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Q. Why do I have chest tightness and heart palpitations followed by dizziness?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 05, 2017 and last reviewed on: Jun 11, 2021

Hi doctor,

I am a 50 year old male. I have been having intermittent episodes of moderate dizziness preceded by pain in the neck or head. It happens almost four times a year and some of these symptoms are also preceded with chest tightness and heart palpitations. On one of such occasion, I thought I would black out, so I went to the local hospital. Unfortunately, they made mistakes which led to the various ECG readings and Holter monitor readings to go missing due to faulty equipment.

I do not have any congenital heart issues, so I am wondering why am I experiencing some strange pinging sensations at times which cause no pain. I also visited a neurologist whom I believe did not take me seriously and a head MRI showed no issues. After a couple of years of this, I went to a clinical laboratory to have an allergy test done, concentrating on metals as I have titanium screw from a tooth implant. The tests showed no allergy reaction to metals, but it did show an antibody response to myelin basic protein, which could indicate an autoimmune problem affecting nerves. The first test showed below 2 (which is the baseline between reactive and non-reactive indication) and the second test sample was also 2, but the third test was 3, which is above the baseline. The report for this MELISA test explained that this could indicate that my immune system was attacking the myelin protein.

I am concerned as I am at an early stage of an autoimmune disease. I am not sure what the next step should be. Also, several years ago I had an MRI on my back L5 area due to an old injury, and they noted a perineural cyst. It seems like my back injury to this area has improved with treatment but other symptoms as mentioned above have replaced them. Can you please provide some clue regarding the meaning of the MELISA test results and what my next step should be? I will shortly have a follow-up MRI done to identify any further degeneration of my spine, including the neck as well.

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Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

  • With available reports, I feel the MELISA test reports and your clinical symptoms have a very poor correlation, and it is possible that they are not related.
  • As all the obtained test results are borderline, MELISA test (memory lymphocyte immunostimulation asay) has a high false-positive value.
  • The myriad of symptoms you are experiencing have little correlation with autoimmune disorders, and that make me conclude that they are not related.
  • However, I will suggest you undergo MRI at the time of your next episode, as that may reveal the true nature of the pathology.
  • Despite the facts mentioned above, I am recommending it because it is possible that when you got tested there was remission in neurological pathology which leads to borderline symptoms.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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