[24F] With fast heart rate and irregular periods

Patient Description

A 24-year-old female presents with a fast heart rate and heart palpitations occurring every few days, with episodes lasting approximately 10 minutes and a heart rate of about 110 bpm. These episodes are sometimes triggered by laying down and eating. The patient reports increased stress over the past 6 months. Additionally, she experiences irregular menstrual cycles with random flows and associated pain, increased body weight, acne, and random tremors. She has an increased appetite but no changes in bowel habits. There is a family history of thyroid disorders or PCOS, but she has not been evaluated for these conditions. The patient was diagnosed with anxiety and depression at age 14 but is not currently taking any medications or supplements. She denies heat intolerance, increased sweating, and recent travel to different climates or altitudes.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a couple of potential explanations:

  1. Thyroid Disorders: Your symptoms, including a fast heart rate, increased appetite, weight gain, tremors, and irregular periods, could be related to a thyroid disorder such as hyperthyroidism. Hyperthyroidism occurs when your thyroid gland produces too much thyroid hormone, which can speed up your metabolism and cause symptoms like a rapid heartbeat, tremors, and changes in menstrual cycles. A simple blood test can help diagnose this condition, and treatment may include medications, radioactive iodine, or surgery.

  2. Polycystic Ovary Syndrome (PCOS): Given your irregular periods, acne, and weight gain, PCOS is another possibility. PCOS is a hormonal disorder common among women of reproductive age and can cause irregular menstrual cycles, acne, and weight gain. It can also lead to insulin resistance, which might contribute to increased appetite. Diagnosis typically involves a combination of medical history, physical exam, blood tests, and sometimes an ultrasound. Treatment often includes lifestyle changes, medications to regulate menstrual cycles, and sometimes medications to manage insulin levels.

What you can do

Fast Heart Rate and Palpitations:

  • It's important to consult a healthcare provider to evaluate your heart rate and rule out any underlying conditions. They may recommend an EKG or other heart monitoring tests.
  • Practice relaxation techniques such as deep breathing or meditation to help manage stress, which can sometimes trigger palpitations.

Irregular Periods and Acne:

  • Keep track of your menstrual cycle and any related symptoms using a journal or an app like MDandMe. This information can be helpful for your healthcare provider.
  • Consider consulting a healthcare provider for a hormonal evaluation. They may suggest treatments such as hormonal birth control to help regulate your cycle and manage acne.

Weight Gain and Increased Appetite:

  • Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Regular physical activity can also help manage weight.
  • If you're concerned about your weight or appetite changes, discuss these with your healthcare provider for personalized advice.

What you should look out for

While your symptoms are concerning, they are not immediately life-threatening. However, you should seek medical attention if you experience:

  • A heart rate that consistently exceeds 100 beats per minute at rest or is accompanied by chest pain or shortness of breath.
  • Significant changes in your menstrual cycle or new symptoms such as severe pain or heavy bleeding.
  • Any new or worsening symptoms that affect your daily life or well-being.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. They can provide guidance tailored to your specific needs and health history.

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2 mo ago


People Also Ask


What are the common symptoms of hyperthyroidism?

Common symptoms of hyperthyroidism include a rapid heartbeat, weight loss despite increased appetite, tremors, sweating, anxiety, and irregular menstrual cycles. A blood test measuring thyroid hormone levels can help diagnose this condition.


How is Polycystic Ovary Syndrome (PCOS) diagnosed?

PCOS is typically diagnosed through a combination of medical history, physical examination, blood tests to check hormone levels, and sometimes an ultrasound to look for ovarian cysts. Symptoms like irregular periods, acne, and weight gain are also considered.


Can stress cause heart palpitations and how can they be managed?

Yes, stress can trigger heart palpitations by increasing adrenaline levels, which can affect heart rate. Managing stress through relaxation techniques such as deep breathing, meditation, and regular exercise can help reduce palpitations.


What lifestyle changes can help manage weight gain and increased appetite?

To manage weight gain and increased appetite, focus on a balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins. Regular physical activity is also important. Consulting a healthcare provider for personalized advice can be beneficial.


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