[20F] Experiencing fatigue and dizziness post-POTS episode

Patient Description

A 20-year-old female reports severe fatigue and lightheadedness following a suspected POTS episode. The fatigue is constant and significantly impacts daily activities. The patient also experiences sharp chest pain and warmth in the back, which began after the episode and is gradually subsiding. Additional symptoms include pain radiating from the arm, nausea, headache, cold and white fingers, and purple/blue hands and feet. These symptoms have been present for two days, with similar episodes occurring since a COVID-19 infection a year and a half ago. The patient typically faints during POTS episodes but did not this time. No relief has been found for the dizziness or other symptoms.

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Arora's Assessment

What might be happening

Your symptoms could be related to several conditions:

  1. Postural Orthostatic Tachycardia Syndrome (POTS): This condition can cause fatigue, dizziness, and lightheadedness, especially after standing. It often follows viral infections like COVID-19.

  2. Raynaud's Phenomenon: The cold and white fingers, along with purple/blue hands and feet, suggest this condition, where blood flow to extremities is reduced.

  3. Nerve Compression or Injury: The shooting pain from your arm could be due to nerve issues, possibly related to your posture or an injury.

  4. Migraine or Tension Headache: Your headache and nausea could be related to these common types of headaches.

Typical treatments might include lifestyle changes, medications to manage symptoms, and physical therapy. Testing could involve blood tests, heart rate monitoring, and possibly imaging studies.

What you can do

For Fatigue and Dizziness:

  • Stay hydrated and increase salt intake if advised by your doctor.
  • Wear compression stockings to improve circulation.
  • Use MDandMe to journal your symptoms and track any patterns.

For Cold and Discolored Extremities:

  • Keep your hands and feet warm with gloves and socks.
  • Avoid stress and caffeine, which can trigger symptoms.

For Arm Pain:

  • Rest the affected arm and avoid activities that worsen the pain.
  • Consider over-the-counter pain relief like ibuprofen, if appropriate.

For Headache and Nausea:

  • Rest in a dark, quiet room.
  • Stay hydrated and try small, frequent meals.

What you should look out for

Seek medical attention if you experience:

  • Worsening chest pain or difficulty breathing.
  • Fainting or severe dizziness.
  • Persistent or worsening symptoms.

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

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8 mo ago

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People Also Ask


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how is it related to COVID-19?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects circulation (blood flow). It involves the nervous system and is characterized by an excessive increase in heart rate when standing up. It can cause symptoms like fatigue, dizziness, and lightheadedness. POTS can develop after viral infections, including COVID-19, due to potential impacts on the autonomic nervous system.


What are the symptoms and triggers of Raynaud's Phenomenon?

Raynaud's Phenomenon is a condition where small blood vessels in extremities like fingers and toes constrict excessively in response to cold or stress, leading to color changes (white, blue, then red), coldness, and sometimes pain. Triggers include cold temperatures and emotional stress. Keeping warm and avoiding stress can help manage symptoms.


How can nerve compression or injury cause arm pain and what are the treatment options?

Nerve compression or injury can cause pain that radiates from the arm due to pressure on nerves, often from poor posture, repetitive movements, or injury. Treatment options include rest, physical therapy, ergonomic adjustments, and pain relief medications. In some cases, medical interventions like injections or surgery may be necessary.


What are some effective ways to manage headaches and nausea?

To manage headaches and nausea, it is helpful to rest in a dark, quiet room, stay hydrated, and eat small, frequent meals. Over-the-counter pain relievers may be used if appropriate. Identifying and avoiding triggers, such as stress or certain foods, can also be beneficial. If symptoms persist, consulting a healthcare provider is recommended.


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