Dizziness, Eye Tremors, and Heart Pain: When to Seek Help

Dizziness, nystagmus, chest pain?

Last October, I woke up one morning and suddenly experienced a spinning sensation, accompanied by nystagmus, numbness and heat in the back of my head, tinnitus, a feeling of tightness in my chest, and difficulty breathing.
I subsequently vomited multiple times before the symptoms began to ease.
An ENT specialist diagnosed me with "benign paroxysmal positional vertigo" (BPPV), caused by displaced otoliths, and recommended rehabilitation for recovery.
By February of this year, I had no more dizziness.
However, on the morning of April 10, I experienced a similar episode upon waking, repeating the aforementioned symptoms four times, and I was unable to move my head at all.
After vomiting four times within three hours, I was finally able to seek medical attention.

P.S.
In the days leading up to both episodes, I had experienced near-asphyxiation due to exercise, requiring me to squat down and take deep breaths for about 10 minutes before returning to normal.

Current symptoms:
1.
Occasional chest pain and difficulty breathing.

2.
I need to be extra cautious when getting in and out of bed to reduce the risk of sudden dizziness.

3.
The dizziness is no longer as severe as before.

4.
Persistent tinnitus and a numb sensation in the back of my head.
Q: Which department should I consult, or what specific tests should I undergo?

Roger, 30~39 year old female. Ask Date: 2006/05/03

Dr. He Dongjin reply Cardiology

Dear Ken, you may consult an otolaryngologist or a neurologist.
If you experience chest tightness and pain, it can be observed further, as it may be caused by severe vomiting leading to acid reflux.
If the symptoms persist, please visit a cardiologist for further evaluation.
Thank you for your correspondence, and we at Changhua Hospital care about your well-being.

Reply Date: 2006/05/03

More Info

Based on your description of symptoms, it is crucial to approach this situation with a comprehensive understanding of the potential underlying causes. Your experience of dizziness, eye tremors, heart pain, and other associated symptoms can be indicative of several medical conditions, and it is essential to seek appropriate medical attention.

Given the complexity of your symptoms, I recommend that you first consult with a primary care physician or a general practitioner. They can conduct an initial assessment and may refer you to specialists based on their findings. Here are some potential specialists you might consider:
1. Neurologist: Since you are experiencing dizziness, eye tremors, and a sensation of numbness in the back of your head, a neurologist can evaluate for any neurological conditions that might be causing these symptoms. They may conduct imaging studies, such as an MRI or CT scan, to rule out any structural issues in the brain.

2. Otolaryngologist (ENT): Given your history of dizziness and ear-related symptoms, an ENT specialist can assess for vestibular disorders, which can cause balance issues and dizziness. They may perform tests to evaluate your inner ear function.

3. Cardiologist: Since you have reported heart pain and breathing difficulties, it is advisable to see a cardiologist. They can conduct tests such as an electrocardiogram (ECG), echocardiogram, or stress tests to evaluate your heart's health and rule out any cardiovascular issues.

4. Physical Therapist: If your dizziness is indeed related to vestibular issues, a physical therapist specializing in vestibular rehabilitation can provide exercises to help improve your balance and reduce dizziness.

In terms of diagnostic tests, the following may be beneficial:
- Blood Tests: To check for any metabolic or electrolyte imbalances that could contribute to your symptoms.

- Imaging Studies: As mentioned, MRI or CT scans can help visualize any structural abnormalities in the brain.

- Balance Tests: These may include tests like the Dix-Hallpike maneuver or posturography to assess your balance and vestibular function.

It is important to communicate all your symptoms clearly to your healthcare provider, including the timing, duration, and triggers of your episodes. This information will help them make a more accurate diagnosis.

In the meantime, consider keeping a symptom diary to track when your symptoms occur, their severity, and any potential triggers. This can provide valuable information to your healthcare provider and assist in developing an effective treatment plan.

Lastly, if you experience any worsening of symptoms, such as severe chest pain, shortness of breath, or neurological deficits (like weakness or difficulty speaking), seek emergency medical attention immediately. Your health and safety are paramount, and timely intervention can be critical in managing any serious conditions.

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