Chest Pain and Dizziness: The Impact of High Cholesterol - Cardiology

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Chest tightness and pain, discomfort in the heart, shortness of breath, neck stiffness, and dizziness?


A month ago, I suddenly experienced dizziness, shortness of breath, and discomfort in my heart after getting angry.
I went to the hospital and had an electrocardiogram (ECG) and a 24-hour Holter monitor, both of which were normal (although there were a few instances of a heart rate of 165 during the 24 hours).
Since then, I have continued to experience chest tightness, heart discomfort, dizziness, and shortness of breath (especially while wearing a mask), along with neck stiffness and numbness in my hands and feet.
One day, I suddenly had left chest pain and went to the emergency room; the ECG was normal, and chest imaging was also normal.
Blood tests for thyroid function were normal, but I received abnormal results yesterday: cholesterol 251, triglycerides 214, low-density lipoprotein (LDL) 164, and fasting blood glucose 114.
I am unsure if the high cholesterol is causing this series of discomfort.
If it is related to cholesterol, is there currently a risk that requires medication, or can I manage it through diet alone? Should I consult a specialist for further evaluation? My symptoms persist, especially at night when I feel like I'm about to fall asleep and suddenly wake up.
Thank you.

Mr. Sun, 40~49 year old female. Ask Date: 2022/06/28

Dr. He Dongjin reply Cardiology


Hello, high cholesterol is not necessarily the cause of a series of discomforts; it is often related to autonomic nervous system issues.
You can start by managing your diet on your own, or if you prefer, you can take medication to control it.
Currently, your symptoms are not related to high cholesterol.
Changhua Hospital cares about your well-being.

Reply Date: 2022/06/28

More Info


Understanding the relationship between high cholesterol levels and symptoms such as chest pain, dizziness, and discomfort is crucial for managing your health. Based on your recent medical history, including episodes of dizziness, shortness of breath, and chest discomfort, it is essential to consider several factors that may contribute to your symptoms.

Firstly, high cholesterol levels, particularly elevated low-density lipoprotein (LDL) cholesterol, can lead to atherosclerosis, a condition where arteries become narrowed and hardened due to plaque buildup. This can restrict blood flow to the heart and other organs, potentially leading to symptoms such as chest pain (angina), shortness of breath, and even dizziness if the brain is not receiving adequate blood supply. Your reported cholesterol levels—total cholesterol at 251 mg/dL, triglycerides at 214 mg/dL, and LDL at 164 mg/dL—are indeed above the recommended thresholds, which could increase your risk for cardiovascular diseases.

However, it is also important to note that your heart-related tests, including the electrocardiogram (ECG) and chest examinations, returned normal results. This suggests that while your cholesterol levels are concerning, they may not be the sole cause of your symptoms. Other factors, such as anxiety, stress, or even physical reactions to wearing a mask, could also contribute to feelings of chest tightness and dizziness. The sudden onset of symptoms, particularly after a stressful event, may indicate a panic attack or anxiety-related response rather than a direct cardiovascular issue.

Given your symptoms and elevated cholesterol levels, it is advisable to take a proactive approach. Here are some recommendations:
1. Dietary Changes: Focus on a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Reducing saturated fats, trans fats, and cholesterol intake can help lower your LDL levels. Foods high in omega-3 fatty acids, such as fish, flaxseeds, and walnuts, can also be beneficial.

2. Regular Exercise: Engaging in regular physical activity can help improve your cholesterol levels and overall cardiovascular health. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week.

3. Weight Management: If you are overweight, losing even a small percentage of your body weight can help improve your cholesterol levels and reduce your risk of heart disease.

4. Monitoring Symptoms: Keep track of your symptoms, including when they occur and their severity. This information can be valuable for your healthcare provider in determining the next steps.

5. Follow-Up with Healthcare Providers: Given your ongoing symptoms, it would be prudent to consult with a healthcare provider specializing in cardiology or internal medicine. They may recommend further testing, such as a stress test or imaging studies, to evaluate your heart's function and rule out any underlying conditions.

6. Consider Medication: If lifestyle changes alone do not adequately lower your cholesterol levels, your healthcare provider may discuss the possibility of cholesterol-lowering medications, such as statins.

In conclusion, while high cholesterol can contribute to cardiovascular symptoms, it is essential to consider the broader context of your health. By adopting a healthy lifestyle and working closely with your healthcare team, you can effectively manage your cholesterol levels and address your symptoms. Remember to communicate openly with your healthcare provider about all your symptoms and concerns, as this will help them provide the best care tailored to your needs.

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