Heart & Cardiology/RBBB with symptoms


Dr. Pearl:

My case involves a number of factors, which I never quite attributed to the heart until recently. In March 2012, I was in class and I had a very sudden case of vertigo and nausea, which caused me to go into the ER via EMS. I remember the dizziness coming in waves and lasting a few hours. I complained of chest pains, so the medics ran an EKG and found everything normal with the exception of some "abnormality" in the right sinus region. I cannot remember exactly what it was now. The ER dismissed me as having either the beginning of an infection (ended up with an ear infection 3 days later coincidentally), dehydration, or a panic attack.

Ever since that night I have been living with daily "brain fog," a dizzy like feeling, a faint feeling (never actually fainted, but have the pressure in the back of the eyes and feel like I will), nausea, motion sickness, and headaches. Every so often I'll get a "jolt" of vertigo which lasts a few seconds and is accompanied by chest and upper back pain (between the shoulder blades). It feels almost like indigestion. When this occurs my pulse rate (which is already low, but I have dismissed because I am a runner) drops to the mid 40s-50s.

This morning I had another jolt of dizziness and went into the doctor. They ran an EKG and I was told that based upon the result, and one I had 6 months ago, it looks like I have an incomplete electric current into the right region of my heart. I think it's referred to as an RBBB. My doctor said that this could be the reason why I am having all the other symptoms and I need to get it checked out ASAP. It has been about 18 hours now and my pulse is still around 48-55bpm and I have the chest pains. Is there any advice you could give? Would this be more heart related or just anxiety? I'm nervous about going into the ER if it's just anxiety as I was dismissed with before. I do have a history of heart disease (grandparents/father) and arrhythmia (grandparent/great-grandparent) in the family. Thanks.

This is not something that can be properly evaluated over the Web. Your dizziness and nausea sound like vertigo which generally an ear problem but could be neurologic. You should consider a formal evaluation with an ENT specialist. Good luck!!!
         Dr. P

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Frank J. Pearl, M.D.


Voluntary Professor of Medicine, University of Miami Miller School of Medicine, Miami, FL. Board certified in cardiovascular disease

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