Dizziness and Palpitations: A Comprehensive Guide

Dizziness and palpitations?

Hello, Doctor ^^ In October, I suddenly felt my heart racing inexplicably, and I felt very uncomfortable all over, even experiencing dizziness.
I wasn't sure if it was psychological, but I also felt scared.
At first, I sought help at a general internal medicine clinic, but my condition didn't improve.
I underwent a CT scan, which showed no issues with my brain, and then I was referred to a larger hospital's internal medicine department.
They suggested that my symptoms were due to sleep issues, but I still didn't feel better.
I continued to experience dizziness and palpitations, and at night, I would have tinnitus in my left ear.

Later, I visited an ENT clinic where I was prescribed medication for a few days.
During my second follow-up visit, the doctor recommended that my mother refer me to the neurology department at Cheng Kung University Hospital.
They conducted several tests (such as walking heel-to-toe and standing on one leg while jumping), and the neurologist said everything was fine.

I wanted to consult a cardiologist because I feel that my dizziness might be related to my heart rate.
For instance, when I took the medication prescribed by the ENT doctor, my heart rate increased, and I felt even more dizzy! I asked the ENT doctor about this, and he said that the medication he prescribed wouldn't cause palpitations.
I remember he prescribed DIPHENIDOL for me, and I also consulted a traditional Chinese medicine practitioner.
He suggested that my dizziness was due to weak heart function, which prevents adequate blood flow to the head.

My dizziness isn't from visual stimuli; it feels like I'm spinning on my own, and I constantly feel like my body is tilting backward.
This sensation persists even now.
Doctor, what should I do? Could you please help me? Thank you!

Lu Dan, 10~19 year old female. Ask Date: 2011/12/10

Dr. He Dongjin reply Cardiology

Hello, you may be experiencing low blood pressure or autonomic nervous system dysfunction, which can lead to issues such as arrhythmia and tachycardia.
Have you been feeling more anxious lately or experiencing some sleep disturbances? Since you are located in the southern part of Taiwan, I recommend visiting a cardiologist nearby for evaluation.
It might be beneficial to consider medications for autonomic nervous system dysfunction to help alleviate your symptoms.
Changhua Hospital cares about your well-being.

Reply Date: 2011/12/10

More Info

Dizziness and palpitations can be distressing symptoms that significantly impact your quality of life. Understanding the underlying causes and appropriate management strategies is crucial for alleviating these symptoms. Based on your description, it seems you've undergone a thorough evaluation, including imaging studies and various specialist consultations. However, let's delve deeper into the potential causes and management options for your symptoms.

Understanding Dizziness and Palpitations
1. Dizziness: This term encompasses various sensations, including lightheadedness, unsteadiness, and a feeling of faintness. Dizziness can arise from several factors, including vestibular disorders (inner ear issues), neurological conditions, cardiovascular problems, and even psychological factors such as anxiety.

2. Palpitations: This refers to the sensation of feeling your heart beating, which may feel like a fluttering, pounding, or racing heart. Palpitations can be benign or indicative of an underlying heart condition. Common causes include anxiety, caffeine intake, certain medications, and arrhythmias.

Potential Causes of Your Symptoms
Given your history and the evaluations you've undergone, here are some potential causes for your symptoms:
- Anxiety and Stress: Psychological factors can significantly contribute to both dizziness and palpitations. Anxiety can lead to hyperventilation, which may cause dizziness and a racing heart. It’s essential to consider whether stressors in your life may be exacerbating your symptoms.

- Vestibular Disorders: Conditions affecting the inner ear, such as vestibular neuritis or Meniere's disease, can lead to dizziness and balance issues. If you experience episodes of vertigo (a spinning sensation), this could be a contributing factor.

- Cardiovascular Issues: While your imaging studies may not have shown significant issues, it's still important to evaluate for conditions like arrhythmias or other heart-related problems. An electrocardiogram (ECG) or Holter monitor may be useful in capturing any irregular heart rhythms.

- Medication Side Effects: You mentioned taking Diphenidol, which is an antihistamine that can cause drowsiness and dizziness in some individuals. If you feel that your symptoms worsen with this medication, it may be worth discussing alternative treatments with your healthcare provider.

- Cervical Spine Issues: Sometimes, neck problems can lead to dizziness due to nerve compression or reduced blood flow to the brain. If you have any neck pain or stiffness, this could be a contributing factor.

Management Strategies
1. Lifestyle Modifications: Reducing caffeine and alcohol intake, staying hydrated, and maintaining a balanced diet can help manage symptoms. Regular physical activity can also improve cardiovascular health and reduce anxiety.

2. Cognitive Behavioral Therapy (CBT): If anxiety is a significant factor, CBT can be beneficial in addressing the psychological aspects of your symptoms. This therapy helps you develop coping strategies and reduce anxiety-related symptoms.

3. Vestibular Rehabilitation: If your dizziness is related to vestibular dysfunction, a physical therapist specializing in vestibular rehabilitation can provide exercises to improve balance and reduce dizziness.

4. Medication Review: Consult with your healthcare provider about your current medications. If you suspect that a particular medication is exacerbating your symptoms, they may consider adjusting your treatment plan.

5. Follow-Up with Specialists: Since you have already seen various specialists, it might be helpful to have a coordinated follow-up with a primary care physician who can help manage your overall health and refer you to specialists as needed.

Conclusion
In summary, dizziness and palpitations can stem from a variety of causes, including anxiety, vestibular disorders, and cardiovascular issues. A comprehensive approach that includes lifestyle modifications, psychological support, and careful medication management is essential. If your symptoms persist or worsen, further evaluation by a cardiologist or neurologist may be warranted. Always keep an open line of communication with your healthcare providers to ensure that you receive the best possible care tailored to your specific needs.

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