Lightheadedness still after 3 weeks

The trouble with "lightheadedness"

by Gotrhythm - 2022-06-25 13:55:47

LIghtheadeness is one of those words that can have as many meanings as there are people feeling it. I'm sure you know what you mean, but other people (and doctors) don't. And unfortunately, it also has many, many causes. Some of the causes are heart-related, but many of them like diet, medications, other medical conditions, aren't. My point? It may take a while to track down the cause, and it might have nothing to do with your heart or pacemaker.

"Your pacemaker is working fine" only means the pacemaker is working the way it is programmed to. It doesn't mean the way it's programmed is optimal for your needs.

So, what can you do? First the fact that you have had one good day is actually a very good sign. It means that what ever is causing the lightheadedness is changeable. It isn't some fixed condition. And it means that at least for some activity levels your pacemaker settings are working well for you.

dehydration? anxiety?

by Lavender - 2022-06-25 16:39:29

Hi there, sorry to hear that you are experiencing this. I got a biventricular CRT-P device February 2021. I had been having six months of fainting or near fainting spells before a 30 day heart monitor finally caught the "ventricular standstill" which nearly took my life. So, of course, here I was thinking that now I would not have anymore woozy spells. But then, one day I felt extremely lightheaded, so much so that I layed down and called the cardiologist. I was told there was nothing wrong with my pacemaker. I also was told that I had not been drinking enough water. They said that with the pacemaker, I had to be even more careful to drink more water, and to stay out of the heat. The cardio nurse told me to have pretzels handy and if I feel woozy, to eat a couple and drink water. (Of course if you are to limit salt, you may not be wise to increase salt with pretzels-that's just for me.)

About three months later, while at a luncheon with friends, I once more turned my head to the side and felt lightheaded. I had been drinking water during the lunch, but it was a very hot day. I was in air conditioning, but apparently that slight feeling of being woozy, caused a kind of post traumatic stress anxiety in me, causing me to be anxious and I left. Once I was in the car, with the seat laid back, I was fine again. I called the cardiologist and asked them to review my overnight monitor report the next morning. Everything was fine.

It took me months to learn to trust the pacemaker and know that it will doggedly do its job, day and night. A lot of my lightheadedness was fear and sometimes dehydration.

Just wondering if post traumatic stress is causing you anxiety, which can also come with nausea. 

I am sorry you have to deal with this, but I can also tell you that even though it was seven months til I noticed I felt really good and was no longer anxious about things, you already had ONE GOOD DAY...lol may it be the start of many more!

Just a few questions

by Gemita - 2022-06-25 17:58:11

Don, first of all, you needed your pacemaker since I believe you have a confirmed diagnosis of Sick Sinus Syndrome and a pacemaker will fix the problem of a low heart rate associated with this condition.  It won’t however, as already mentioned, fix the problem of a fast heart rate, or an irregular arrhythmia like AF and your doctors should have explained this to you.  A pacemaker cannot control falls in blood pressure either that may occur due to an intermittent arrhythmia like AF, or to the blood pressure meds that we may need to take to control any fast heart rates.  I see you have had problems with both AF and blood pressure drops in the past Don.

Having said the above, please don’t despair. I still believe when your heart has settled down and got used to pacing, when you have recovered from the trauma of implant, you will feel so much better.  It took me several months of worsening AF and other arrhythmias, adjustments to my pacemaker and to my medication before my heart finally settled.  We all heal at different rates.  I can now honestly say that my pacemaker is working well for me, my AF is controlled on minimum meds, so I am well pleased with the result and I am sure you will be too.  Three weeks is no time to heal at all.  Anyway, one day of feeling normal is progress indeed Don, isn’t it? 

Perhaps you might want to ask your doctor something like the following:-

(1) Are there any pacemaker settings we could adjust to see whether my AF could be better managed if my main symptom of ? lightheadedness is due to intermittent episodes of AF or other heart rhythm abnormalities? (There are anti tachycardia and other preventive pacing measures that your EP may have set up Don to reduce your AF burden.  Ask what they are?  A copy of your main pacemaker settings would also be helpful so that you could learn all about these).  

(2) Would it be possible to have a review of all my medication Metoprolol, Losartan, Lipitor, Aspirin and to have some blood checks to look for any abnormalities as a cause for some of my symptoms - nausea, fatigue, lightheadedness?  (Remember Don, Blood Pressure meds, Statins, Aspirin, Beta Blockers may all cause unwanted symptoms and sometimes blood checks can be very helpful to make sure that levels of your medication are not building up in your blood stream or causing other difficulties.  It would also give your doctors the opportunity to check that you haven't developed another health problem, like an infection for example). 

(3) You could also ask perhaps specifically for your electrolytes to be checked?  I know with Losartan for example, you may need to have blood checks to see how well your kidneys are working and the amount of potassium that is present in your blood.  Based on this, your doctor may decide to change your dose of Losartan.  The same with Lipitor (a Statin), you usually need to have initial periodic blood tests to check your liver function but no doubt your doctor is doing this already? 

You don’t have to suffer in silence and it could be that an adjustment of your meds and pacemaker settings might just help you.  Please keep us updated.