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Forum Name: Cardiology Symptoms

Question: My symptoms of dizziness, left fingers numbness and waking


 markjpro - Thu Dec 30, 2004 4:09 pm

I am wondering about the symptoms I have been experience 2-3 times a month recently and then seldomly over the past several years. I find my sleep disturbed and sit up, noticing my fingers are numb, sometimes in both hands but recently, my left hand. In the last two months this is combined with subsiquent dizziness when I stand up and walk. I can hold myself up and don't fall but its unusual for me. I think a couple of times I experience chest discomfort and heart pounding but not really painful.

What do you think?

I am thinking of encouraging my naturopath to refer me for a cardiac workup. I am fit and run. I can easily jog for an hours, usually more. My total triglicerides are 280 and the bad cholesteral is 200, last check. I have always battled my lipid levels with nutrition and exercise.

I am wondering about the merits of low dose statins. My mom had CHD and open heart surg at 50 and lived 18 yrs beyond that with exercise and improved diet. She smoked lots ...

Thanks in advance, Mark
 Dr. Yasser Mokhtar - Tue Jan 04, 2005 11:07 am

User avatar Dear Mark,

Why do you think your sleep gets disturbed?

The symptoms that you are suffering from could be related to each other (caused by the same disease process) or not (occur individually but simultaneously.

They could be related to:

Regarding the numbness sensation in your hands
1. Sleeping on either of your hands with compression of the nerves and then once you wake up, the nerves start to be uncompressed, feeling starts to come back and you feel this numbness feeling.
2. Carpal tunnel syndrome in either or both hands.
3. Arthritis in your neck.

Regarding the dizziness when you first wake up and then stand up:
When one stands up the blood gets pooled in the lower extremities and the blood pressure becomes lower, the nerves that control the blood vessels make the vessel constric the blood pressure becomes higher and normalized once more. As one ages, the nerves that control the blood vessels become less efficient and especially when you are just awake because those vessels are usually kind of depressed during sleep, so when one stands up, the blood pools to the lower extremities, but it takes the blood vessels a while to compensate for the pooling of blood by consticting the blood vessel and during that period of time, the blood pressure is lower than normal and there is less blood going to the brain and hence the dizziness. The solution to this is not to get up at once when you wake up but rise slowly from the recumbant position, sit on the edge of the bed for 30 seconds or so and then rise slowly. This palpitation could be related to the fact that your heart rate increases in a trial to increase the blood flow to various organs when you stand up. This, if the palpitations occur when you stand up.

Regarding the chest discomfort and the heart pounding, this can occur if your sleep is disturbed and you wake up feeling apprehended. The palpitations can be the cause of the chest discomfort.

If these symptoms were related, and from your description, i believe they are not, they could be caused by low blood flow to the brain and this could be a prelude to a stroke. but this explanation does not explain the heart pounding and the chest discomfort.

Do i think that you need to be seen by a cardiologist for a cardiac work-up? Most probably not, reason being, even though you are a male over 50 with a definite positive family history of coronary disease (which are positive risk factors for coronary disease), yet it looks that you have been leading a healthy life style (with nutrition and exercise and not smoking), you don't have any other diseases that are major risk factors for coronary disease (like dibates and hypertension), but the most important thing is that your chest pain is atypical and you can run for more than an hour without getting any chest pain.

If you are referred to a cardiologist, the first step would be a treadmill stress test, which in your case, most probably will be negative because of your excellent fitness. A stress echocardiogram could be done as well. But, if there is a stong suspicion (which i believe there isn't), then a coronary angiogram is going to be the test of choice.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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