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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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5 minutes of dizziness last night 6:30PM. Very sweaty. Lost

Customer Question

5 minutes of dizziness last night 6:30PM. Very sweaty. Lost color (wife noted especially in lips), some hearing, disoriented… as a 57 year old, 6'1, 216 pound male recent H1AC 6.4; went to ER. 20mg Lovastatin (low HDLs) and baby aspirin daily. Generally very healthy; often walk 5+ miles in a day.
They ruled out all the things that could kill me: clean tests included: enzymes, electrolytes and EKG ("good wave form": static and over a couple of hours in the ER. Insulin reading = 200. 1 liter of saline; no other meds.
"Normal" BP has been 140/80 pulse 65; was 95/65 pulse 72 when hooked up perhaps 20 minutes after incident; had stopped sweating and was feeling normalish and a little silly for going to ER, AND know it's important to go if there is doubt.
Probably not dehydrated; had 20+ oz of water between 5-6:20
Had been feeling a little ill; ate several pieces of fruit from Edible Arrangements as dinner; then felt bad enough to refuse pizza and tasty salad (unusual for me!).
Diagnosed as "Near Syncope." ER Dr. & RN suggested a "Holter Test," and if it happens again, MRI/ultrasound of blood circulation in neck.
Normal stool at 9:30PM yesterday and again 7:30AM & 3PM today. LOTS of belching; not much flatulence.
Have had wheezing and a cough 4 days: VERY unusual for me. Right inside pectoral muscle hurts like a bruise to the touch. Just this morning observed significant pain lower left abdomen during cough; appendix came out in 1981.
Don't smoke; last alcohol was Sunday; often weeks without alcohol.
Similar instances: Feb 2003 on an airplane; flight attendant gave me water & several packets of sugar; was fine
May 2008: went to ER 2AM via ambulance; diagnosed vasovagal event GI tract issue; felt much better after vomiting probably bad taco. Held a second night due to pneumonia
Feb 2013: went to ER 10PM via wife; diagnosed vasovagal event GI tract issue; felt much better after vomiting probably bad Vietnamese buffet.
How do I think about this? Good web links to review?
Submitted: 9 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 9 months ago.

Hello

The answer is simple; you need the holter monitor.

I would say for 48 hours.

Enough has happened that you need to rule out heart rhythm problems.

The ER did not do this.

http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Holter-Monitor_UCM_446437_Article.jsp#.VuIIgX0rJD8