[18F] Experiencing nausea, elevated heart rate, and headaches

Patient Description

An 18-year-old female has been experiencing nausea that disrupts her ability to eat and sleep, occurring during and after meals for about a month. The nausea is severe, rated at a 7 out of 10, and is accompanied by an elevated heart rate. She also experiences sharp, transient chest pains and dizziness. The patient has a history of emetophobia, which contributes to her anxiety when nauseous. She has been dealing with anxiety for approximately a year. Additionally, she reports severe headaches that occur twice a month or less, lasting for hours and located at the back of her head. She has a past medical history of epilepsy in childhood and a diagnosis of Borderline Personality Disorder. Her mother had coronary artery disease before the age of 55. The patient is not currently on any medication and is not aware of any drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Gastroesophageal Reflux Disease (GERD): This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms such as nausea after eating.

    • Treatment typically involves lifestyle modifications (such as avoiding certain foods and drinks that trigger symptoms) and over-the-counter or prescription medications to reduce stomach acid.
  • Gastritis: This is an inflammation of the stomach lining. It can cause nausea, especially after eating, as well as a loss of appetite.

    • Treatment usually involves taking medications to reduce stomach acid, which helps relieve gastritis symptoms and promotes healing.
  • Anxiety Disorders: Given your history of emetophobia and Borderline Personality Disorder, it's possible that your symptoms of nausea, rapid heart rate, and dizziness could be related to anxiety. Anxiety can cause a variety of physical symptoms, including those you've described.

    • Treatment for anxiety disorders often involves a combination of psychotherapy (talk therapy) and medications.
  • Migraines: These are a type of headache characterized by severe, throbbing pain, often on one side of the head. They can cause nausea and dizziness, and can last for hours to days.

    • Treatment typically involves taking medications to stop symptoms and prevent future attacks.

Please note that these are possible explanations based on the information you've provided, but they are not definitive diagnoses. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Try to identify any triggers for your nausea and avoid them if possible. This might include certain foods or drinks, or eating large meals.
  2. Practice relaxation techniques, such as deep breathing, meditation, or yoga, to help manage your anxiety.
  3. Keep a headache diary to track when your headaches occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.
  4. Stay hydrated and eat small, frequent meals instead of three large meals a day. This can help manage your nausea.

What you should look out for

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

  • Severe chest pain
  • Difficulty breathing
  • Vomiting blood or material that looks like coffee grounds
  • A sudden, severe headache unlike any you've had before
  • Fainting or loss of consciousness

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 accurate information.

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11 mo ago

People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, chest pain, and nausea, especially after eating.


How can anxiety disorders contribute to physical symptoms like nausea and dizziness?

Anxiety disorders can trigger the body's stress response, leading to physical symptoms such as nausea, dizziness, increased heart rate, and even chest pain. These symptoms occur because anxiety can affect the autonomic nervous system, which controls involuntary bodily functions.


What are some effective treatments for migraines?

Effective treatments for migraines include medications to relieve symptoms, such as triptans and NSAIDs, and preventive medications like beta-blockers or anticonvulsants. Lifestyle changes, such as stress management and avoiding known triggers, can also help.


What lifestyle changes can help manage gastritis symptoms?

Lifestyle changes to manage gastritis include eating smaller, more frequent meals, avoiding spicy and acidic foods, reducing alcohol and caffeine intake, quitting smoking, and managing stress through relaxation techniques.


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