[18F] Experiencing heart palpitations, fatigue, chills, blurred vision, and abdominal pain

Patient Description

An 18-year-old female reports experiencing episodes of heart palpitations, fatigue, chills, and transient blurred vision for a couple of months. These episodes, where the heart races for about 15-30 minutes, occur randomly and are accompanied by heavy breathing but no fainting. The patient feels fatigue, which is exacerbated by stress, anger, and anxiety, leading to difficulty focusing and a lack of motivation. Additionally, the patient experiences a dull abdominal pain rated 6/10, primarily in the mornings, along with frequent chills and coldness, particularly in the hands, which sometimes show blotches. The patient has been taking Trazodone Hydrochloride (50 mg) and Guanfacine Hydrochloride (2 mg) once daily for about a month and a few months, respectively. There is no known family history of cardiac or thyroid conditions, no use of recreational drugs, alcohol, or tobacco, and no known allergies or adverse reactions to medications. The patient has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Anxiety or Panic Disorder: These conditions can cause a variety of physical symptoms, including a racing heart, fatigue, chills, and blurred vision. They can also cause gastrointestinal symptoms like stomach pain and nausea.

    • Treatment typically involves psychotherapy (talk therapy), medications, or both. It's important to discuss your symptoms with a healthcare provider to determine the best treatment plan for you.
  • Side Effects of Medication: Both Trazodone and Guanfacine can cause side effects that may explain some of your symptoms. Trazodone can cause blurred vision, fatigue, and gastrointestinal symptoms. Guanfacine can cause a slow heart rate, which may feel like a racing heart if it suddenly returns to normal.

    • If you suspect your symptoms may be related to your medication, it's important to discuss this with your healthcare provider. Do not stop taking your medication without speaking to your doctor first.
  • Thyroid Disease: Conditions like hyperthyroidism can cause a variety of symptoms, including a racing heart, fatigue, and sensitivity to cold.

    • Diagnosis typically involves blood tests to measure levels of thyroid hormones. Treatment depends on the specific condition and may involve medication, radioactive iodine, or surgery.
  • Anemia: This condition, which involves a lack of healthy red blood cells to carry adequate oxygen to your body's tissues, can cause fatigue, a racing heart, and feeling cold.

    • Diagnosis typically involves blood tests. Treatment depends on the cause of the anemia and may involve dietary changes, supplements, or medications.

What you can do

While waiting for your appointment with a healthcare provider, you may find the following strategies helpful:

  1. Practice stress management techniques, such as deep breathing, yoga, or meditation. These can help manage symptoms of anxiety and improve your overall well-being.
  2. Maintain a balanced diet and stay hydrated. This can help manage gastrointestinal symptoms and support overall health.
  3. Get regular exercise, but avoid strenuous activity if it worsens your symptoms. Exercise can help manage anxiety and improve energy levels.
  4. Keep a symptom diary. This can help you and your healthcare provider identify patterns and triggers for your symptoms.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain or discomfort
  • Trouble breathing
  • Fainting or loss of consciousness
  • Severe abdominal pain
  • Any other symptoms that are severe or concerning to you

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care.

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10 mo ago

People Also Ask


Can anxiety or panic disorders cause physical symptoms like heart palpitations and blurred vision?

Yes, anxiety or panic disorders can cause a variety of physical symptoms, including heart palpitations, fatigue, chills, and blurred vision. These symptoms can also include gastrointestinal issues like stomach pain and nausea.


What are the potential side effects of Trazodone and Guanfacine that could explain my symptoms?

Trazodone can cause side effects such as blurred vision, fatigue, and gastrointestinal symptoms. Guanfacine can cause a slow heart rate, which might feel like a racing heart if it suddenly returns to normal. It's important to discuss any suspected side effects with your healthcare provider.


How is thyroid disease diagnosed and what are the common symptoms?

Thyroid disease is typically diagnosed with blood tests that measure levels of thyroid hormones. Common symptoms of hyperthyroidism include a racing heart, fatigue, and sensitivity to cold. Treatment may involve medication, radioactive iodine, or surgery, depending on the specific condition.


What are the symptoms and treatment options for anemia?

Anemia can cause symptoms like fatigue, a racing heart, and feeling cold. It is diagnosed through blood tests. Treatment depends on the cause and may involve dietary changes, supplements, or medications.


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