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Dizzy Spells

Cardiac causes of dizzy spells

Being light headed or dizzy can be alarming symptoms that often warrant investigation for potential underlying heart related diagnosis. These symptoms can indicate transient reductions in blood flow to the brain, potentially originating from cardiovascular abnormalities. Evaluating these symptoms requires a comprehensive diagnostic approach, which may involve electrocardiography (ECG), Holter monitoring, 24-hour blood pressure monitoring, and echocardiography.

ECG serves as a fundamental tool in the initial evaluation of patients experiencing dizzy spells. It helps to detect arrhythmias or electrical system of the heart disturbances. 

Holter monitoring extends the evaluation by allowing continuous ECG monitoring at home for a prolonged period, for even up to 2 weeks. This extended monitoring facilitates the detection of transient heartbeat abnormalities that may not be captured during a standard ECG. Holter monitoring is particularly useful in identifying intermittent slow heart beats, called bradyarrhythmias, fast heart beats, called tachyarrhythmias, or heart blocks that could precipitate feeling light headed. In patients with fluctuating blood pressure readings, 24 hour blood pressure monitoring offers additional information regarding blood pressure throughout the day. It provides insights into the presence of swings in blood pressure, including low readings, called hypotension and high readings, called hypertension. Both can be responsible for symptoms of light-headedness.

Often symptoms of dizziness lead to careful explanation and patient`s reassurance. In our clinics we consider reassurance as a very important step in patients` journey as allows them to move forward with their lives and worry less about their symptoms. On the other hand if indeed the symptoms are due to an important underlying diagnosis, the treatment strategy is implemented swiftly. 

In conclusion, heart related causes of being light headed require a thorough diagnostic approach encompassing various modalities, including ECG Holter monitoring 24-hour blood pressure monitoring and often echocardiography. These investigations aim to identify underlying  arrhythmias, autonomic dysfunction such as POTS (Postural Orthostatic Tachycardia Syndrome), or structural heart abnormalities contributing to symptoms. 

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