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Heart beating very hard and dizziness

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For the last 3 months I have been aware of my heart beating very hard, not fast but hard (a real thumping), which is most notable at rest and something new to me?

In the last 3 weeks have had sharp central chest pain, with some slight dizziness on occasion.

I went to the ED on Weds and they did a CT of my heart and kept me in overnight and monitored me in the cardio ward.

The CT showed nothing but "Small plaque (25%) LAD prox 1/3" everything else normal.

All my ob's where normal overnight.

I was discharged with a script for Atrovastatin 40mg Daily

Last night I woke at 4am with a sensation of passing out? This happened several times.

This morning I have felt the onset of dizziness which makes me take several deep breaths and it seems to make it come right, but I feel quite unwell in general...

I am concerned that the hospital found nothing wrong with me but I know something is wrong!

Category: Cardiologist

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Category: Cardiologist
 26 Doctors Online


Thanks for your query at I can understand your concern.

Your central sharp chest pain doesnt seem to be anginal in origin. Also your CT angio report is not suggestive of significant coronary artery disease.

Please answer the following questions to help me assess your condition better.

About your dizziness. Does it always occur when you have this chest pain?
Does it occur with this thumping sensation in your chest?
Does your thumping sensation occur with your chest pain?Have you noticed your heart rate or pulse rate during these episodes?
Do objects spin before your eyes? or your head spins? or are there blackout sensations?
What does waking with passing out sensation mean?
Have you got an ECG done? Please get an ECG done preferably when you have an episode. Holter and 2d echo would be the next logical investigation.

Please get back with the info, also please feel free to discuss follow-up questions.

Thank you. Regards.

Patient replied :

Hello Dr

My dizziness is not directly associated with chest pain, in fact they seem separate.
Thumping sensation has been there for a few months with no pain. Pain is recent (2 weeks).
My resting heart rate is about 70-80bpm, which seems a little high.
The dizziness is not spinning but more of a mild blackout sensation (never fully blacked out)...
I have had three episodes where while asleep I have suddenly woken up with the blackout sensation, heart rate quite high and heart thumping! I know this sounds strange (as I'm already asleep). It lasted about 10 mins each time and I was able to get back to sleep.
Yes I was on the ECG for for 24hrs in hospital, with no alerts or problems.
I'm not sure if it was Holter and/or 2d echo?
I am back at work now (desk job) and the pain has subsided a lot, but the mild blackout dizziness still comes and goes throughout the day, even when just sitting typing like at the moment.
I have a discharge summary I can upload if that would help?
Thank you for your time.


Well, one thing we can be reasonable sure is that the dizziness is not related to a heart problem. The chest pain is not typical of a cardiac problem, the ECG monitoring was normal and all other tests do not show any major problem. Moreover the chest pain and dizziness symptoms do not appear to directly relate. A heart rate less than 80 is perfectly normal. So from cardiology point of view things seems to be fine.

The dizziness or rather blackouts has some features of a mild panic attack. Please note, I am not saying this is panic attack. Since you have been medically evaluated in a thorough manner, you can just observe or rather watch and wait.

In case if the symptoms persist or worsens you may need further investigations like 2D echo and Halter (these are some investigations for your heart). But I do not think you will need this. Meanwhile I recommend you to avoid any personal or work related stress. Stay in company with friends and family. Stay physically active. (mild to moderate aerobic exercise for 30 minutes per day)

Hope this helps
Thank you.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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