Resolved question:
Hello, I've been to my Primary Care Doctor, Cardiologist, and ENT (otolaryngologist).
I want a doctor to read over what's happened and see if they have any other thoughts about what might be going on.
About 6 weeks ago I started having slight chest pain. I had experienced this kind of thing before, and been checked out by a cardiologist. A few days after the chest pain started I had an episode of heart racing (maybe 110 pulse) and high levels of chest pain (this happened while resting). I went to the emergency room. My EKG was a little abnormal, but not too concerning. (Please see the lab results from January 3rd from the attached documents.) About 8 hours later I was sent home. No diagnosis no explanation. My cardiologist suggested that I take omeprazole 20mg for a few weeks and see if that would help. I'm pretty certain that the pain I experienced was not related to reflux problems. My primary care doctor had me into her office, and ran some lab tests (see the results from January 5th). My thyroid numbers were a little high and the doctor asked me to have them rechecked in 6 weeks (Thydorid numbers are normal now). In any case, over the next week my chest pain started to go away.
Around February 6th I started having balance, vertigo, and headache issues. I went to my primary care doctor who gave me shots of decadron and rocephin and a Z-Pack (5 day dose pack of azithromycin). My headaches went away, but the vertigo/balance issues did not. I started to generally feel a little bit off -- joint soreness, malaise, like I was recovering from an illness. About February 16th I called my primary care doctor who sent me to an ENT. The ENT said I had perfect hearing, but that in my left ear I had Benign Paroxysmal Positional Vertigo and that they would do a maneuver to correct that.
Today Feburary 20th, I woke up and took a shower, and then after the shower felt like I was having a hot-flash, intense bodily heat with a cold sweat. I felt like I was going to faint. I sat down and immediately had incredibly strong nausea I vomited a small amount. I went to the doctor's office and talked with her about these symptoms and that I had joint soreness, malaise, and felt like I was recovering from an illness. The doctor suggested that currently there are a lot of stomach bugs and viral infections going on that could cause these type of symptoms. The doctor gave me a Flu test (Flu test was negative, please see lab results from Febuary 20th). I have a prescription from the doctor for Tamiflu and Zofran (Ondansetron).
Submitted:
4 Days
Category:
ENT Specialist
Hello,
Thank you for your query at DoctorSpring.com
You are suffering from chest pain for 6 weeks (which improved 2 weeks back) and your all blood investigation were normal including Hb, counts, sugar, creatinine,
thyroid test. Only cholesterol is marginally raised.
Now issue is that you are suffering from vertigo for 2 weeks.you were told that it
is BPPV left sided, you also have body pain and nausea and vomiting, your hearing is
normal.
With all this information. it seems that your chest pain was a different problem
and this vertigo is not related to that, at your examination and ECG were normal
and you do not have any more chest pain
Now this vertigo may be BPPV and it is most common cause of vertigo, still I want
to know some more information.
-nature of giddiness- spinning or rotatory / unsteadiness
-is it episodic or persistent
-duration of each episode
-aggravating factor - change in position, looking upwards/turning head / bending
forward or lying in bed.
associated symptoms you have including nausea and vomiting with body ache and
malaise.
So two important differential will be BPPV or vestibular neuronitis or
vestibula pathy.
All can be treated very easily so need not to worry. with a detailed history and
examination we can diagnose and treat it.
Please fee free to discuss,
Hope this helps
Regards
Thank you for your detailed response!
I am occasionally still having heart pain. I will not have any pain for a few days, and then I will have pain several times throughout the day. The pain is not severe.
Please see my answers below:
Hello,
With all this information most probable diagnosis is BPPV only. So you need to visit local Ent specialist , he can repeat positional test and if positive he can do epley's maneuver. Following that you can start tab. Betahistine 16 mg three times daily for five days. If positional test negative then you can do ENG ( electronystagmogram). It will give more detailed information.
Hope this helps
Best regards,
Dr. Sunil Jalan
MBBS, DLO,MS(CMC,VELLORE)DNB(ENT),DAA,MBA(HM)