[22F] Experiencing fast heart rate, nausea, and other symptoms

Patient Description

A 22-year-old female has been experiencing a fast heart rate, particularly at night, about four times a week for the past two months. These episodes occur at rest and are accompanied by trembling and sweaty palms. She also reports feeling nauseous for the past three weeks, with the severity at a level 5, which sometimes persists throughout the day. The nausea is alleviated by sleeping or eating light meals. Additionally, she experiences shakes in her legs and shoulders, described as similar to anxiety but without feeling anxious, also for the past two months. The patient has a history of anxiety and OCD, diagnosed at age 14. She reports heat intolerance and weight gain, alongside alternating constipation and diarrhea. She consumes caffeine, alcohol, and nicotine. She is currently taking fiber supplements and has no known allergies to medications. There is a family history of thyroid problems and cardiac conditions.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following conditions could be possible:

  • Hyperthyroidism: This condition occurs when your thyroid gland produces too much of the hormone thyroxine. Symptoms can include increased heart rate, tremors, changes in menstrual patterns, and heat intolerance. Your family history of thyroid problems and your symptoms of heat intolerance, weight gain, and changes in bowel movements could suggest this condition.

    • Diagnosis typically involves blood tests to measure your levels of thyroid-stimulating hormone (TSH) and thyroxine. Treatment can include medication, radioactive iodine, or surgery.
  • Panic Disorder: This is an anxiety disorder characterized by recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, and shaking. Your history of anxiety and OCD, along with your symptoms of a fast heart rate, trembling, and feeling like you're about to throw up, could suggest this condition.

    • Diagnosis is typically made based on your symptoms and medical history. Treatment can include psychotherapy, medication, or both.
  • Premenstrual Dysphoric Disorder (PMDD): This is a severe form of premenstrual syndrome that includes physical and behavioral symptoms that usually resolve with the onset of menstruation. Your symptoms of irregular periods, fatigue, and a general sick feeling could suggest this condition.

    • Diagnosis is typically made based on your symptoms and their timing in relation to your menstrual cycle. Treatment can include lifestyle changes, medication, or both.

Please remember that these are just possibilities based on the information you've provided, and they are not a definitive diagnosis. Only a healthcare provider can provide a formal diagnosis.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may refer you to a specialist if necessary.
  2. Keep a symptom diary. This can help you and your healthcare provider identify patterns in your symptoms and potential triggers.
  3. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular exercise, ensuring you get enough sleep, and managing stress.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Chest pain or discomfort
  • Shortness of breath
  • Severe abdominal pain
  • Sudden or severe headache
  • Fainting or loss of consciousness
  • Any other symptom that is severe or concerning to you

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 appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of hyperthyroidism?

Common symptoms of hyperthyroidism include increased heart rate, tremors, weight loss, heat intolerance, changes in menstrual patterns, and increased bowel movements. Diagnosis typically involves blood tests to measure thyroid hormone levels.


How can panic disorder be distinguished from other anxiety disorders?

Panic disorder is characterized by recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, sweating, and shaking. It is distinguished from other anxiety disorders by the unexpected nature and frequency of the panic attacks.


What lifestyle changes can help manage symptoms of Premenstrual Dysphoric Disorder (PMDD)?

Lifestyle changes that can help manage PMDD include regular exercise, a balanced diet, adequate sleep, stress management techniques, and avoiding caffeine and alcohol. Keeping a symptom diary can also help in identifying patterns and triggers.


How does family history affect the risk of developing thyroid problems?

Family history can increase the risk of developing thyroid problems because genetic factors can play a significant role in the function of the thyroid gland. If there is a family history of thyroid issues, it is important to monitor symptoms and consult with a healthcare provider for regular check-ups.


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