[28F] With rapid heart rate, fatigue, and body aches
Patient Description
A 28-year-old female presents with rapid heart rate occurring on and off for the past five days, with episodes lasting about 20-30 minutes each. These episodes occur suddenly without specific triggers and are accompanied by occasional dizziness and shortness of breath, but no chest pain. The patient also reports heart palpitations. Additionally, she has been experiencing extreme fatigue, tender breasts, and dull body aches primarily in the lower back, upper back, and neck, rated 6 out of 10 in severity, for the same duration. The patient has not had any recent injuries to her back or neck. She has been taking Phentermine 37.5 mg once daily before breakfast for the past four months without prior issues. She reports nausea but no vomiting, and no recent changes in diet or caffeine intake. Her menstrual periods are usually regular, but she is currently two days late; a recent pregnancy test was negative. She has no history of thyroid conditions, pre-existing conditions, or chronic illnesses. She is not taking any other medications, supplements, or herbal remedies, and has no known drug allergies.
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Arora's Assessment
What might be happening
Based on the symptoms you've described, here are some possible explanations:
Rapid Heart Rate, Dizziness, and Shortness of Breath
- Phentermine Side Effects: Phentermine is a stimulant that can cause an increased heart rate, palpitations, dizziness, and shortness of breath. These side effects can sometimes appear even after months of use.
- Anxiety or Panic Attacks: These can cause sudden episodes of rapid heart rate, dizziness, and shortness of breath, especially if there are no clear triggers.
- Thyroid Issues: Although you haven't been diagnosed with thyroid conditions, hyperthyroidism can cause rapid heart rate and other symptoms you're experiencing. A thyroid function test might be necessary.
Extreme Fatigue and Body Aches
- Viral Infection: A viral infection can cause extreme fatigue, body aches, and sometimes nausea.
- Hormonal Changes: Given that your period is late and you have tender breasts, hormonal changes related to your menstrual cycle or early pregnancy (despite a negative test) could be contributing to your symptoms.
Tender Breasts and Late Period
- Hormonal Fluctuations: Hormonal changes related to your menstrual cycle can cause breast tenderness and a delayed period.
- Early Pregnancy: Although your pregnancy test was negative, it's still possible to be pregnant, especially if the test was taken very early.
What you can do
Rapid Heart Rate, Dizziness, and Shortness of Breath
- Consult Your Doctor: Given the potential side effects of Phentermine, it's important to consult your doctor. They may adjust your dosage or suggest an alternative medication.
- Monitor Symptoms: Keep a journal of your symptoms, including the time of day they occur and any potential triggers. You can use MDandMe to track your symptoms and share this information with your healthcare provider.
- Stay Hydrated: Dehydration can exacerbate symptoms like dizziness and rapid heart rate. Make sure you're drinking enough water.
Extreme Fatigue and Body Aches
- Rest: Ensure you get plenty of rest to help your body recover.
- Over-the-Counter Pain Relief: Consider taking over-the-counter pain relievers like ibuprofen or acetaminophen to help with body aches.
- Stay Hydrated and Eat Well: Proper nutrition and hydration can help alleviate fatigue and support your immune system.
Tender Breasts and Late Period
- Take Another Pregnancy Test: If your period doesn't start in a few days, consider taking another pregnancy test.
- Consult Your Doctor: If your period remains irregular or you continue to experience breast tenderness, consult your healthcare provider for further evaluation.
What you should look out for
Given the severity of some of your symptoms, you should seek medical care as soon as possible. Reasons to seek care more urgently include:
- Severe Chest Pain: If you experience severe chest pain, seek emergency medical attention immediately.
- Fainting or Severe Dizziness: If you faint or experience severe dizziness, seek medical care immediately.
- Worsening Symptoms: If your symptoms worsen or new symptoms appear, consult your healthcare provider.
Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and treatment plan. If you have more questions or need further assistance, feel free to continue the conversation.
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4 mo ago