[23F] Experiencing severe migraines and cardiovascular symptoms

Patient Description

A 23-year-old female has been experiencing severe migraines for 6 months, with throbbing pain primarily on the right side of her head, sensitivity to light and sound, and fatigue. The migraines are rated 8/10 for pain and can last up to two days. She also reports chronic tachycardia with heart rates of 105-120 bpm at rest, palpitations, and episodes of dizziness and lightheadedness. Additionally, she has had episodes of facial flushing, fever, chills, and significant fatigue. She has gained weight and had a severe headache described as the 'worst headache of her life.' Her current medications include Lamictal, Wellbutrin, Lisinopril, and Propranolol. She has a known allergy to Penicillin and no known pre-existing conditions.

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Arora's Assessment

What might be happening

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

  • Migraines: Your description of one-sided, throbbing headaches that last for days and are associated with light and sound sensitivity is consistent with migraines. Migraines are a common neurological condition and can be triggered by various factors such as stress, certain foods, or hormonal changes.

    • Treatment typically involves medications to relieve symptoms (pain relievers) and prevent future attacks (preventive medications).
  • Autonomic Dysfunction: This condition affects the autonomic nervous system, which controls involuntary body functions like heart rate, blood pressure, and body temperature. Symptoms can include tachycardia, palpitations, facial flushing, and temperature dysregulation.

    • Treatment often involves managing symptoms and underlying conditions.
  • Anxiety Disorders: While you've mentioned not feeling stressed or overwhelmed, it's worth noting that anxiety can manifest physically with symptoms like tachycardia, palpitations, and flushing.

    • Treatment typically involves psychotherapy, medication, or both.
  • Hormonal Imbalances: Conditions like hyperthyroidism or pheochromocytoma can cause symptoms like tachycardia, palpitations, flushing, and weight gain.

    • Treatment involves addressing the underlying hormonal imbalance, often with medication.

Please note that these are possibilities and not a definitive diagnosis.

What you can do

  1. Consult with a healthcare provider: Given your symptoms, it's important to seek medical attention. They can perform a thorough evaluation and potentially order tests to determine the cause of your symptoms.

  2. Monitor your symptoms: Keep a record of your symptoms, noting when they occur, their severity, and any potential triggers. This can help your healthcare provider in their evaluation.

  3. Lifestyle modifications: Regular exercise, a healthy diet, adequate sleep, and stress management can help manage some of your symptoms and improve overall health.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or shortness of breath
  • Sudden, severe headache
  • Sudden weakness or numbness, particularly on one side of the body
  • Difficulty speaking or understanding speech
  • Sudden vision changes

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.

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11 mo ago

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People Also Ask


What are common triggers for migraines and how can they be managed?

Common triggers for migraines include stress, certain foods (like aged cheese and processed meats), caffeine, alcohol, hormonal changes, and lack of sleep. Management often involves identifying and avoiding triggers, using medications to relieve symptoms, and preventive treatments to reduce the frequency of attacks.


What is autonomic dysfunction and what are its common symptoms?

Autonomic dysfunction is a condition where the autonomic nervous system does not work properly, affecting involuntary body functions such as heart rate, blood pressure, and temperature regulation. Common symptoms include tachycardia, palpitations, dizziness, lightheadedness, and facial flushing.


Can anxiety cause physical symptoms like tachycardia and palpitations?

Yes, anxiety can manifest with physical symptoms such as tachycardia, palpitations, sweating, and flushing. These symptoms occur due to the body's 'fight or flight' response being activated.


What are the potential causes of hormonal imbalances that could lead to symptoms like tachycardia and weight gain?

Hormonal imbalances can be caused by conditions such as hyperthyroidism, pheochromocytoma, or adrenal gland disorders. These imbalances can lead to symptoms like tachycardia, palpitations, weight gain, and changes in body temperature. Treatment typically involves addressing the underlying hormonal issue.


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