[18F] Experiencing heart rushing, body aches, dizziness, and hallucinations

Patient Description

An 18-year-old female reports experiencing sudden onset of heart rushing, body aches, dizziness, and hallucinations. The heart rushing episodes occur suddenly and are triggered by physical exertion or during sleep, causing her to wake up suddenly. These episodes are accompanied by shortness of breath, chest pain, nausea, vomiting, sweating, and clamminess. The body aches are rated as 6 out of 10 in severity and worsen when standing. The patient has a history of depression and anxiety, diagnosed four years ago, and psychogenic non-epileptic seizures (PNES), diagnosed about a month and a half ago. She is currently taking Seroquel XR 100mg once daily at bedtime and Cymbalta 60mg in the morning. There are no known allergies or adverse reactions to medications, and she does not take any over-the-counter medications, supplements, or herbal remedies. There have been no recent changes in her menstrual cycle, and there is no family history of heart disease or stroke.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential concerns that need immediate attention:

  1. Cardiac Issues: The combination of heart rushing, chest pain, shortness of breath, sweating, and nausea could indicate a serious heart condition, such as a heart attack or arrhythmia. These symptoms require urgent medical evaluation to rule out any life-threatening conditions.

  2. Panic Attack: Given your history of anxiety, it's possible that some of these symptoms could be related to a panic attack. However, the presence of chest pain and shortness of breath makes it crucial to first rule out cardiac issues.

  3. Medication Side Effects: Seroquel XR and Cymbalta can sometimes cause side effects that include dizziness, heart palpitations, and hallucinations. It's important to discuss these symptoms with a healthcare provider to determine if your medications might be contributing.

  4. Non-Epileptic Seizures (PNES): While PNES typically doesn't cause heart-related symptoms, stress and anxiety associated with PNES could potentially exacerbate your symptoms.

What you can do

  1. Seek Immediate Medical Attention: Given the seriousness of your symptoms, especially the chest pain and shortness of breath, it's important to seek immediate medical care. Please go to the nearest emergency room or call 911 for assistance. Do not drive yourself; have someone else take you if possible.

  2. Monitor Symptoms: While waiting for medical help, try to stay calm and note any changes in your symptoms. This information can be helpful for healthcare providers.

  3. Discuss Medications: Once the immediate concern is addressed, discuss your current medications with your healthcare provider to ensure they are not contributing to your symptoms.

  4. Follow Up on Mental Health: Continue to work with your mental health provider to manage your anxiety and depression, as these can impact your physical health.

Remember, it's crucial to get a professional medical evaluation to determine the exact cause of your symptoms and receive appropriate treatment.

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2 mo ago

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People Also Ask

What could cause sudden heart rushing and chest pain in a young adult?

Sudden heart rushing and chest pain in a young adult could be caused by a variety of factors, including cardiac issues such as arrhythmias, panic attacks, or even side effects from medications. It's important to seek medical evaluation to rule out serious conditions.

Can anxiety and depression medications cause hallucinations and dizziness?

Yes, medications like Seroquel XR and Cymbalta, which are used to treat anxiety and depression, can sometimes cause side effects such as hallucinations and dizziness. It's important to discuss these symptoms with a healthcare provider.

What are psychogenic non-epileptic seizures (PNES) and how do they differ from epileptic seizures?

Psychogenic non-epileptic seizures (PNES) are episodes that resemble epileptic seizures but are not caused by electrical disruptions in the brain. They are often related to psychological factors such as stress or trauma, and are managed differently than epileptic seizures.

How should one respond to sudden onset of severe symptoms like shortness of breath and chest pain?

If you experience sudden severe symptoms like shortness of breath and chest pain, it's crucial to seek immediate medical attention. Call emergency services or go to the nearest emergency room, and avoid driving yourself. These symptoms could indicate a serious condition that requires prompt evaluation.

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