[27F] With visual disturbances, tremors, and cardiovascular symptoms

Question

Most of the intense symptoms lasted less than 15 minutes. The dizziness, tingling in my feet, numbness on the right side of my mouth (has been ongoing for years), vision blacking out, and heart pounding have persisted on and off. The medical professionals who witnessed it have no idea what happened or at least haven’t told me.

Patient Description

A 27-year-old female presents with an inability to focus vision, episodes of vision blacking out, room spinning, lightheadedness, and a sensation of impending fainting. She also reports eye twitching, rapid pronounced trunk tremors extending to her arms and legs, and a recent episode of hypertension (172/110) and tachycardia (heart rate of 150). The jerking tremors have been occurring for about a week and typically last 5-10 minutes. The patient finds relief through focused breathing and medical intervention. Additionally, she experiences numbness and tingling in her left foot and lower leg, mild confusion, head pressure, and speech difficulties such as feeling like speaking in slow motion and stuttering. There is less control and sensation in the muscles on one side of her face, particularly near the mouth. The patient has a history of orthostatic hypotension and hypertension during this episode, as well as chronic facial rashes. She has a family history of heart attacks but her troponin levels were normal. She has been a long-term nicotine user and is allergic to sulfa.

Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several potential conditions that could be causing your symptoms. Here are some possibilities:

Stroke or Transient Ischemic Attack (TIA): Given your symptoms of vision changes, lightheadedness, high blood pressure, rapid heart rate, numbness, tingling, and difficulty speaking, a stroke or TIA is a serious possibility. These conditions occur when blood flow to a part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Immediate medical attention is crucial.
Hypertensive Crisis: Your blood pressure reading of 172/110 is very high and could indicate a hypertensive crisis, which can lead to serious complications such as stroke, heart attack, or organ damage. Symptoms like dizziness, lightheadedness, and vision changes can be associated with this condition.
Orthostatic Hypotension: This condition occurs when your blood pressure drops significantly upon standing up, leading to dizziness, lightheadedness, and fainting. It can be associated with rapid heart rate and other symptoms you've described.
Seizure or Neurological Disorder: The jerking tremors, vision changes, and feeling like you are going to pass out could be related to a seizure or another neurological disorder. These conditions require prompt evaluation by a healthcare professional.

What you can do

Seek Immediate Medical Attention: Given the severity of your symptoms, it is crucial to seek immediate medical attention. Go to the nearest emergency room or call 911. Do not drive yourself; have someone else take you or call for an ambulance.
Monitor Symptoms: While waiting for medical help, try to stay calm and monitor your symptoms. If you experience worsening symptoms such as severe headache, increased confusion, or loss of consciousness, seek emergency help immediately.
Follow Medical Advice: Once you receive medical attention, follow the advice and treatment plan provided by your healthcare provider. This may include medications to manage blood pressure, further diagnostic tests, or referrals to specialists.
Lifestyle Modifications: If you are a smoker, consider seeking help to quit smoking, as nicotine can contribute to cardiovascular issues. Maintain a healthy diet, stay hydrated, and avoid excessive caffeine or alcohol intake.

Remember, I am not a doctor, and it is essential to receive a formal diagnosis and treatment from a healthcare professional. Your symptoms are serious and require prompt medical evaluation.

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5 mo ago

People Also Ask

What are the symptoms of a transient ischemic attack (TIA) or stroke?

Symptoms of a TIA or stroke can include sudden numbness or weakness, especially on one side of the body, confusion, trouble speaking or understanding speech, vision problems, dizziness, loss of balance, and severe headache. Immediate medical attention is crucial.

How can a hypertensive crisis affect the body?

A hypertensive crisis can lead to severe complications such as stroke, heart attack, or organ damage. Symptoms may include severe headache, vision problems, chest pain, difficulty breathing, and confusion. It requires urgent medical treatment to lower blood pressure safely.

What is orthostatic hypotension and how is it managed?

Orthostatic hypotension is a condition where blood pressure drops significantly upon standing, causing dizziness, lightheadedness, or fainting. Management includes staying hydrated, standing up slowly, wearing compression stockings, and sometimes medication.

What are the potential causes of tremors and vision changes?

Tremors and vision changes can be caused by neurological disorders, seizures, or conditions affecting the brain such as TIA or stroke. Other causes might include medication side effects or metabolic issues. A thorough medical evaluation is necessary to determine the cause.

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3 Comments

Arora (Bot)#28060

5 mo ago

It's understandable to feel concerned when symptoms persist and the cause is unclear. The combination of your symptoms—dizziness, tingling, numbness, vision issues, and heart pounding—can be complex and may overlap with multiple conditions. Some possibilities include neurological disorders, cardiovascular issues, or even metabolic imbalances. The fact that some symptoms have been ongoing for years, like the numbness on the right side of your mouth, might suggest a chronic condition. It’s important to continue working with your healthcare providers, who may need to conduct further tests or refer you to specialists to pinpoint the exact cause. Keeping a detailed symptom diary can also help in identifying patterns and triggers.

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Leo#3962

5 mo ago

Hey there, I'm a med student, not quite a doctor, but your symptoms of vision blacking out, impending fainting, numbless, speech difficulties, and loss of muscle control seem like they could be caused by a TIA, which is a transient blood clot in the brain that you can't detect on imaging (unlike a stroke). The tremors plus the other symptoms could also be consistent with a seizure, which again they can't test for but they can monitor over time by keeping you in the hospital to do an electroencephalogram (EEG). Did they do that?

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Leo#3962

5 mo ago

I'm sorry that so much is going on, it must be a lot to deal with. You can submit your test results to the "explain result" chat flow on MDandMe to get some clarity and update me here. You can also use the journalling feature in "Past Chats" to write down what symptoms you experience each day so that you can get a summary of your recent history to show your doctor.

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[27F] With visual disturbances, tremors, and cardiovascular symptoms

What might be happening

What you can do

Experiencing symptoms?