Can Dizziness Indicate Angina in Elderly Patients?

Could dizziness be a sign of angina?

My mother is in her 80s and often experiences dizziness.
She has visited a family medicine clinic and underwent an electrocardiogram (ECG) test, which came back normal.
Does this mean she does not have angina?

Xi Feng, 50~59 year old female. Ask Date: 2023/12/10

Dr. Li Han reply Cardiology

Hello, regarding your question, "Could dizziness be a sign of angina?" Your mother is in her 80s and often experiences dizziness.
She has visited a family medicine clinic and undergone an electrocardiogram (ECG), which returned normal results.
However, your concern is whether she has angina.
Let's first explore the nature of her symptoms.
Is she experiencing dizziness, a heavy feeling in the head, blackouts, instability when standing, or vertigo?
Angina refers specifically to chest pain, but more broadly, it encompasses any clinical manifestations caused by myocardial ischemia (lack of oxygen to the heart muscle).
The most common symptom is chest discomfort, but other symptoms such as shortness of breath, sweating, upper abdominal pain, back pain, jaw pain, and fainting can also occur, especially in women or the elderly, where symptoms may be less typical.

An ECG is commonly used as a diagnostic tool or for risk stratification, but a normal result does not rule out the possibility of coronary artery disease.
Given your mother's age and her dizziness, if the physician considers heart-related issues, they may first want to rule out arrhythmias (such as conduction blocks) or aortic stenosis.
However, dizziness is often more related to otolaryngological or neurological issues.
It may be beneficial to consult with the relevant specialists.

Take care, and best wishes from the Changhua Hospital, Ministry of Health and Welfare.

Reply Date: 2023/12/10

More Info

Dizziness in elderly patients can indeed be a concerning symptom, and while it does not directly indicate angina, it can be associated with various cardiovascular issues, including coronary artery disease (CAD) and angina. In older adults, the presentation of angina may not always be typical; instead of the classic chest pain, they might experience atypical symptoms such as dizziness, fatigue, or shortness of breath. This is particularly relevant in the elderly, as they may have a higher threshold for pain and may not report chest discomfort even when experiencing ischemic events.

In your mother's case, the fact that she has experienced dizziness and has undergone an electrocardiogram (ECG) that returned normal results is a positive sign. A normal ECG can suggest that there are no significant acute ischemic changes at the time of the test. However, it is essential to understand that a normal ECG does not completely rule out the possibility of coronary artery disease or angina. CAD can be present without causing immediate changes to the ECG, especially if the ischemia is not occurring at the time of the test.

Dizziness can arise from various causes, including but not limited to:
1. Orthostatic Hypotension: A drop in blood pressure upon standing can lead to dizziness. This is common in older adults and can occur due to dehydration, medications, or autonomic dysfunction.

2. Vestibular Disorders: Issues related to the inner ear can cause dizziness and balance problems, which may be mistaken for cardiovascular issues.

3. Cardiac Conditions: While less common, arrhythmias or heart failure can lead to dizziness due to inadequate blood flow to the brain.

4. Neurological Issues: Conditions such as transient ischemic attacks (TIAs) or strokes can present with dizziness and should be evaluated promptly.

5. Medication Side Effects: Many medications, especially those used to treat hypertension or heart conditions, can cause dizziness as a side effect.

Given your mother's age and symptoms, it is crucial to have a comprehensive evaluation. If her dizziness persists or worsens, or if she develops new symptoms such as chest pain, palpitations, or shortness of breath, further investigation may be warranted. This could include additional cardiac testing, such as a stress test or echocardiogram, to assess her heart's function and blood flow more thoroughly.

In summary, while a normal ECG is reassuring, it does not entirely exclude the possibility of angina or other cardiac conditions in elderly patients. Continuous monitoring and open communication with her healthcare provider are essential to ensure her symptoms are appropriately managed and any underlying issues are addressed. If dizziness is a recurrent problem, it may be beneficial to explore further diagnostic options to rule out any serious conditions.

Similar Q&A

Are These Symptoms Signs of Angina? Understanding Heart Health Risks

Hello Doctor: Sometimes when I exercise, I suddenly experience palpitations, a tight feeling in my chest, accompanied by shortness of breath, dizziness, blurred vision, tinnitus, nausea, weakness, and numbness (which extends to my arms, shoulders, and jaw). This sensation lasts f...

Dr. He Dongjin reply Cardiology
Hello, it seems that your symptoms are likely due to insufficient physical activity during the weekdays and possibly related to mitral valve prolapse or hyperventilation, rather than angina. The situation for a 15-year-old is different from that of older adults, so there's n...

Understanding Dizziness in the Elderly: Causes and Care Options

My grandmother has heart issues (she has a pacemaker) and is currently on medication for hypertension. Recently, she has been experiencing frequent dizziness, leading to discomfort (despite multiple consultations and changes in medication with no improvement). Several physicians ...

Dr. Liang Yinpan reply Geriatrics
Hello Jenny: The possible causes of your grandmother's dizziness and recommendations are as follows: 1. Issues with battery function or medication dosage may lead to unstable blood pressure or arrhythmias causing dizziness, so it is advisable to consult a cardiologist. 2. Di...

Understanding Dizziness in Elderly Patients: When to Seek Medical Help

Doctor: Hello! My father is 88 years old with a blood pressure of 145/105 and a blood sugar level of 97/210 (he has been taking antihypertensive medication and medication for high blood sugar from Miaoli Provincial Hospital for a long time). However, he has been experiencing freq...

Dr. Ouyang Wenzhen reply Geriatrics
Hello Tian Tian, your father has a history of stroke, as well as hypertension and diabetes, which indeed places him at high risk for recurrent stroke or vascular dementia. Currently, your father is experiencing dizziness, and the first consideration should be "orthostatic hy...

Understanding Dizziness, Shortness of Breath, and Palpitations in Seniors

Hello doctor, I am asking on behalf of my mother. She is 63 years old and has recently been experiencing frequent dizziness, which is often accompanied by shortness of breath and palpitations occurring 2 to 3 times a day, lasting from half an hour to several hours. Currently, she...

Dr. Liu Hongxiang reply Family Medicine
Hello, Xiao Mei: Your mother does not have a history of heart disease, but she has recently been experiencing frequent dizziness, along with shortness of breath and palpitations, occurring 2 to 3 times a day and lasting from half an hour to several hours. She also has unexplained...