Dizziness and chest pain associated with HCM

Posted by archer @archer, Jun 24 6:48pm

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

Liked by angiev18

Hello. I was surprisingly diagnosed with HCM about 5 years ago when I was 65. After a big check up last November where I was told all was ok, stable, and come back in 6 months for another check up, I started to become more symptomatic late December. I was experiencing constant dizziness with chest discomfort. After it progressed to where I was out of breath while walking etc. I learned in early February 2020 that it had progressed to HOCM and was told the obstruction had changed and I needed a septal myectomy immediately. I had it done late February and am now recuperating. It was my dizziness and chest pains that made me more aware that the issue had changed. I hope this helps and it is not meant to alarm you, just to pay attention to symptoms and be proactive to take care of it. I thank my lucky stars I had it done before Covid became so pronounced. The week I returned home was when the world stopped which has become another issue of its own.
Good luck,
Barb.

Liked by angiev18

REPLY

Hi @archer, I see that you have posted similar questions about dizziness and chest pains in a few other discussions. I have been concerned about atrial fibrillation's reported on my watch occasionally along with some irregular heartbeats. I ran across some references to dizziness and chest pain associated with Afib and was wondering if it might be something to consider.

Atrial Fibrillation in Hypertrophic Cardiomyopathy: Diagnosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006972/
Feb 28, 2018 – Atrial fibrillation is common in hypertrophic cardiomyopathy with a … Prevalence of Atrial fibrillation and stroke in non-referral bias HCM cohorts.

How does it feel to have atrial fibrillation?: https://www.afibmatters.org/what-do-i-need-to-know/how-does-it-feel-to-have-atrial-fibrillation/
Atrial fibrillation – Symptoms & causes: https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
What are the Symptoms of Atrial Fibrillation (AFib or AF)?: https://www.heart.org/en/health-topics/atrial-fibrillation/what-are-the-symptoms-of-atrial-fibrillation-afib-or-af

Perhaps @oldkarl, @ch665296f, @reenj62 and @predictable have some thoughts or suggestions they can share with you.

Have you been able to discuss the symptoms with your doctor?

REPLY
@johnbishop

Hi @archer, I see that you have posted similar questions about dizziness and chest pains in a few other discussions. I have been concerned about atrial fibrillation's reported on my watch occasionally along with some irregular heartbeats. I ran across some references to dizziness and chest pain associated with Afib and was wondering if it might be something to consider.

Atrial Fibrillation in Hypertrophic Cardiomyopathy: Diagnosis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006972/
Feb 28, 2018 – Atrial fibrillation is common in hypertrophic cardiomyopathy with a … Prevalence of Atrial fibrillation and stroke in non-referral bias HCM cohorts.

How does it feel to have atrial fibrillation?: https://www.afibmatters.org/what-do-i-need-to-know/how-does-it-feel-to-have-atrial-fibrillation/
Atrial fibrillation – Symptoms & causes: https://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/symptoms-causes/syc-20350624
What are the Symptoms of Atrial Fibrillation (AFib or AF)?: https://www.heart.org/en/health-topics/atrial-fibrillation/what-are-the-symptoms-of-atrial-fibrillation-afib-or-af

Perhaps @oldkarl, @ch665296f, @reenj62 and @predictable have some thoughts or suggestions they can share with you.

Have you been able to discuss the symptoms with your doctor?

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—Extremely helpful. My current symptoms (dizziness and occasional chest discomfort) have been with me for about three weeks. Sincere thanks for alerting me to the possibility of AFib. This now seems more serious than we realized. My next Dr's appointment is three months away, but have arranged to see the Nurse Practitioner in two weeks. Again, thanks.

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@bbonchek

Hello. I was surprisingly diagnosed with HCM about 5 years ago when I was 65. After a big check up last November where I was told all was ok, stable, and come back in 6 months for another check up, I started to become more symptomatic late December. I was experiencing constant dizziness with chest discomfort. After it progressed to where I was out of breath while walking etc. I learned in early February 2020 that it had progressed to HOCM and was told the obstruction had changed and I needed a septal myectomy immediately. I had it done late February and am now recuperating. It was my dizziness and chest pains that made me more aware that the issue had changed. I hope this helps and it is not meant to alarm you, just to pay attention to symptoms and be proactive to take care of it. I thank my lucky stars I had it done before Covid became so pronounced. The week I returned home was when the world stopped which has become another issue of its own.
Good luck,
Barb.

Jump to this post

—Thanks. Your experience and detailed information have been invaluable. Was anything done to mitigate the dizziness in the interim before the surgery?
—Again, sincere thanks. best, archer.

REPLY

Once I was informed about how advanced my condition became knowing surgery was imminent, I was told to take it easy, stay hydrated, and stay aware of what my body was telling me. There is always a danger of falling when one is light headed so I started to use my walking sticks when I moved about outside especially since we live on a farm so walk on uneven ground. My medications were also slightly adjusted. There was not much I could do other than that. After my surgery, the light headedness went away. It is a long road but one worth going on. I wish you the best and hope we can stay in touch. I would love to talk to you in person if you would like to do that. FYI I had my surgery at Cleveland Clinic. Although my initial evaluation was done at Mayo at Rochester, it was more convenient to move my care to Cleveland Clinic since my husband's family is from there and along with lots of friends. We live in Southern Indiana so that makes it much closer than Mayo. Cleveland Clinic is first rate as is Mayo. I would only choose one of those places for treatment.
Best of luck.

REPLY
@bbonchek

Once I was informed about how advanced my condition became knowing surgery was imminent, I was told to take it easy, stay hydrated, and stay aware of what my body was telling me. There is always a danger of falling when one is light headed so I started to use my walking sticks when I moved about outside especially since we live on a farm so walk on uneven ground. My medications were also slightly adjusted. There was not much I could do other than that. After my surgery, the light headedness went away. It is a long road but one worth going on. I wish you the best and hope we can stay in touch. I would love to talk to you in person if you would like to do that. FYI I had my surgery at Cleveland Clinic. Although my initial evaluation was done at Mayo at Rochester, it was more convenient to move my care to Cleveland Clinic since my husband's family is from there and along with lots of friends. We live in Southern Indiana so that makes it much closer than Mayo. Cleveland Clinic is first rate as is Mayo. I would only choose one of those places for treatment.
Best of luck.

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—You mention that your medications were adjusted. Did that help the dizziness at all? What were the medications?
—thanks, archer.

REPLY

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.

Liked by angiev18

REPLY
@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.

Jump to this post

—Really helpful info. Thanks a mill. —best, archer

REPLY
@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.

Jump to this post

—Oh, just one more thing. Really hate troubling you like this. But something in my symptoms is puzzling. The dizziness is always accompanied by a sort of pressure behind the eye area — a bit like sinus pressure. By any chance, did you have the same?

REPLY

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.

REPLY
@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.

Jump to this post

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.

Liked by angiev18

REPLY

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.

REPLY
@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.

Jump to this post

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.

REPLY
@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.

Jump to this post

—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.

REPLY
@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.

Jump to this post

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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