[35F] Experiencing dizziness, irregular heartbeat, and other symptoms

Patient Description

A 35-year-old female presents with constant dizziness, rated 8/10 in severity, which worsens upon standing, especially in the shower, with her heart rate reaching 150 bpm when standing. She also experiences irregular heartbeat, left arm pain and numbness, fatigue, pressure in the left side of the throat, occasional chest pain, forgetfulness affecting daily activities, and a new constant headache. The patient has a family history of heart disease, with her father having died of a pulmonary embolism. A recent CT scan revealed cervical lordosis and spondylosis. She is currently taking Midodrine and is allergic to Codeine. The patient is under the care of a cardiologist and has undergone an echocardiogram and tilt table test.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, there are a few potential conditions that could be contributing to your symptoms:

  1. Postural Orthostatic Tachycardia Syndrome (POTS): This condition can cause an increased heart rate when standing, leading to dizziness, fatigue, and other symptoms. It often requires specialized management and treatment.

  2. Cardiac Arrhythmia: Irregular heartbeats can lead to dizziness, fatigue, and chest discomfort. It's important to continue working with your cardiologist to monitor and manage this condition.

  3. Cervical Spondylosis: This is a common age-related condition affecting the joints and discs in your neck. It can lead to symptoms like neck pain, stiffness, and sometimes numbness or weakness in the arms if nerves are compressed. This might explain the left arm pain and numbness you're experiencing.

  4. Cervical Lordosis: Changes in the natural curve of the neck can sometimes contribute to neck pain and headaches.

It's important to discuss these findings with your healthcare provider to understand their significance and how they might relate to your overall health picture.

What you can do

Dizziness and Irregular Heartbeat:

  • Continue following up with your cardiologist for ongoing evaluation and management.
  • Monitor your heart rate and symptoms, especially when standing, and keep a record to share with your healthcare provider.
  • Stay hydrated and consider increasing your salt intake if recommended by your doctor.

Left Arm Pain and Numbness:

  • Consider physical therapy exercises to improve neck posture and reduce nerve compression.
  • Use ergonomic supports for your neck and arms, especially when working at a desk.

Fatigue and Headache:

  • Ensure you are getting adequate rest and managing stress levels.
  • Maintain a balanced diet and regular exercise routine to support overall health.

Forgetfulness:

  • Use reminders and organizational tools to help manage daily tasks and responsibilities.
  • Discuss any concerns about cognitive changes with your healthcare provider.

You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Given the severity of your symptoms and the possibility of life-threatening causes, you should seek medical care as soon as you can. Reasons to seek care even more urgently include:

  • Severe chest pain or difficulty breathing
  • Fainting or loss of consciousness
  • Sudden weakness or numbness in your arms or legs

Remember, it's important to continue working closely with your healthcare providers to address these symptoms and receive appropriate care.

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1 mo ago

Top picked over-the-counter products for POTS: Heart Rhythm Society Treatment Consensus

People Also Ask


What is Postural Orthostatic Tachycardia Syndrome (POTS) and how is it managed?

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition characterized by an excessive increase in heart rate when standing up, leading to symptoms like dizziness, fatigue, and palpitations. Management often includes lifestyle changes such as increased fluid and salt intake, wearing compression garments, and medications to help regulate heart rate and blood pressure.


How can cervical spondylosis cause arm pain and numbness?

Cervical spondylosis is a degenerative condition affecting the neck's joints and discs. It can lead to arm pain and numbness if the changes in the cervical spine compress nearby nerves. Treatment may involve physical therapy, medications, and ergonomic adjustments to relieve pressure on the nerves.


What are the potential causes of dizziness and irregular heartbeat?

Dizziness and irregular heartbeat can be caused by several conditions, including cardiac arrhythmias, POTS, and other cardiovascular issues. It's important to work with a cardiologist to diagnose the underlying cause and develop a treatment plan, which may include medications, lifestyle changes, or further testing.


How can I manage forgetfulness and cognitive changes in daily life?

Managing forgetfulness and cognitive changes can involve using organizational tools like calendars and reminders, maintaining a healthy lifestyle with adequate sleep, nutrition, and exercise, and discussing any significant changes with a healthcare provider to rule out underlying conditions.


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