[28F] With severe heart palpitations, headaches, and shortness of breath

Patient Description

A 28-year-old female presents with episodes of heart palpitations characterized by a sensation of the heart stopping and then having a very forced beat. These episodes are accompanied by a feeling of heaviness, weakness, and difficulty breathing. The patient also experiences sudden, severe, and debilitating headaches, primarily located at the top middle, middle of the forehead, back of the head, and base of the skull. These headaches sometimes cause aching in the neck arteries. The symptoms began yesterday, with the heart symptoms starting first and becoming increasingly noticeable. The patient reports that the headaches occur at least once an hour and last between 15 seconds to 1 minute. The shortness of breath is severe enough to interfere with daily activities, causing the patient to miss work. The patient has a past medical history of hypertension, surgical hypothyroidism, anemia, unspecified heart arrhythmia, migraines, and osteoarthritis. Family history includes a mother who died of a brain aneurysm at age 31, a father with severe hypertension, and paternal grandparents and an aunt with various heart issues. The patient is currently taking Synthroid, Coreg, Losartan, Spironolactone, and Wellbutrin. No known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several serious conditions that could be causing your symptoms:

  1. Cardiac Arrhythmia: Your description of your heart feeling like it stops and then has a forced beat, along with dizziness, shortness of breath, and chest tightness, suggests that you might be experiencing a significant heart rhythm problem. Arrhythmias can be dangerous and require immediate medical attention.

  2. Acute Coronary Syndrome (ACS): Given your family history of heart disease and your symptoms of chest tightness and severe headaches, there is a possibility that you could be experiencing a form of ACS, which includes heart attacks. This is a medical emergency.

  3. Hypertensive Crisis: Your history of hypertension and the severe, sudden headaches could indicate a hypertensive crisis, which is when blood pressure becomes dangerously high and can lead to complications like stroke or heart attack.

  4. Brain Aneurysm or Stroke: Given your family history of brain aneurysms and your severe headaches, there is a concern that you could be experiencing a brain aneurysm or a stroke. Both conditions are medical emergencies and require immediate attention.

What you can do

  1. Seek Immediate Medical Attention: Given the severity and combination of your symptoms, it is crucial that you seek medical attention immediately. Go to the nearest emergency room or call 911. Do not drive yourself; have someone else take you or call for an ambulance.

  2. Monitor Symptoms: While waiting for medical help, try to stay calm and monitor your symptoms. If you experience worsening chest pain, increased shortness of breath, or if you lose consciousness, inform the emergency responders immediately.

  3. Avoid Physical Activity: Until you receive medical evaluation, avoid any physical activity that could exacerbate your symptoms.

  4. Inform Medical Staff: When you arrive at the hospital, make sure to inform the medical staff about your medical history, family history, and the medications you are currently taking. This information will help them provide the best care for you.

Remember, I am not a doctor, and this advice is based on the symptoms you've described. It is essential to get a formal diagnosis and treatment from a healthcare professional. Please seek care immediately.

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2 mo ago

People Also Ask

What are heart palpitations and when should I be concerned about them?

Heart palpitations are sensations of a fast-beating, fluttering, or pounding heart. They can be caused by stress, exercise, medication, or, in some cases, an underlying medical condition. You should be concerned if they are accompanied by dizziness, chest pain, shortness of breath, or fainting, as these could indicate a more serious heart condition.

Can severe headaches be related to heart problems or high blood pressure?

Yes, severe headaches can be related to heart problems or high blood pressure. High blood pressure can lead to headaches, and in some cases, severe headaches can be a sign of a hypertensive crisis or other cardiovascular issues. It's important to seek medical attention if you experience sudden, severe headaches along with other symptoms like chest pain or shortness of breath.

What is a hypertensive crisis and what are its symptoms?

A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke or other serious health issues. Symptoms may include severe headache, shortness of breath, nosebleeds, and severe anxiety. It requires immediate medical attention to prevent complications.

How can family history of brain aneurysms affect my health?

A family history of brain aneurysms can increase your risk of developing one. Aneurysms can be hereditary, and if you have a close relative who has had one, it's important to discuss this with your doctor. They may recommend monitoring or preventive measures to manage your risk.

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