I am 31, male. What could cause palpitations and dizziness?

Question

Hello doctor,

I am a 31-year-old male. I have been suffering from heart palpitations, dizziness, gasping for air upon falling asleep, and horrible fatigue. I recently started having a poor appetite, and I get a hot feeling in my face.

Also, I get these times when I have poor memory and feel spaced out. I have had many tests done, but all have come back fine. This has been destroying my life for six years, but the symptoms have fluctuated in intensity over the years.

I have done CBC, magnesium, ANA reflex, Vitamin D, and many more tests.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I have gone through all the investigations. All reports are looking normal (attachment removed to protect patient identity). Do you take alcohol or caffeinated drinks regularly? Do you suffer from anemia?

Possible causes of your symptoms may be anxiety neurosis, obstructive sleep apnea, gastroesophageal reflux with asthma, bronchial asthma, thiamine deficiency, and major depression. Do not worry. It may also be a normal condition.

Avoid alcohol consumption, spicy foods, especially at night, caffeinated and carbonated drinks. Do regular exercise and yoga. And take tablet Pantoprazole 40 mg before breakfast for two weeks. Do not sleep immediately after dinner. Keep the head end of the bed elevated.

I suggest you undergo a few investigations, such as spirometry, polysomnography, 24-hour esophageal pH monitoring, complete blood picture, serum electrolytes, serum calcium, and a psychiatric consultation.

Take tablet Alprazolam 0.25 mg once after dinner for five days, Thiamine 100 mg once a day for one month. Consult your specialist doctor, discuss with them, and take the medicines with their consent. Review after one week with the above investigations.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Through messages, I can only think of possible causes. But I need a detailed history and examination to conclude.

Anxiety neurosis can explain dizziness and palpitations. During the episode, you may experience palpitations, nausea, and chest tightness. Different people may present differently.

One more cause can be paroxysmal tachycardia, which needs 24-hour Holter monitoring. During that particular period, you may develop arrhythmia, which may cause palpitations and dizziness. This is not detectable at the time of echo and ECG (electrocardiography).

It is possible that some acid may enter the trachea during an episode of acid reflux and may trigger the above symptoms. In which you may develop sudden tightness in the chest, breathing difficulty, and dizziness.

Also, vestibular causes like BPPV (benign paroxysmal positional vertigo) and vestibular neuronitis may present with dizziness and vomiting on head movements. But it may not cause palpitations.

Cervical spine problems may also present, such as dizziness and neck pain. But no palpitations. Get the x-ray of the cervical spine, 24-hour Holter monitoring, and then we will conclude. If you feel dizzy with head movements, please take the tablet Vertin (Betahistine) 16 mg thrice a day for five days.

I hope this helps you.

Thank you.