[22F] Experiencing a range of symptoms including arm ache and lightheadedness

Patient Description

A 22-year-old female has been experiencing a constant dull ache in her left arm, ranging from a 3 to a 6 on the pain scale, for approximately one week. The ache starts near the shoulder, intensifies near the bicep and elbow, and radiates down to the fingers. She also reports weakness in the arm, making it difficult to lift or hold objects. Additionally, she describes a buzzing tingling sensation, cramping with both dull and sharp pains, cold sweats, nausea, lightheadedness, and intermittent left rib pain. She has difficulty sustaining breath while singing, which is a new symptom. The patient has a history of PCOS diagnosed two years ago and anxiety diagnosed eight years ago. She is currently taking Vyvanse, escitalopram, and propranolol, all once daily for the past 1-3 months, and has a known allergy to penicillin.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Anxiety or Panic Disorder: Your symptoms of lightheadedness, heart palpitations, cold sweats, and tingling could be related to anxiety or panic attacks. These symptoms can be very intense and scary, but they are not life-threatening. Anxiety can also cause physical symptoms like muscle tension, which could explain your aches and cramping.

    • Treatment typically involves a combination of psychotherapy (cognitive-behavioral therapy is often effective) and medication. You mentioned you are already taking escitalopram and propranolol, which are often used to manage anxiety.
  • Gastrointestinal issues: Your symptoms of nausea, gas, and cramping could be related to a gastrointestinal issue such as irritable bowel syndrome (IBS) or gastritis.

    • Treatment typically involves dietary changes, stress management, and sometimes medication.
  • Cardiovascular issues: Your symptoms of heart palpitations, weakness, and aching in your left arm could be related to a cardiovascular issue. However, without more information, it's difficult to determine the likelihood of this. It's important to seek immediate medical attention if these symptoms are severe or persistent.

Please note that these are just possibilities based on the information you've provided. It's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

  1. Continue taking your prescribed medications as directed by your healthcare provider.
  2. Practice stress management techniques, such as deep breathing, progressive muscle relaxation, or mindfulness meditation, which may help reduce symptoms of anxiety.
  3. Maintain a balanced diet and regular exercise routine, which can help manage symptoms of both anxiety and gastrointestinal issues.
  4. Monitor your symptoms and note any patterns or triggers. This information can be helpful when consulting with a healthcare professional.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms become severe or persistent
  • You experience chest pain or pressure, especially if it radiates to your left arm or jaw
  • You have difficulty breathing

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

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People Also Ask


What could be causing the dull ache and weakness in my left arm?

The dull ache and weakness in your left arm could be due to several factors, including muscle tension from anxiety, a potential cardiovascular issue, or even a nerve-related problem. It's important to consult with a healthcare professional to determine the exact cause.


Are my symptoms of nausea and lightheadedness related to anxiety?

Yes, symptoms like nausea and lightheadedness can be related to anxiety or panic attacks. Anxiety can manifest with physical symptoms, including gastrointestinal discomfort and dizziness.


Could my medications be contributing to my symptoms?

It's possible that your medications, such as Vyvanse, escitalopram, and propranolol, could contribute to some of your symptoms. Side effects can include nausea, dizziness, and changes in heart rate. Discuss any concerns with your healthcare provider.


When should I seek immediate medical attention for my symptoms?

Seek immediate medical attention if your symptoms become severe or persistent, especially if you experience chest pain or pressure that radiates to your left arm or jaw, or if you have significant difficulty breathing.


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