Dizziness and Heart Issues: A Guide to Symptoms and Concerns

Dizziness, heart discomfort, chest tightness or pain, and shortness of breath?

Hello, doctor.
I have a history of dizziness for 15 years, with symptoms including spinning sensations, tinnitus, nausea, blurred vision, shortness of breath, palpitations, and a rapid heartbeat (these symptoms occur during episodes and have become more frequent in recent years).
Whenever I feel unwell, my pulse tends to exceed 100 beats per minute.
When I was 17, I was diagnosed with a pituitary tumor, which resulted in elevated prolactin levels.
I have also experienced adrenal cortex abnormalities in the past.
Two years ago, the tumor was approximately 1 cm in size.
Recently, after feeling unwell, I went to the emergency room and was hospitalized.
My symptoms included dizziness, tinnitus, and blurred vision, and I was prone to falling.
I experienced shortness of breath when walking, climbing stairs, or lying flat, with my heart racing to the point where I could hear it, and a sensation of heaviness and tightness in my chest, along with shortness of breath and coughing.

I underwent a cardiac ultrasound, and the doctor informed me that there was evidence of cardiac weakness, though the cause is unknown.
I apologize, doctor, as I do not have a copy of the test results to share with you, so I can only describe my situation.
A cardiologist confirmed that my heart function is indeed compromised.
Due to my condition, I was unable to undergo an exercise echocardiogram, so the doctor recommended a cardiac CT scan at my own expense.
However, the doctor also mentioned that some underlying causes might not be detectable even with testing (with about an 80% chance of identifying the issue).
The cardiologist explained that heart failure can cause shortness of breath even when lying down, which I do experience.
The cardiologist suggested that using oxygen at home might provide some comfort for my condition (while hospitalized under the care of a neurologist, I was on oxygen for an extended period due to dizziness and shortness of breath).
I am unclear about the necessity of using oxygen at home.
Is it essential, or is it just a temporary relief for discomfort? If my heart function deteriorates, is it possible for me to develop heart failure? Or does poor heart function already indicate that I am on the path to heart failure? The uncertainty is quite frightening, especially at my age, as it’s hard to imagine experiencing heart failure.
I have always experienced dizziness and a rapid heartbeat after exercise, which I initially attributed to my pituitary tumor.
However, the sudden emergence of cardiac issues has left me confused about which specialist to consult.
I have never seen a cardiologist before.
Is there a connection between my dizziness and my heart condition? Can I afford to ignore the heart issue without treatment? Currently, I experience chest tightness and palpitations while taking medication, eating, or lying down.

The most significant impact on my life is the dizziness, and I am eager to identify its cause.
However, this has led to many questions.
I apologize for having so many inquiries, and I appreciate your assistance.
Thank you!

Xiao Xun, 30~39 year old female. Ask Date: 2022/01/09

Dr. He Dongjin reply Cardiology

Hello, if I were you, I would have many questions as well.
However, I apologize that the information provided is limited and cannot answer your inquiries.
It is advisable to visit the cardiology outpatient department of the hospital for a physician to explain the examination results.
Changhua Hospital cares about your well-being.

Reply Date: 2022/01/09

More Info

Understanding dizziness and heart issues can be quite complex, especially when symptoms overlap and involve multiple systems in the body. Based on your detailed description, it seems you are experiencing a range of symptoms that include dizziness, palpitations, shortness of breath, and chest discomfort, which can be distressing and confusing.

Firstly, it's important to recognize that dizziness can stem from various causes, including vestibular disorders, neurological issues, and cardiovascular problems. Given your history of a pituitary tumor and the associated hormonal imbalances, it’s possible that some of your symptoms may be linked to these conditions. The pituitary gland plays a crucial role in regulating hormones that affect various bodily functions, including stress response and metabolism, which can indirectly influence heart function and overall well-being.

Your symptoms of dizziness, tinnitus (ear ringing), nausea, and visual disturbances suggest a possible vestibular issue, which could be exacerbated by anxiety or panic attacks, especially if you have a history of panic disorder. The sensation of your heart racing, particularly during episodes of dizziness, can be a physiological response to anxiety or a direct result of cardiovascular strain.

Regarding your heart health, the echocardiogram indicating reduced heart function is a significant finding. While it’s not uncommon for younger individuals to experience transient heart issues, persistent heart dysfunction can lead to more serious conditions, including heart failure. Heart failure does not necessarily mean that the heart has stopped working; rather, it indicates that the heart is not pumping blood as effectively as it should, which can lead to symptoms like shortness of breath, fatigue, and fluid retention.

The recommendation from your cardiologist to consider a cardiac CT scan is prudent, as it can provide more detailed information about the structure and function of your heart. While it’s true that not all issues may be visible on imaging, this step can help rule out significant problems such as coronary artery disease or structural abnormalities that could be contributing to your symptoms.

As for the use of supplemental oxygen at home, this can be beneficial if you are experiencing significant shortness of breath, especially when lying down. Oxygen therapy can help alleviate symptoms and improve your comfort level. However, it is essential to use it under medical supervision to ensure it is appropriate for your condition.

To address your concerns about heart failure, it’s crucial to understand that having reduced heart function does not automatically mean you are in heart failure. Heart failure is a clinical diagnosis that involves a combination of symptoms, physical examination findings, and diagnostic tests. It’s essential to monitor your symptoms closely and maintain regular follow-ups with your healthcare providers.

In terms of managing your symptoms, it would be advisable to continue working with both your cardiologist and neurologist. They can collaborate to determine if there is a connection between your heart function and your dizziness. Additionally, lifestyle modifications, such as reducing stress, avoiding caffeine, and engaging in gentle physical activity, may help manage your symptoms.

Lastly, it’s understandable to feel anxious about your health, especially with the complexity of your symptoms. Seeking support from mental health professionals can also be beneficial in managing anxiety and improving your overall quality of life. Remember, you are not alone in this journey, and there are healthcare professionals who can help guide you through your concerns and treatment options.

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