardiac anxiety? Is it caused by MVP? Or do you think this is some sort of general anxiety disorder? Im pretty sure my cardiologist did every test on, 24 hour heart monitor, echocardiogram, ekg, advanced bloodwork etc.. What other tests would they need do perform?
Brief Answer:
Hi, by cardiac anxiety I meant you have developed an anxiety
Detailed Answer:
Hi, by cardiac anxiety I meant you have developed an anxiety that you have a cardiac problem. Since you say all your cardiac tests were done, I think you should relax and stop worrying. Only discuss need for medication for MVP (since you are having episodic symptoms) and review of your backache. Hope to have you fine soon--regards
Hi, by cardiac anxiety I meant you have developed an anxiety
Detailed Answer:
Hi, by cardiac anxiety I meant you have developed an anxiety that you have a cardiac problem. Since you say all your cardiac tests were done, I think you should relax and stop worrying. Only discuss need for medication for MVP (since you are having episodic symptoms) and review of your backache. Hope to have you fine soon--regards
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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