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What Causes Shortness Of Breath, Dizziness And Weakness In Legs?
Question: 60 y/o female contracted flu 5 weeks ago with symptoms subsiding 2 weeks ago and returned to work. On 4/4, fainted at work and rushed to ER....diagnosed with syncope unknown origin and pneumonia - blood work unremarkable; . EKG returned an undescribed anomaly which ER doc thought was not likely to be serious and recommended later cardiologist follow-up. Returned to work 4/8. Today, while grocery shopping, had shortness of breath, dizziness, lightheadedness, leg weakness in both legs felt like legs would collapse....walked into nearby ER.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to syncope (fainting):
- a cardiac arrhythmia
- orthostatic hypotension
- an epilepsy
- vertebro-basilar insufficiency
Other metabolic causes (like electrolyte imbalance, anemia, low blood sugar, etc.) have been excluded by your blood lab tests, which you refer to have been unremarkable.
Could you please upload your resting ECG for me to review and give another professional opinion?
I would recommend consulting with your attending physician and performing further tests to investigate for the possible cause of these episodes:
- A cardiac ultrasound to examine your cardiac function and structure
- An ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia
- A Doppler ultrasound of the cervical vessels to examine the blood flow to the brain
- A head Up tilt test to exclude possible orthostatic hypotension. I would also recommend measuring your blood pressure in sitting and then standing position. A decrease more than 20mm Hg in your blood pressure when standing up compared to sitting position would be indicative of orthostatic intolerance. You can do these measurement at home. It is not difficult.
If all the above tests result normal, you should consult with a neurologist and perform a brain EEG. Your symptoms are not typical of Epilepsy seizures, but if all the above tests result normal, this possibility should be ruled in/out too.
You should discuss with your doctor on the above issues.
Hope you will find this answer helpful!
Best wishes,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I carefully passed through your question and would explain that it is important performing a comprehensive differential diagnosis of different causes that may lead to syncope (fainting):
- a cardiac arrhythmia
- orthostatic hypotension
- an epilepsy
- vertebro-basilar insufficiency
Other metabolic causes (like electrolyte imbalance, anemia, low blood sugar, etc.) have been excluded by your blood lab tests, which you refer to have been unremarkable.
Could you please upload your resting ECG for me to review and give another professional opinion?
I would recommend consulting with your attending physician and performing further tests to investigate for the possible cause of these episodes:
- A cardiac ultrasound to examine your cardiac function and structure
- An ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during the day and exclude possible cardiac arrhythmia
- A Doppler ultrasound of the cervical vessels to examine the blood flow to the brain
- A head Up tilt test to exclude possible orthostatic hypotension. I would also recommend measuring your blood pressure in sitting and then standing position. A decrease more than 20mm Hg in your blood pressure when standing up compared to sitting position would be indicative of orthostatic intolerance. You can do these measurement at home. It is not difficult.
If all the above tests result normal, you should consult with a neurologist and perform a brain EEG. Your symptoms are not typical of Epilepsy seizures, but if all the above tests result normal, this possibility should be ruled in/out too.
You should discuss with your doctor on the above issues.
Hope you will find this answer helpful!
Best wishes,
Dr. Iliri
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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