Dizziness, Nausea, and Chest Discomfort: A Family Medicine Perspective

Q: Dizziness, Nausea, and Chest Discomfort: A Family Medicine Perspective

Hello： 1. <br>Your chest discomfort accompanied by dizziness and vomiting may indicate the possibility of an acute arrhythmia; additionally, it is important to consider whether there is a condition of anemia. <br>2. <br>Your abdominal discomfort may be related to your menstrual c

Dizziness, blurred vision, nausea?

Today, while I was taking the MRT, I suddenly felt unwell.
It started with a cool sensation in my left chest, followed by dizziness, and my vision gradually blurred to the point where I could barely see.
However, my breathing was relatively smooth, and I remained conscious.
I knew I needed to quickly exit the train and was aware of which station I got off at.
I vomited a little into my mask while on the MRT, and after getting off, I started vomiting again.
After vomiting, I felt much better, and my vision gradually returned to normal.
The staff at the station noticed my vomiting and pale complexion, so they allowed me to rest at their consultation station.
During this time, I only felt a dull pain in my lower abdomen.
Later, when my family picked me up to rest, I measured my blood pressure; it was slightly low but not far from normal.
My heart rate was a bit fast, around 90 beats per minute.
I felt weak and very tired, so I slept for most of the morning.
The abdominal pain persisted but eased after using the restroom.
I would like to know why I experienced these symptoms.
I had a similar episode at the end of December last year, but it was milder, with only dizziness and vomiting, and it resolved after resting.
I do not experience motion sickness, and I have not felt unwell during my daily MRT commutes to school.
I am currently nearing the end of my menstrual period, and I recall having a similar experience around this time last month.
Could this be related?

Miss Zhan, 10~19 year old female. Ask Date: 2023/02/15

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
Your chest discomfort accompanied by dizziness and vomiting may indicate the possibility of an acute arrhythmia; additionally, it is important to consider whether there is a condition of anemia.
2.
Your abdominal discomfort may be related to your menstrual cycle; however, if it improves after a bowel movement, there is no need to worry too much.
In summary, it is recommended that you seek medical evaluation from a cardiologist or a family medicine physician.

Reply Date: 2023/02/15

More Info

Experiencing dizziness, nausea, and chest discomfort can be alarming, especially when it occurs suddenly in a public setting like the subway. Based on your description, it seems that you encountered a combination of symptoms that could be attributed to several potential causes. Let's break down your experience and explore possible explanations from a family medicine perspective.

Firstly, the sensation of left chest discomfort, particularly if it felt "cool" or "tingly," could be related to a variety of factors. While cardiac issues are often a primary concern when chest discomfort is involved, your ability to breathe normally and maintain awareness suggests that it may not be an acute cardiac event. However, it is essential to consider that any chest discomfort should be evaluated by a healthcare professional to rule out serious conditions, especially if it recurs.

Dizziness and nausea, particularly when accompanied by vomiting, can be indicative of several conditions. One possibility is that you experienced a vasovagal response, which is a common cause of fainting or near-fainting episodes. This can occur due to stress, pain, or even standing for prolonged periods, leading to a sudden drop in heart rate and blood pressure. The fact that you felt better after vomiting supports this theory, as it may have relieved some of the pressure or discomfort you were experiencing.

Another consideration is the potential influence of hormonal changes related to your menstrual cycle. Many women experience symptoms such as dizziness, nausea, and abdominal pain during their menstrual periods due to hormonal fluctuations. If your symptoms coincided with the end of your cycle, it is possible that they were exacerbated by these hormonal changes. Conditions like dysmenorrhea (painful periods) or premenstrual syndrome (PMS) can also contribute to these symptoms.

Additionally, gastrointestinal issues could be at play. The abdominal pain you described, which improved after using the restroom, may suggest a gastrointestinal disturbance such as bloating, constipation, or even gastritis. Stress and anxiety can also lead to gastrointestinal symptoms, which might explain the nausea and vomiting.

Given your experience, here are some recommendations for managing and understanding your symptoms:
1. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any associated factors (like your menstrual cycle, stress levels, or dietary changes). This can help identify patterns and triggers.

2. Stay Hydrated: Ensure you are drinking enough fluids, especially if you experience vomiting. Dehydration can exacerbate dizziness and fatigue.

3. Consult a Healthcare Provider: Since you experienced a significant episode, it would be wise to consult a family medicine physician or a healthcare provider. They may recommend tests such as an electrocardiogram (ECG), blood tests, or imaging studies to rule out any underlying conditions.

4. Consider Lifestyle Factors: Evaluate your diet, sleep patterns, and stress levels. Sometimes, lifestyle modifications can significantly improve symptoms.

5. Rest and Recovery: After such an episode, allow yourself time to rest and recover. Fatigue can linger after significant physical stress, such as vomiting or dizziness.

In conclusion, while your symptoms may have been benign and related to hormonal changes or a vasovagal response, it is crucial to take them seriously, especially if they recur. A thorough evaluation by a healthcare professional can provide peace of mind and help ensure that any underlying issues are addressed appropriately.

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