[32F] With numbness in toes and ankles, tight left calf, and other symptoms

Patient Description

A 32-year-old female presents with numbness in her toes and ankles, tightness in her left calf that radiates down her leg and can hurt, a pounding heartbeat when lying down, lightheadedness, dizziness, and tiredness. The tightness in her left calf has been present for about a month and is rated as moderate in severity. It worsens with prolonged standing or being at work. She also reports moderate leg pain for about a month. Additionally, she experiences dull chest pain, palpitations, and irregular heartbeats. There is no swelling, redness, warmth, or changes in the color of the skin on her leg. She has not experienced any episodes of fainting or near-fainting. Her last menstrual period was 4 days earlier than expected. Her medical history includes anxiety and depression (diagnosed 7 years ago), asthma (diagnosed at age 7), and pre-diabetes (diagnosed 5 years ago). She is allergic to Prednisone. Current medications include Zoloft (25mg once daily), esomeprazole (20mg once daily), an over-the-counter allergy medicine (10mg once daily), and albuterol (as needed).

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Numbness in Toes and Ankles, Tight Left Calf, and Leg Pain

  • Peripheral Neuropathy: This condition can cause numbness, tingling, and pain in your extremities. It is often associated with diabetes or pre-diabetes, which you have a history of.
  • Deep Vein Thrombosis (DVT): A blood clot in a deep vein, usually in the legs, can cause pain, swelling, and tightness. This is a serious condition that requires immediate medical attention.
  • Sciatica: Compression or irritation of the sciatic nerve can cause pain that radiates down the leg, often accompanied by numbness or tingling.

Pounding Heartbeat When Lying Down, Lightheadedness, Dizziness, and Tiredness

  • Anxiety: Given your history of anxiety, these symptoms could be related to anxiety or panic attacks.
  • Cardiac Issues: Conditions like arrhythmias or heart valve problems can cause palpitations, dizziness, and fatigue.
  • Orthostatic Hypotension: A drop in blood pressure when you stand up can cause dizziness and lightheadedness.

Dull Chest Pain

  • Gastroesophageal Reflux Disease (GERD): This can cause chest pain that is often described as a dull ache. You are taking esomeprazole, which is used to treat GERD.
  • Musculoskeletal Pain: This type of pain can be due to muscle strain or inflammation.

What you can do

Numbness, Tight Calf, and Leg Pain

  • Peripheral Neuropathy: Monitor your blood sugar levels closely and maintain a healthy diet. Regular exercise can also help improve symptoms.
  • Deep Vein Thrombosis (DVT): Seek immediate medical attention to rule out DVT. This is a medical emergency.
  • Sciatica: Gentle stretching and over-the-counter pain relievers like ibuprofen can help. Avoid activities that worsen the pain.

Pounding Heartbeat, Lightheadedness, Dizziness, and Tiredness

  • Anxiety: Practice relaxation techniques such as deep breathing exercises, meditation, or yoga. Continue taking your prescribed medications and consider talking to a mental health professional.
  • Cardiac Issues: Schedule an appointment with your healthcare provider for a thorough evaluation. They may recommend tests like an ECG or Holter monitor.
  • Orthostatic Hypotension: Stay hydrated and avoid sudden changes in posture. Compression stockings can also help.

Dull Chest Pain

  • GERD: Continue taking esomeprazole as prescribed. Avoid foods and drinks that trigger your symptoms, such as spicy foods, caffeine, and alcohol.
  • Musculoskeletal Pain: Apply a warm compress to the affected area and consider over-the-counter pain relievers.

What you should look out for

Given the severity and variety of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Sudden or severe chest pain: This could indicate a heart attack or other serious condition.
  • Swelling, redness, or warmth in your leg: These could be signs of a blood clot.
  • Fainting or severe dizziness: This could indicate a serious underlying condition.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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6 mo ago

People Also Ask


What could be causing numbness in my toes and ankles?

Numbness in the toes and ankles can be caused by peripheral neuropathy, which is often associated with diabetes or pre-diabetes. It can also be due to nerve compression or irritation, such as sciatica.


Why do I experience a pounding heartbeat when lying down?

A pounding heartbeat when lying down could be related to anxiety, which you have a history of, or it could be due to cardiac issues like arrhythmias. It's important to consult a healthcare provider for a thorough evaluation.


What are the possible reasons for my lightheadedness and dizziness?

Lightheadedness and dizziness can be caused by anxiety, cardiac issues, or orthostatic hypotension, which is a drop in blood pressure when standing up. Staying hydrated and avoiding sudden posture changes can help manage these symptoms.


How can I manage dull chest pain associated with GERD?

To manage dull chest pain associated with GERD, continue taking esomeprazole as prescribed and avoid foods and drinks that trigger symptoms, such as spicy foods, caffeine, and alcohol. Applying a warm compress and using over-the-counter pain relievers can also help with musculoskeletal pain.


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