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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Dizziness, Nausea And Tightness In Chest?

My daughter is out of the country. She is 21. She broke her foot. Two days later, Drs. diagnosed (English not first language so possible vague areas) as a side-effect of cipro (she was taking for an unrelated infection), she had heat at the back of her neck, nausea, and what she said felt like "tighness in her veins". Yesterday, a couple weeks after this incident, she was watching a film in a movie theatre - heart began to race, dizziness, same tightness. She went to the ER in an ambulance. The EKG showed no abnormality. It was called an arrythmia -- but I had the impression the Dr thought it was "anxiety". She was not anxious at the time of the incident. This is of great concern to me and I am 7000 miles away.
Any insight? I'd be grateful.
Wed, 23 Sep 2015
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Cardiologist 's  Response
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that a comprehensive differential diagnosis between anxiety and cardiac arrhythmia should be done.

You should know that even the trauma she has gone through (foot breaking) could be related to anxiety and heart palpitations.

I would recommend consulting with the GP for a careful physical examination , a resting ECG and a chest x ray. Some blood lab tests (complete blood count, PCR, sedimentation rate, thyroid hormone levels, cortisol plasma levels, fasting glucose and blood electrolytes) are needed to exclude other possible metabolic causes like chronic anemia, thyroid or adrenal gland dysfunction.

An ambulatory 24-48 hours monitoring and a cardiac ultrasound may be necessary if suspicions of a possible cardiac arrhythmia are raised.

If all the above tests result normal, the most probable cause of her symptomatology would be just pure anxiety.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Greetings!

Dr. Iliri
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What Causes Dizziness, Nausea And Tightness In Chest?

Hello! Welcome and thank you for asking on HCM! Regarding your concern, I would explain that a comprehensive differential diagnosis between anxiety and cardiac arrhythmia should be done. You should know that even the trauma she has gone through (foot breaking) could be related to anxiety and heart palpitations. I would recommend consulting with the GP for a careful physical examination , a resting ECG and a chest x ray. Some blood lab tests (complete blood count, PCR, sedimentation rate, thyroid hormone levels, cortisol plasma levels, fasting glucose and blood electrolytes) are needed to exclude other possible metabolic causes like chronic anemia, thyroid or adrenal gland dysfunction. An ambulatory 24-48 hours monitoring and a cardiac ultrasound may be necessary if suspicions of a possible cardiac arrhythmia are raised. If all the above tests result normal, the most probable cause of her symptomatology would be just pure anxiety. Hope to have been helpful! Feel free to ask any other questions, whenever you need! Greetings! Dr. Iliri