Should I Visit the ER? Experiencing Mild Persistent Vertigo, Chest Discomfort, and a Rapid Pulse
Greetings, I am a 34-year-old female, standing at 5’9" and weighing 170 lbs, currently dealing with lingering health complications following a hypertensive crisis I experienced in 2021. My ongoing symptoms include mild vertigo that occurs daily, pulsatile tinnitus, and discomfort in my left shoulder. I struggle to lift my arm above my head due to intense tightness and tension; however, an MRI has ruled out a rotator cuff tear. Additionally, I experience chest pain that feels like a persistent pinching sensation in one localized area, which can be quite sharp and lasts for hours intermittently. At times, I also feel faint. While imaging of my head has been completed (with a head MRA), my chest has not been examined yet. Recently, I underwent an ultrasound of the carotid artery, which indicated an elevated velocity of 229 in the subclavian artery, but thankfully, there was no sign of stenosis. Since a reading above 200 could suggest significant stenosis, I have concerns about potential stenosis originating from lower regions. Moreover, I have noticed a rib deformity which raises my suspicions regarding thoracic outlet syndrome, among other possibilities. I am hesitant to inconvenience the emergency room, yet I am struggling with ongoing vertigo and related symptoms. I am uncertain about what imaging may be required, but I am contemplating requesting a chest MRA for further investigation.
Answers (1)
2/16/2026, 10:50:34 PM
OpenHealth AI
Your symptoms of mild persistent vertigo, chest discomfort, and a rapid pulse are concerning, especially in the context of your medical history with hypertension and the recent ultrasound findings. It's understandable to feel hesitant about visiting the emergency room, but it's important to prioritize your health and safety.
Main Points:
- Your symptoms may indicate serious underlying conditions, warranting further investigation.
- Given the complexities of your situation, focusing on key symptoms and immediate next steps is essential.
Explanation:
Vertigo can be caused by a variety of issues, including inner ear problems or neurological concerns. Your chest discomfort, especially with the sharp, localized pain, and the rapid pulse, could indicate issues related to blood flow or even vascular conditions. While you’ve had imaging that reassures you in some areas, the combination of your symptoms might warrant further exploration for any potential complications.
Next Steps:
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Seek Immediate Care:
- Given the combination of symptoms—especially the chest discomfort and feelings of faintness—it's crucial to seek evaluation from a healthcare professional. You may not be ‘inconveniencing’ them; instead, you are being proactive about possible serious conditions.
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Monitor Symptoms:
- Keep track of when your symptoms occur, their intensity, and any triggers. Note if any specific actions (like lifting your arm) worsen your discomfort.
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Consider Imaging Requests:
- Discuss with the healthcare provider the need for a chest MRA given your risk factors and symptoms. Documenting this request can push for further investigation into possible vascular issues related to your history.
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Hydration and Rest:
- Ensure you are well-hydrated and try to manage stress, both of which can help with blood pressure and overall well-being. Avoid any strenuous activities that might aggravate your symptoms.
By addressing these critical points, you are taking the right steps toward understanding and managing your health situation effectively. Please prioritize seeking care in light of your symptoms.
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