The Medical Consumer's Advocate
Dizziness and heart
rate/rhythm problems
Q:
I saw your page on the web.
I am a police officer and am having some weird problems
with dizziness, heart rate, and quality of pulse.
I am almost 43 years old. I am 6 feet 2 inches tall
and weigh 255 pounds. I have recently had blood work done
and all looks good, including a thyroid check. Last week
I did a stress test and passed with no problems. This was
my second stress test in less than a year. My cholesterol
is about 140 and my triglycerides are 78. I occasionally
smoke a cigar (about 1 or 2 a month at the most). I maybe
consume 3 - 4 drinks of alcohol a month. I have had a
slightly elevated blood pressure at times (140/102) but
usually the BP is in the area of 130/90.
I have weird symptoms which seem to occur mainly when
I am overheated, particularly when I have on my
bulletproof vest and police gear which adds about 25
pounds to my frame. I get dizzy as though I am about to
pass out. My heart rate drops from its usual 90-100 per
minute to somewhere between 40 & 50 beats per minute.
My pulse becomes erratic. For example, I may get 5 rapid
beats then 2 or 3 very slow beats. then 3 or 4 rapid,
then a long pause, then a slow beat or two.
I am going tomorrow to my cardiologist to get a heart
monitor to wear for 30 days. Last week, when I went for
my stress test, my lying down blood pressure was 120/80.
When I stood up, the blood pressure was something like
100/84. The nurse said I may have been a little
dehydrated. I do have a difficult time drinking lots of
water.
I have noticed that the situation most often occurs
when a subject I am dealing with starts giving me lip, a
hard time, or resisting arrest. However, it doesn't
always occur and is less likely to occur if I am not
overly hot.
Am I describing any symptoms that sound familiar? I
am really getting scared that I may pass out in an
emergency situation, particularly if my life is being
threatened.
Any help or advice you can offer would be greatly
appreciated.
A: Heart rhythm problems can certainly lead
to feelings of lightheadedness, faintness, or even imbalance. Output from the heart drops a bit, the brain
doesn't get its quota, and the individual experiences the effects of a brain
deprived of oxygen.
A big rush of catecholamines
(adrenaline, in other words) can certainly lead to increased
irritability of the heart, which could conceivably bring on
an arrhythmia (heart rhythm problem) that would not
necessarily show up on a stress test.
Taken together, this could be the
explanation for your problem. Talk this over with your
cardiologist; he undoubtedly sees much more of this than I
do. I would like to comment, though, that your cardiologist
is (in my non-cardiologist's opinion) doing everything right.
The stress test was the right move, as is the longer term
monitor. By the way, if this is what I think it is (as
described above), there are medications to help with this
problem; here again, your cardiologist can advise you much
better than I can. Good luck!