[35F] Experiencing persistent headache with neurological and cardiac symptoms

Patient Description

A 35-year-old female presents with a persistent, intense headache rated 9 out of 10, located at the back of the head and behind the eyes, lasting for two weeks. The headache is exacerbated by bright lights and loud sounds, with no relief from any interventions. It began suddenly and is accompanied by blurred and dark vision, daily fatigue, numbness in the hands and feet, and episodes of rapid heart rate that start suddenly, sometimes with shortness of breath. The patient also reports nausea and olfactory hallucinations of smoke. There is no history of similar headaches, recent head injuries, or significant changes in medication, stress, or lifestyle. The patient denies any chest pain, swelling in the legs or ankles, changes in appetite, or family history of cardiovascular or neurological conditions. No known chronic illnesses or pre-existing conditions, and the patient is allergic to penicillin.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several potential concerns that need immediate medical attention:

  1. Migraine with Aura: Your symptoms, including a severe headache, sensitivity to light and sound, and visual disturbances, could indicate a migraine with aura. Migraines can cause intense pain and other neurological symptoms. Treatment often involves medications to relieve symptoms and prevent future attacks.

  2. Stroke or Transient Ischemic Attack (TIA): The sudden onset of a severe headache, blurred vision, numbness in your hands and feet, and rapid heart rate could be signs of a stroke or TIA. These are medical emergencies that require immediate evaluation and treatment to prevent permanent damage.

  3. Cluster Headache: These are severe headaches that occur in cyclical patterns or clusters. They can cause intense pain around or behind one eye, along with other symptoms like a runny nose or tearing. Treatment may include medications to relieve pain and prevent future episodes.

  4. Pheochromocytoma: This is a rare tumor of the adrenal gland that can cause symptoms like rapid heart rate, headache, and high blood pressure. It requires medical evaluation and treatment.

  5. Carbon Monoxide Poisoning: The sensation of smelling smoke that isn't there, along with headache and nausea, could suggest carbon monoxide exposure. This is a serious condition that requires immediate medical attention and removal from the source of exposure.

What you can do

Given the severity and combination of your symptoms, it's crucial to seek medical attention immediately. Here are some steps you can take:

  • Go to the Emergency Room: Due to the potential for serious conditions like a stroke or carbon monoxide poisoning, it's important to get evaluated by a healthcare professional as soon as possible. If you are unable to get to the hospital yourself, call 911 or have someone take you.

  • Avoid Driving: Given your symptoms, it's safer to have someone else drive you to the hospital or call for emergency services.

  • Monitor Your Symptoms: Keep track of any changes or worsening of your symptoms, and inform the medical team when you arrive at the hospital.

  • Stay Calm: While it's important to seek help quickly, try to stay as calm as possible to avoid increasing your heart rate further.

Please remember that this information is not a substitute for professional medical advice. It's important to get evaluated by a healthcare provider to receive a proper diagnosis and treatment.

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2 mo ago

People Also Ask


What are the common symptoms of a migraine with aura?

Common symptoms of a migraine with aura include visual disturbances such as flashing lights or zigzag patterns, severe headache, sensitivity to light and sound, nausea, and sometimes numbness or tingling in the face or hands.


How can you differentiate between a migraine and a stroke?

A migraine typically involves a severe headache with possible visual disturbances and sensitivity to light and sound, while a stroke may present with sudden numbness or weakness, confusion, trouble speaking, and loss of balance. Immediate medical evaluation is crucial to differentiate between the two.


What are the signs of carbon monoxide poisoning?

Signs of carbon monoxide poisoning include headache, dizziness, weakness, upset stomach, vomiting, chest pain, and confusion. If you suspect carbon monoxide poisoning, get fresh air immediately and seek emergency medical attention.


What should you do if you suspect a pheochromocytoma?

If you suspect a pheochromocytoma, which can cause symptoms like rapid heart rate, headache, and high blood pressure, it's important to consult a healthcare provider for evaluation and possible imaging tests to confirm the diagnosis and discuss treatment options.


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