Q & A: Ask the doctor

Hello Doctor,I have been having bouts of dizziness and feeling breathless recently. My heart beats fast even when I have not done anything strenuous. I have difficulties in breathing but when I went for a checkup, the doctors said I was in good health. I am, worried that I could get heart complications. What could be the problem Colombe 24 -----------------------------------------------Dear Colombe,You are too young to have serious heart related problems like a coronary artery disease, hypertension e.t.c hence the doctors conclusion. Such cases do occur exceptionally but probability rises in middle years onwards. Lesions of the heart valves is the only heart related condition likely in a young person. You have not specified whether your symptoms are related to standing up from supine/sitting position or some exertion, e.t.c. How many times do you get these problems in a week/ month and how long do they persist? Do you get relief spontaneously or do you need some medicines or rest?With your age, symptoms like palpitations and breathlessness occur commonly due to anxiety or anemia (i.e. deficiency of necessary amount of iron in the body). Among organic causes, some prolonged fever or lung pathology can also cause these symptoms. Palpitations are the uncomfortable awareness of the heart beating - what you are experiencing. Normally one gets palpitations during stress like before an interview or presentation or after any exertion like running. The heart rate also increases during these stressful events contributing to the palpitations. Anxiety also leads to palpitations. Breathlessness is also linked to palpitations due to the adrenergic response of the body.What do you feel during the bout of dizziness? Does your head feel like it is spinning around (vertigo) or you feel like darkness coming before eyes and falling down (syncope)? Vertigo in a young person commonly occurs due to problems in the inner ear, when it is associated with altered hearing and or tinnitus (noises in the ear). If the heart beats very fast, the filling of the heart with blood being propelled in the body is impaired; this can lead to dizziness and breathlessness.Syncope in a young adult is commonly the result of low blood pressure due to standing for a long time. Severe anemia can also cause it. Have you done a hemoglobin estimation and electrocardiogram? If they are normal, it is unlikely to be a heart problem.You need to learn to relax both physically as well as mentally. Do some creative work in your leisure time. This shall prevent palpitations and also associate breathlessness and dizziness. Take a nutritious and balanced diet. If you have to stand for a long time, move the toes while standing. This helps in preventing low blood pressure and dizziness. Keeping the ears dry and protected from droughts of cold air protects the ear from damage and dizziness.Do not be anxious about heart problems because persistent anxiety will aggravate all the problems you have. Dr. Rachna PandeSpecialist –internal medicine Ruhengeri Hospital