<s>[INST] I am a 39 yr old male in which i had part of my aorta replaced at mayo in feb of 2012 and have enlarged left ventricle . Recently i have been experiencing multiple blackout episodes, dizzy spells, chronic pounding headaches . More recently my left side of my face and arm go numb and sometimes most of my body. My bp s and hr s from arm to arm vary substanially and afib only appears on my left arm. when i try to relax it feels like my heart is going to pound out of my chest, i get soaking wet from sweat, and havent been able to get any sleep in a few days. I have a mayo appoint in 6 days and have been to my er in the one horse town i live in multiple times. I refuse to go anymore cause i havent received any dx or answers to my problems and feel they will eventually kill me. is there any suggestions besides go to the er? [/INST] Hi, Thank you for posting your query. Your symptoms are strongly suggestive of multiple Ties (transient ischemic attacks) and you need emergent evaluation to find out the source. Most likely, it could be plaques in aorta, or it could be related to atrial fibrillation. You should be on anti-platelets and anticoagulants (if not already on) to prevent any risk of brain strokes. Please get back if you require any additional information. Best wishes, Chat Doctor. Ly/ </s>