[29F] With shaking, chest pain, and dizziness

Patient Description

A 29-year-old female presents with sudden onset of aggressive shivering throughout the entire body, occurring once a month and lasting 30 minutes to an hour. The patient also reports chest pain described as a squeezing sensation with brief sharp pains, rated 5/10 in severity, and shortness of breath characterized as air hunger, which improves with calming efforts. Additional symptoms include dizziness, fatigue, nausea, watery diarrhea (three episodes today), muscle twitching, jaw stiffness, and feeling hot. The patient has a history of hyperthyroidism and a stroke earlier this year. Current medications include Methimazole 5 mg three times a week, Propranolol 40 mg three times a day, Aspirin 81 mg once a day, and Vitamin D 1250 mcg once a week. No known drug allergies. No recent travel or new medications reported. The patient consumes a small amount of caffeinated tea but no other substances.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possibilities to consider:

  1. Heart-Related Issues: Your chest pain, shortness of breath, and fluctuating heart rate could indicate a heart problem, such as angina or a heart attack. Given your history of stroke, it's crucial to address these symptoms immediately.

  2. Thyroid Storm: As you have hyperthyroidism, a thyroid storm is a serious condition that can cause symptoms like shaking, rapid heart rate, and fever. This requires urgent medical attention.

  3. Panic Attack: Some of your symptoms, like shaking, chest pain, and shortness of breath, can also occur during a panic attack. However, given your medical history, it's important to rule out more serious conditions first.

  4. Electrolyte Imbalance: Diarrhea and muscle twitching could lead to an imbalance in electrolytes, which can cause various symptoms, including dizziness and fatigue.

What you can do

  • Seek Immediate Medical Attention: Given the seriousness of your symptoms, especially with your history of stroke, it's important to seek medical care right away. Please go to the emergency room or call 911.

  • Do Not Drive Yourself: If possible, have someone else drive you to the hospital or call for an ambulance.

  • Stay Calm: While waiting for help, try to stay as calm as possible. Deep breathing might help with the shortness of breath.

  • Inform Medical Staff: Make sure to inform the medical team about your hyperthyroidism, recent stroke, and current medications.

Remember, it's crucial to get evaluated by a healthcare professional to determine the exact cause and receive appropriate treatment.

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2 mo ago

People Also Ask

What are the symptoms of a thyroid storm and how is it treated?

A thyroid storm is a life-threatening condition that occurs in people with hyperthyroidism. Symptoms include high fever, rapid heart rate, sweating, shaking, confusion, and agitation. Treatment typically involves medications to block thyroid hormone production, beta-blockers to control heart rate, and supportive care in a hospital setting.

Can hyperthyroidism cause chest pain and shortness of breath?

Yes, hyperthyroidism can cause chest pain and shortness of breath. The increased levels of thyroid hormones can lead to a rapid or irregular heartbeat, which may result in these symptoms. It's important to manage hyperthyroidism effectively to prevent complications.

What are the potential heart-related issues that could cause chest pain and shortness of breath?

Potential heart-related issues that could cause chest pain and shortness of breath include angina, heart attack, or other cardiovascular conditions. These symptoms require immediate medical evaluation, especially in individuals with a history of stroke or other heart problems.

How can electrolyte imbalances affect the body and what are the symptoms?

Electrolyte imbalances can affect the body's normal function, leading to symptoms such as dizziness, fatigue, muscle twitching, and irregular heartbeats. These imbalances can occur due to dehydration, diarrhea, or other medical conditions and may require medical treatment to restore balance.

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