Dizziness and chest pain associated with HCM

Posted by archer @archer, Jun 24, 2020

---Has anyone experienced dizziness as a frequent and troubling symptom?

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@bbonchek

I was on a very high dose of Verapimil 240mg is the am and 180 mg in the pm. That seemed to be the main one. I played around with Metropolol for a bit but it seriously disagreed with me. Everyone is different so it is important to do what your doc says. My doc said it was important to not let your blood pressure get too low when it is stressed out with HOCM. It's is truly a juggling match to figure it out. My dizziness never really went away for the 3 months before the surgery.

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You mentioned that Metoprolol disagreed with you. Could you explain more about that. I am on Metoprolol also taking 125 mg twice a day now. Would appreciate more information. Thanks.

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Metoprolol made me very dizzy especially when I got up after sitting or laying down. I could not tolerate it well and took much less than you. I have talked to others who have had the same reactions. When I would wake up in the am, I would have to slowly become upright and start to move around. But, it is probably an important medication for keeping your heart healthy for now. Talk to your doc about it. After my surgery, I was able to stop taking it.

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@bbonchek

Please, you are not troubling me at all. It is nice to share with others who are going through the same thing. We are kindred spirits and you are not alone. I did have similar symptoms. With me, my head hurt and I had lots of headaches. I think not having a clear oxygenated blood flow to the brain must contribute to this. i had a problem with my local cardiologist not taking me seriously the year previous to my surgery. I am from a small town where larger numbers of complicated cases are not seen. It was not until I went to Mayo then to Cleveland Clinic on my own volition that they realized how serious it really was.

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B, ---You cannot know how helpful your responses have been. Finally, thanks to you, we will be more informed and will have meaningful questions to ask during next appointment. In my case, the head phenomenon is more of a pressure or fullness, specifically around the eyes. This had been with me for many years and always accompanied dizziness, but it was never constant. We thought it was an allergy/sinus complication. Even my physician thought so -- probably because my Ejection Fraction was within normal range.
---By the way, two quick questions: Do you know what your Ejection Fraction was during that highly symptomatic phase? Also, was the progression from HCM to HOCM discovered via an Echocardiogram? This second question is because you noted that the change took place rather quickly, within 2-3 months. My last Echo was about a year ago (July), indicating an Ejection Fraction of 55%. Am wondering if another one is in order -- chiefly, would it explain the persistent symptoms. Meanwhile, the dizziness/unsteadiness has become constant, while the chest discomfort is infrequent -- but sometimes involves the left arm. Obviously, pretty worried. Again, your informed responses have given much relief and some hope.
---Thanks, archer.

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@angiev18

You mentioned that Metoprolol disagreed with you. Could you explain more about that. I am on Metoprolol also taking 125 mg twice a day now. Would appreciate more information. Thanks.

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---Hello. You mention taking Metoprolol 125 mg twice daily. That is double my current dosage. Has it helped you with any symptoms -- specifically dizziness or unsteadiness?
---Thanks, archer.

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@archer

B, ---You cannot know how helpful your responses have been. Finally, thanks to you, we will be more informed and will have meaningful questions to ask during next appointment. In my case, the head phenomenon is more of a pressure or fullness, specifically around the eyes. This had been with me for many years and always accompanied dizziness, but it was never constant. We thought it was an allergy/sinus complication. Even my physician thought so -- probably because my Ejection Fraction was within normal range.
---By the way, two quick questions: Do you know what your Ejection Fraction was during that highly symptomatic phase? Also, was the progression from HCM to HOCM discovered via an Echocardiogram? This second question is because you noted that the change took place rather quickly, within 2-3 months. My last Echo was about a year ago (July), indicating an Ejection Fraction of 55%. Am wondering if another one is in order -- chiefly, would it explain the persistent symptoms. Meanwhile, the dizziness/unsteadiness has become constant, while the chest discomfort is infrequent -- but sometimes involves the left arm. Obviously, pretty worried. Again, your informed responses have given much relief and some hope.
---Thanks, archer.

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I have CHF, nearly a lifelong diagnosis. My ejection fraction ranges from 40-65, depending on some environmental factors such as diet, other diseases, etc. The CHF with preserved ejection fraction is, among other things, known as highly probably marker of Gelsolin, RyR2, and Fukutin Limb Girdle Muscular Dystrophy. (They come together, most of the time) Helsinki and OMIM have some good articles on this.

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@archer

B, ---You cannot know how helpful your responses have been. Finally, thanks to you, we will be more informed and will have meaningful questions to ask during next appointment. In my case, the head phenomenon is more of a pressure or fullness, specifically around the eyes. This had been with me for many years and always accompanied dizziness, but it was never constant. We thought it was an allergy/sinus complication. Even my physician thought so -- probably because my Ejection Fraction was within normal range.
---By the way, two quick questions: Do you know what your Ejection Fraction was during that highly symptomatic phase? Also, was the progression from HCM to HOCM discovered via an Echocardiogram? This second question is because you noted that the change took place rather quickly, within 2-3 months. My last Echo was about a year ago (July), indicating an Ejection Fraction of 55%. Am wondering if another one is in order -- chiefly, would it explain the persistent symptoms. Meanwhile, the dizziness/unsteadiness has become constant, while the chest discomfort is infrequent -- but sometimes involves the left arm. Obviously, pretty worried. Again, your informed responses have given much relief and some hope.
---Thanks, archer.

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I saw my doctor at Cleveland Clinic (CC) last November and was told it was still HCM, go home, and come back in 6 months. After thanksgiving, I became more sypmtomatic feeling more dizziness, and was constantly light headed. After many conversations with my CC doc, I went to see him in early Feb, had a stress echo, was told it had progressed to a serious place where it became obstructive, and surgery was needed. I had a bulge blocking my aorta and when my mitral valve opened and closed, the little leaflets got stuck between the bulge and the aorta. He told me to go home and do nothing until the surgery. I had to surgery on Feb. 26. An amazing series of events. Last November, my ejection fraction was in the near normal range.

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---Now, fully understood. Simply put, a near-normal ejection fraction can change in a very short time. Thank God you persisted. Congratulations on your journey.

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It is very important to be attentive, listen to your body and get the answers from your doc asap. Good luck. I am happy to share any time.

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@archer

---Hello. You mention taking Metoprolol 125 mg twice daily. That is double my current dosage. Has it helped you with any symptoms -- specifically dizziness or unsteadiness?
---Thanks, archer.

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In January I was diagnosed with hypertension after making a visit to a Prompt care and sent directly to the ER. Admitted overnight for observation and an Echocardiogram was done which disable left side heart wall thickened. Diagnosed me with hypertension and sent me home on Metoprolol 25 mg twice a day. Kept my blood pressure down for a week or so, back to ER with blood pressure out of control, dizziness, chest discomfort, shaky, SOB. After several visits to ER with same symptoms a Cardiac MRI completed send got the diagnosis of HOCM snd referred to Mayo Clinic. Delays with insurance approval and then COVID 19, I skim scheduled for Septum Myectomy in July due to Metoprolol dose keeps getting increased but only holds blood pressure for sp long and then dose gets increased again. So gradually it has been increased to current dose of 125 mg twice daily. I seem also on Cardizem 360 mg daily and HCTZ 12.5 mg daily. I have symptoms everyday. Just holding til my surgery date

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@oldkarl

I have CHF, nearly a lifelong diagnosis. My ejection fraction ranges from 40-65, depending on some environmental factors such as diet, other diseases, etc. The CHF with preserved ejection fraction is, among other things, known as highly probably marker of Gelsolin, RyR2, and Fukutin Limb Girdle Muscular Dystrophy. (They come together, most of the time) Helsinki and OMIM have some good articles on this.

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---Thanks for the information. My CHF was diagnosed last year and, apparently, progressed from HCM. As mentioned elsewhere, my chief symptoms are --and always had been-- dizziness (with head discomfort), chest pains and fatigue. Since the CHF diagnosis, there is also difficulty lying flat in bed and, for a time, some edema. What have your symptoms been, and what medications have helped to control them? Very happy that you mentioned the data regarding preserved ejection fraction. Again, thanks. best, archer.

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