[36F] Experiencing fainting, fatigue, and irregular heartbeat

Patient Description

A 36-year-old female has been experiencing fatigue, fainting, and an irregular heartbeat for approximately 2.5 months. The fainting episodes are preceded by lightheadedness lasting 5 to 10 minutes and are not alleviated by sitting or lying down. The patient experiences nausea post-fainting, rating the severity as 6 out of 10. She has a history of supraventricular tachycardia and has been experiencing episodes of bradycardia and tachycardia throughout the day for the past 2 years. The patient also suffers from hemiplegic migraines, diagnosed 20 years ago. She has noted swelling in her feet and ankles by the end of the day and has a sensitivity to light. The patient has allergies to morphine, iodine, and tramadol. Her current medications include a daily multivitamin and ibuprofen and Tylenol as needed for headaches and body pain. She also has a family history of heart disease and is a smoker, which may be contributing to her symptoms.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Supraventricular Tachycardia (SVT): Given your history of SVT, your symptoms of irregular heartbeats, lightheadedness, and fainting could be related to this condition. SVT is a condition where your heart suddenly beats much faster than it should. It usually happens because of faulty electrical connections in the heart.

    • Treatment options for SVT include medications, lifestyle changes, and sometimes procedures to correct the heart's electrical system.
  • Orthostatic Hypotension: This condition causes a sudden drop in blood pressure when you stand up from a sitting or lying position, leading to lightheadedness and fainting. It could be a possibility given your symptoms, especially if these episodes occur when you stand up or start walking.

    • Treatment typically involves lifestyle modifications such as standing up slowly, staying hydrated, and avoiding alcohol and certain medications.
  • Cardiac Arrhythmias: Given your history of SVT and your symptoms of irregular heartbeats and fainting, other types of cardiac arrhythmias could also be a possibility. These are conditions where the heart beats too fast, too slow, or irregularly.

    • Treatment depends on the type of arrhythmia and may include medications, lifestyle changes, and sometimes procedures or surgery.
  • Neurocardiogenic Syncope (also known as Vasovagal Syncope): This is a common cause of fainting and can be triggered by various factors such as standing for long periods, heat exposure, or emotional distress. Given that your fainting episodes seem to occur when you're walking or upset, this could be a possibility.

    • Treatment typically involves lifestyle modifications such as staying hydrated and avoiding triggers.

What you can do

You should definitely seek medical attention for your symptoms. In the meantime, here are some things you can do:

  1. Try to identify any triggers for your fainting episodes and avoid them if possible.
  2. Stay hydrated and avoid alcohol, which can affect your heart rate and blood pressure.
  3. Stand up slowly from a sitting or lying position to help prevent lightheadedness and fainting.
  4. Continue taking your medications as prescribed.

What you should look out for

Seek immediate medical attention if you experience:

  • Chest pain or discomfort
  • Shortness of breath
  • Severe or worsening symptoms
  • Symptoms that interfere with your daily activities

Remember, while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of supraventricular tachycardia (SVT)?

Common symptoms of supraventricular tachycardia (SVT) include a rapid heartbeat, palpitations, dizziness, lightheadedness, fainting, and sometimes chest pain or shortness of breath.


How can orthostatic hypotension be managed at home?

Orthostatic hypotension can be managed at home by standing up slowly, staying well-hydrated, wearing compression stockings, and avoiding alcohol and large meals. It's also helpful to elevate the head of the bed and increase salt intake if advised by a doctor.


What lifestyle changes can help manage cardiac arrhythmias?

Lifestyle changes to help manage cardiac arrhythmias include avoiding caffeine and alcohol, quitting smoking, managing stress, maintaining a healthy weight, and following a heart-healthy diet. Regular exercise and monitoring your heart rate can also be beneficial.


What are the typical triggers for neurocardiogenic syncope?

Typical triggers for neurocardiogenic syncope include prolonged standing, heat exposure, dehydration, emotional distress, and sometimes pain or the sight of blood. Identifying and avoiding these triggers can help manage the condition.


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