[30F] With severe headaches, fainting, and high blood pressure

Patient Description

A 30-year-old female presents with severe headaches, high blood pressure, and episodes of fainting. The patient reports throbbing pain in the back of her head, lasting up to an hour or more, primarily occurring between 3:00 AM and 11:00 AM. The pain is rated as 10 out of 10. Headaches can be triggered by heat and exercise, with no effective relief from medications. The patient has experienced these headaches since childhood, with worsening frequency and intensity in adulthood, occurring about three times a month. Additionally, she experiences lightheadedness, dizziness, and blurry vision, especially when the headaches occur. Fainting episodes have been happening for about three months, sometimes with no warning signs, and occasionally resulting in complete loss of consciousness. The patient also reports sharp chest pain radiating to the left arm and leg, shortness of breath, and palpitations. Family history includes high blood pressure and heart disease on both maternal and paternal sides, with a grandfather who passed away from heart cancer last year. Past medical history includes anemia, scoliosis, and vitamin D deficiency, diagnosed at age 13. Current medications include Escitalopram, Propranolol, and Atorvastatin, taken once daily, with dosages unknown. The patient also takes iron, vitamin D3, and B12 complex supplements. No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several serious conditions that could be contributing to your symptoms:

  1. Hypertensive Crisis: Your blood pressure readings of 211/138 are extremely high and could indicate a hypertensive crisis. This is a medical emergency that can lead to severe complications such as stroke, heart attack, or organ damage. The sharp chest pain radiating to your left arm and leg, along with shortness of breath and palpitations, are particularly concerning and could be signs of a heart attack.

  2. Stroke or Transient Ischemic Attack (TIA): The combination of high blood pressure, headaches, dizziness, and fainting could suggest a stroke or TIA. These conditions occur when blood flow to a part of the brain is interrupted, leading to potential brain damage.

  3. Severe Anemia: Given your history of anemia, it's possible that your symptoms of dizziness, fainting, and headaches are related to low hemoglobin levels, which can reduce oxygen delivery to your brain and other organs.

  4. Cardiac Issues: The chest pain, palpitations, and high blood pressure could indicate underlying heart problems such as arrhythmias or other cardiovascular conditions.

What you can do

  1. Seek Immediate Medical Attention: Given the severity of your symptoms and the potential for life-threatening conditions, you should 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.

  2. Monitor Symptoms: While waiting for medical help, keep track of your symptoms. Note any changes in your chest pain, headaches, dizziness, or vision. This information will be helpful for healthcare providers.

  3. Medication and Supplements: Continue taking your prescribed medications and supplements as directed. However, do not take any additional medications without consulting a healthcare provider.

  4. Avoid Triggers: Try to avoid activities that seem to trigger your symptoms, such as exposure to heat and strenuous exercise, until you have been evaluated by a healthcare professional.

  5. Stay Hydrated and Rest: Ensure you are well-hydrated and get plenty of rest. Avoid any stressful activities that could exacerbate your symptoms.

Remember, I am not a doctor, and this advice is based on the information you have provided. It is crucial to seek care from real health professionals to receive a formal diagnosis and appropriate treatment. Your symptoms are serious and warrant immediate medical attention.

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5 mo ago


People Also Ask


What are the potential causes of severe headaches and high blood pressure?

Severe headaches and high blood pressure can be caused by a variety of conditions, including hypertensive crisis, migraines, or other neurological issues. It's important to seek medical evaluation to determine the underlying cause.


How can fainting episodes be related to high blood pressure and headaches?

Fainting episodes can occur when blood flow to the brain is temporarily reduced, which can be related to high blood pressure, severe headaches, or cardiovascular issues. These symptoms should be evaluated by a healthcare professional.


What are the warning signs of a hypertensive crisis?

Warning signs of a hypertensive crisis include extremely high blood pressure readings, severe headaches, chest pain, shortness of breath, and changes in vision. It is a medical emergency that requires immediate attention.


How does family history of heart disease affect my risk of cardiovascular issues?

A family history of heart disease can increase your risk of developing cardiovascular issues. It is important to discuss your family history with your healthcare provider to assess your risk and consider preventive measures.


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