[35F] Experiencing dizziness, lightheadedness, and chest heaviness

Patient Description

A 35-year-old female reports severe dizziness and lightheadedness that occurs when standing up and stretching, rating the severity at 6 out of 10, with symptoms lasting typically for 2 minutes but sometimes extending up to 4 hours. The dizziness is described as feeling lightheaded and weak, with tunnel vision and blurriness. The patient also experiences significant shortness of breath, described as a pressure on the chest with a sensation of tightness, rating the severity at 8 out of 10, and has been ongoing for about 8 months. Additionally, the patient mentions a heaviness on the chest, rated 7 to 8 out of 10, and palpitations. There is a history of fainting and needing to support oneself against walls or furniture. No leg or ankle swelling is reported. The patient has a medical history of type 2 diabetes, tachycardia, OCD, PTSD, GAD, agoraphobia with panic disorder, insomnia, and migraines, and is also overweight. The patient wears glasses and has hay fever but no known drug allergies. There is a mention of possible lupus but no concern expressed about it. The patient has used recreational drugs, alcohol, or tobacco products recently. Exact medication details are unavailable, but the patient is under medication for several pre-existing conditions.

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Arora's Assessment

What might be happening

Based on the information you've provided, you may be experiencing:

  • 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, lightheaded, and weak. The fact that you experience these symptoms upon standing and stretching suggests this possibility.

    • Treatment typically involves lifestyle changes such as standing up slowly and ensuring adequate hydration. In some cases, medication may be prescribed.
  • Anxiety Disorders: Given your history of Generalized Anxiety Disorder (GAD), Panic Disorder, and agoraphobia, it's possible that some of your symptoms like chest tightness and shortness of breath are related to anxiety.

    • Treatment typically involves a combination of psychotherapy (talk therapy) and medication.
  • Cardiovascular Conditions: Your symptoms of chest heaviness, shortness of breath, and palpitations could potentially indicate a heart condition. Given your history of tachycardia and high blood pressure, this is a possibility that should be evaluated.

    • Treatment depends on the specific condition but may involve lifestyle changes, medication, and in some cases, surgery.

Please note that these are possibilities based on the information you've provided, and only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. For potential Orthostatic Hypotension, try standing up slowly from a seated or lying position. Ensure you are well-hydrated and consider increasing your salt intake (if not contraindicated by other health conditions).
  2. Continue taking your prescribed medications and follow up with your healthcare provider to discuss your symptoms.
  3. Consider seeking help from a mental health professional if your anxiety symptoms are worsening or not well-controlled.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or pressure
  • Difficulty breathing or shortness of breath
  • Fainting or loss of consciousness
  • Rapid or irregular heartbeat

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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11 mo ago

Top picked over-the-counter products for Orthostatic Hypotension: American Heart Association Guidelines

People Also Ask


What is orthostatic hypotension and how can it be managed?

Orthostatic hypotension is a condition where blood pressure drops significantly when standing up from a sitting or lying position, causing dizziness and lightheadedness. Management includes standing up slowly, staying hydrated, and possibly increasing salt intake, unless contraindicated.


How can anxiety disorders contribute to physical symptoms like chest tightness and shortness of breath?

Anxiety disorders can cause physical symptoms such as chest tightness and shortness of breath due to the body's stress response, which can include increased heart rate and muscle tension. Treatment often involves therapy and medication to manage anxiety.


What are the potential cardiovascular conditions that could cause symptoms like chest heaviness and palpitations?

Potential cardiovascular conditions that could cause symptoms like chest heaviness and palpitations include tachycardia, high blood pressure, or other heart-related issues. These conditions require evaluation by a healthcare professional for appropriate diagnosis and treatment.


What lifestyle changes can help manage symptoms of dizziness and lightheadedness?

Lifestyle changes to manage dizziness and lightheadedness include standing up slowly, ensuring adequate hydration, and possibly adjusting salt intake. It's also important to follow any medical advice specific to your health conditions.


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