[19F] With persistent lightheadedness, elevated heart rate, and headache

Patient Description

A 19-year-old female has been experiencing mild lightheadedness, elevated resting heart rate (118 bpm), headache, and shortness of breath for approximately one week. The lightheadedness worsens upon standing, and there is no relief with rest. Blood pressure readings indicate pre-hypertension. The headache is described as a dull, congested sensation throughout the head, rated 5/10 in intensity. Shortness of breath varies from mild to moderate. The patient reports a recent flare-up of Behçet’s disease, with healing mouth and genital ulcers. Eyes are swollen due to frequent crying, and vision is blurry, though she wears glasses and is due for an eye exam. Fluid intake has been low, with occasional consumption of Body Armor drinks and cranberry juice. Current medications include Topamax, Meloxicam, Prozac, Wellbutrin, birth control, and Omeprazole, with the latter two being recent additions. The patient has an allergy to Amoxicillin.

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Arora's Assessment

What might be happening

Your symptoms could be related to several factors, possibly including your Behçet’s disease and recent medication changes. Here are some possibilities:

  1. Dehydration: Your low fluid intake can lead to dizziness, lightheadedness, and an elevated heart rate. Dehydration can also cause dark urine and headaches.

  2. Medication Side Effects: New medications like Omeprazole and Prozac might contribute to some symptoms, such as dizziness or headaches.

  3. Behçet’s Disease Flare-Up: Although your ulcers are healing, systemic effects like fatigue and headaches can linger.

  4. Anxiety or Stress: Crying and emotional distress can exacerbate symptoms like shortness of breath and headaches.

Typical treatments might include increasing hydration, reviewing medications with your doctor, and managing stress.

What you can do

Dehydration:

  • Gradually increase your fluid intake. Try flavored water or electrolyte drinks if plain water is unappealing.
  • Monitor your urine color; aim for light yellow.

Medication Review:

  • Discuss with your doctor whether your new medications could be contributing to your symptoms.

Behçet’s Disease:

  • Continue any prescribed treatments and monitor for new symptoms.
  • Keep a symptom journal using MDandMe to track changes and share with your provider.

Stress Management:

  • Practice relaxation techniques like deep breathing or meditation.
  • Consider speaking with a mental health professional if stress feels overwhelming.

What you should look out for

Seek medical attention if you experience:

  • Severe shortness of breath or chest pain.
  • Fainting or severe dizziness.
  • Worsening headaches or vision changes.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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People Also Ask


Can dehydration cause symptoms like lightheadedness and an elevated heart rate?

Yes, dehydration can lead to symptoms such as lightheadedness, dizziness, and an elevated heart rate. It is important to maintain adequate fluid intake to prevent these symptoms.


What are the potential side effects of starting new medications like Omeprazole and Prozac?

Starting new medications like Omeprazole and Prozac can cause side effects such as dizziness, headaches, and changes in mood or energy levels. It's important to discuss any new symptoms with your doctor.


How can a flare-up of Behçet’s disease affect overall health and symptoms?

A flare-up of Behçet’s disease can cause systemic symptoms like fatigue, headaches, and general malaise, even if specific symptoms like ulcers are healing. Monitoring and managing these symptoms with your healthcare provider is crucial.


What are some effective ways to manage stress and anxiety that might be contributing to physical symptoms?

Effective stress management techniques include deep breathing exercises, meditation, regular physical activity, and speaking with a mental health professional. These can help reduce symptoms exacerbated by stress and anxiety.


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