[18F] Experiencing dizziness, visual disturbances, and palpitations

Patient Description

An 18-year-old female has been experiencing dizziness, visual disturbances, and a pressure in her head for the past 2 to 3 years. The dizziness is described as a spinning sensation and is rated as a 6 out of 10 in intensity. These symptoms are triggered by standing up quickly, taking a shower, holding her arms up, and climbing stairs. The visual disturbances include seeing black spots and temporary vision loss lasting from 5 to 20 seconds, often accompanied by forehead pain. The patient also reports palpitations, irregular heartbeats, and unusual fatigue or weakness. These symptoms worsen during her irregular menstrual periods. She does not experience swelling in her legs or ankles, chest pain, or fainting. There is a family history of similar symptoms in her mother, who has not been diagnosed. The patient is not on any prescription or over-the-counter medications, only taking vitamins, and has no known allergies to medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Orthostatic Hypotension:

    • This condition occurs when your blood pressure drops significantly upon standing up, leading to dizziness, blackouts, and a feeling of being lightheaded. It can also cause a spinning sensation and visual disturbances.
    • Typical treatments include increasing fluid and salt intake, wearing compression stockings, and sometimes medications to help regulate blood pressure.
  2. Anemia:

    • Anemia, particularly iron-deficiency anemia, can cause symptoms like dizziness, fatigue, and palpitations. It can also lead to headaches and a feeling of being air-starved.
    • Treatment usually involves dietary changes to increase iron intake, iron supplements, and addressing any underlying causes of the anemia.
  3. POTS (Postural Orthostatic Tachycardia Syndrome):

    • POTS is a condition that affects circulation (blood flow). It involves the nervous system and can cause symptoms like dizziness, palpitations, and fatigue, especially when standing up.
    • Management includes increasing fluid and salt intake, wearing compression stockings, and sometimes medications to help manage heart rate and blood pressure.
  4. Hormonal Imbalances:

    • Irregular menstrual periods and worsening symptoms during your period could indicate a hormonal imbalance, such as those seen in conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.
    • Treatment depends on the specific hormonal imbalance but may include medications to regulate hormone levels and lifestyle changes.

What you can do

For Orthostatic Hypotension:

  • Stay Hydrated: Drink plenty of fluids throughout the day.
  • Increase Salt Intake: Consult your doctor before making significant changes to your diet.
  • Move Slowly: When standing up, do so slowly to give your body time to adjust.
  • Compression Stockings: These can help improve blood flow and reduce symptoms.

For Anemia:

  • Iron-Rich Diet: Include foods like red meat, beans, lentils, and leafy green vegetables in your diet.
  • Iron Supplements: If recommended by your doctor, take iron supplements as directed.
  • Regular Check-Ups: Monitor your blood levels and follow up with your healthcare provider.

For POTS:

  • Hydration and Salt: Increase your fluid and salt intake as recommended by your doctor.
  • Exercise: Engage in regular, gentle exercise to improve circulation.
  • Compression Stockings: Wear these to help manage symptoms.

For Hormonal Imbalances:

  • Consult a Specialist: See an endocrinologist or gynecologist for a thorough evaluation.
  • Track Symptoms: Use MDandMe to journal your symptoms, track your menstrual cycle, and share this information with your healthcare provider.
  • Lifestyle Changes: Maintain a balanced diet and regular exercise routine.

What you should look out for

Given the severity and duration of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Fainting or Loss of Consciousness: This could indicate a more serious underlying condition.
  • Severe or Worsening Symptoms: If your symptoms become more intense or frequent.
  • New Symptoms: Such as chest pain, severe shortness of breath, or swelling in your legs or ankles.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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5 mo ago


People Also Ask


What is orthostatic hypotension and how can it be managed?

Orthostatic hypotension is a condition where blood pressure drops significantly upon standing, causing dizziness and visual disturbances. Management includes staying hydrated, increasing salt intake, moving slowly when standing, and wearing compression stockings.


How does anemia cause symptoms like dizziness and fatigue?

Anemia, particularly iron-deficiency anemia, can lead to dizziness, fatigue, and palpitations due to a lack of sufficient red blood cells to carry oxygen. It is managed by increasing dietary iron, taking iron supplements, and addressing any underlying causes.


What is POTS and what are common management strategies?

POTS, or Postural Orthostatic Tachycardia Syndrome, affects blood flow and can cause dizziness and palpitations when standing. Management includes increasing fluid and salt intake, regular gentle exercise, and wearing compression stockings.


How can hormonal imbalances affect menstrual cycles and overall health?

Hormonal imbalances can lead to irregular menstrual cycles and exacerbate symptoms like dizziness and fatigue. They may be managed with medications to regulate hormone levels and lifestyle changes, and should be evaluated by a specialist.


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