What causes dizziness,pressure in chest and heart palpitations?
Patient: This only happens on occasion, but is concerning. I feel dizzy and like I am off balance, when this occurs I think I get anxiety because then I feel short of breath and my chest feels a bit heavy. It doesn t last long but is scarey. I sometimes have heart palpitations, I am 51 and wondering if could be peri menopausal symptoms Doctor: Hi, Your symptoms may be explained as presyncope.  I want to know about 1) Presence of diabetes, high blood pressure problem, cholesterol problem if any. 2) Current medication if any. 3) Habits like smoking, alcohol. 4) Any recent illness like loose motions, vomiting, excessive sweating, high grade fever. I will suggest you to undergo following test1) ECG electrocardiogram preferably during episode. 2) Holter's monitoring, electrophysiological study of heart. 3) 2DEcho (echocardiography) 4) Complete blood count,  hemoglobin level. 5) Blood pressure check in supine position and In standing position to know postural hypotension. 6) If all these tests are normal then there may be need of MRI brain with angiography and carotid artery doppler. In your case there may be possibility ofCardiac arrhythmia (abnormal electrical activity of heart), postural hypotension, problems related to blood supply of brain. These symptoms cannot be explained as perimenopausal symptoms.