Neck Ultrasound Follow-Up for Dizziness and Heart Issues

Regarding cervical ultrasound follow-up examination?

Dr.
Peng, previously, due to dizziness, I underwent three cervical ultrasounds: in 1993 (at Shou-Ji Family Medicine), in 2014 (at Chang Gung Neurology), and in 20XX (at Shou-Ji Neurology).
From 2003 to 2013, my dizziness was almost resolved, but after experiencing a myocardial infarction at the end of 2013, the dizziness returned five months later.
A neurologist at Chang Gung performed a cervical ultrasound and informed me of a narrowing in one area of my intracranial vessels, which is likely congenital and not concerning.
However, they also suggested that the dizziness could be related to cardiac issues.
The cardiologist advised me to just take my medication, and for many years, I have been reluctant to undergo further cervical ultrasound follow-ups.
My dizziness began in 1993, while the myocardial infarction occurred in 2013, which is nearly a 30-year gap, yet the doctors insist it is heart-related.
At that time, I was physically robust; although I didn't have six-pack abs, I was certainly fit! After several requests for further evaluation were denied, I sought help from Shou-Ji in 20XX, where the cervical ultrasound results indicated no significant issues, but they suggested annual follow-ups.
Now, if I were to consult Dr.
Peng, should I directly explain my concerns? I am now 59 years old, and it's natural for me to overthink things.
Additionally, my personality tends to lead me to seek confirmation repeatedly (which might be seen as nitpicking).
I hope this won't be too much of a bother for Dr.
Peng.

Mr. Zhang, 50~59 year old female. Ask Date: 2023/02/01

Dr. Peng Shiwei reply Neurology

Hello Mr.
Chang, no problem! You can register first, and then I will help you with the assessment.
Thank you for your inquiry.

Reply Date: 2023/02/01

More Info

Understanding the relationship between dizziness and heart issues, particularly in the context of neck ultrasound follow-ups, can be complex. Your history of dizziness dating back to 1982, combined with a heart attack in 2013, raises important considerations regarding the potential interplay between cardiovascular health and neurological symptoms.

Firstly, dizziness can stem from various causes, including vestibular disorders, neurological issues, and cardiovascular problems. In your case, the fact that your dizziness improved significantly between 1992 and 2002 suggests that there may have been a specific trigger or underlying condition that was resolved or managed during that time. However, the recurrence of dizziness after your heart attack indicates that there may be a connection between your cardiovascular health and your symptoms.

The neck ultrasound (carotid ultrasound) you underwent is a valuable diagnostic tool used to assess blood flow in the carotid arteries and detect any narrowing or blockages that could affect cerebral circulation. The fact that a physician noted a congenital narrowing in your carotid artery but deemed it "without significant concern" suggests that this anatomical variation may not be the primary cause of your dizziness. However, it is essential to consider that even mild narrowing can sometimes contribute to symptoms, particularly if there are other risk factors at play, such as heart disease.

Your cardiologist's assertion that your dizziness may be related to heart issues is not unfounded. Conditions such as arrhythmias, heart failure, or even transient ischemic attacks (TIAs) can manifest as dizziness or lightheadedness. Given your history of heart disease, it is prudent to consider that your cardiovascular status could influence your neurological symptoms. For instance, if your heart is not pumping effectively, it could lead to reduced blood flow to the brain, resulting in dizziness.

Regarding your concerns about follow-up care, it is entirely reasonable to seek clarification and reassurance from your healthcare providers. When you visit Dr. Peng, it would be beneficial to express your history and current symptoms clearly. You might say something like, "I have a long history of dizziness, and I want to understand how my heart health might be contributing to these symptoms, especially after my heart attack in 2013." This approach opens the door for a thorough discussion about your symptoms, the results of previous tests, and the rationale behind any recommended follow-up care.

Additionally, if you have been advised to undergo annual neck ultrasounds, it may be worth discussing the necessity and frequency of these tests with your doctor. While some physicians may prioritize regular monitoring, others might suggest that the risk factors and your overall health status dictate the need for such follow-ups. It is essential to have a collaborative relationship with your healthcare provider, where you feel comfortable asking questions and expressing your concerns.

In conclusion, while there may be a connection between your dizziness and heart health, it is crucial to approach this issue holistically. Regular follow-ups, open communication with your healthcare providers, and a comprehensive evaluation of both your cardiovascular and neurological health will help ensure that you receive the appropriate care and management for your symptoms. Remember, your health is a priority, and seeking clarity is a vital part of managing your well-being.

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