[23M] Experiencing dizziness, chest spasms, and tachycardia

Patient Description

A 23-year-old male reports a 3-month history of dizziness characterized by a pulsating vision field and dizziness at rest, rated as a 5/10 in severity, with no specific time of occurrence or relieving factors. He also experiences chest spasms and discomfort rated 7/10 in severity, fatigue, episodes of bradycardia followed by sudden tachycardia, and pallor. Additionally, the patient notes episodes of fainting or near-fainting, difficulty breathing, shortness of breath, and chest pain radiating to the arm, neck, jaw, or back. He also reports a weird taste in his mouth. There is no family history of heart disease, no recent use of recreational drugs, alcohol, or tobacco, no known allergies or adverse reactions to medications, and he is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Cardiac Arrhythmia: This is a group of conditions characterized by abnormal heart rhythms. They can cause symptoms like palpitations, dizziness, fainting, and chest pain. Your description of your heart rate starting as bradycardia (slow) and suddenly becoming tachycardia (fast) is suggestive of an arrhythmia.

    • Diagnostic tests for arrhythmias typically include an electrocardiogram (ECG), Holter monitoring, and an event recorder. Treatment depends on the type of arrhythmia but may include medication, lifestyle changes, or procedures to correct the rhythm.
  • Panic Disorder: This is a type of anxiety disorder characterized by recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The disorder often occurs with other mental health conditions.

    • Treatment typically involves psychotherapy, medication, or both.
  • Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and you may even faint. The fact that your dizziness worsens with changes in position could suggest this condition.

    • Treatment typically involves lifestyle changes, such as drinking plenty of fluids and avoiding alcohol.

What you can do

Given the severity and duration of your symptoms, it's important that you seek medical attention as soon as possible. In the meantime, here are some steps you can take:

  1. Try to identify any triggers for your symptoms and avoid them if possible.
  2. Stay hydrated and maintain a balanced diet.
  3. Try to get regular exercise, but avoid strenuous activity that could exacerbate your symptoms.
  4. If you feel dizzy, sit or lie down immediately to prevent falls and injuries.

What you should look out for

You should seek immediate medical attention if you experience any of the following:

  • Severe chest pain or chest pain that's worsening
  • Difficulty breathing or shortness of breath that's worsening
  • Fainting or near-fainting episodes
  • Severe dizziness or lightheadedness

Please remember that while I strive to provide accurate information, I am not a doctor and this advice should not replace a consultation with a healthcare professional.

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10 mo ago

People Also Ask


What are the common symptoms of cardiac arrhythmia?

Common symptoms of cardiac arrhythmia include palpitations, dizziness, fainting, chest pain, and shortness of breath. These symptoms occur due to abnormal heart rhythms that can be too fast, too slow, or irregular.


How can panic disorder affect physical health?

Panic disorder can lead to physical symptoms such as palpitations, sweating, shaking, shortness of breath, and chest pain. These symptoms are part of panic attacks, which are sudden periods of intense fear and discomfort.


What is orthostatic hypotension and how is it managed?

Orthostatic hypotension is a condition where blood pressure drops significantly when standing up from sitting or lying down, causing dizziness or lightheadedness. Management includes lifestyle changes like staying hydrated, avoiding alcohol, and sometimes medication.


When should someone seek immediate medical attention for chest pain?

Immediate medical attention should be sought for chest pain if it is severe, worsening, or accompanied by symptoms like difficulty breathing, fainting, or severe dizziness, as these could indicate a serious condition such as a heart attack.


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