[36M] Experiencing erratic heart rate, dizziness, and other symptoms

Patient Description

A 36-year-old male reports experiencing an erratic heart rate with rapid increases and drops within a minute, lasting for multiple hours, typically around 1100 and 1500. The palpitations occur at rest and have a regular rhythm. Accompanying symptoms include dizziness described as a shocking or dropping feeling with lightheadedness, which has been present for 3 years and is exacerbated by standing, walking, and looking up. The patient also experiences numbness and pins and needles in the arms, legs, and face, as well as dimness in vision with different hues during severe episodes, which started a year ago. Additionally, a rash on the elbows, shins, and back of arms, characterized as bumpy, red, itchy, and burning, has been present for 2 weeks. The patient has high uric acid levels and gout in the left foot, with the left big toe joint protruding, which has been ongoing for 8 months. The patient is currently on Effexor (75 mg) and allopurinol (400 mg) and reports no known drug allergies or use of recreational drugs, alcohol, or tobacco. There is no family history of heart disease or any other cardiovascular conditions, and no other pre-existing conditions or chronic illnesses were reported.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Autonomic Dysfunction: This condition affects the autonomic nervous system, which controls functions like heart rate, blood pressure, and digestion. Symptoms can include an erratic heart rate, dizziness, and numbness or tingling in the extremities.

    • Testing typically involves a series of non-invasive tests to evaluate the autonomic nervous system. Treatment usually focuses on managing symptoms and may include medications, lifestyle changes, and treating any underlying conditions.
  • Anxiety Disorders: These are a group of mental health disorders characterized by feelings of anxiety and fear. Symptoms can include an erratic heart rate, dizziness, numbness or tingling in the extremities, and changes in vision.

    • Treatment typically involves psychotherapy (talk therapy), medications, or both.
  • Gout: This is a type of arthritis that usually affects the big toe. It's caused by high levels of uric acid in the blood, which can cause sharp, severe pain, redness, and swelling in the joints.

    • Treatment typically involves medications to control pain and reduce uric acid levels.
  • Dermatitis: This is a general term that describes inflammation of the skin. It can cause a rash that is itchy and red.

    • Treatment typically involves identifying and avoiding substances that irritate your skin, using skin creams to control inflammation, and taking antihistamines to control itching.

Remember, these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

Here are some general suggestions based on your symptoms:

  1. Schedule an appointment with your doctor to discuss your symptoms. They may refer you to a specialist, such as a neurologist or a dermatologist, for further evaluation.
  2. Keep a symptom diary. Note when your symptoms occur, what you're doing at the time, and what foods you've eaten. This could help identify any patterns or triggers.
  3. Try to maintain a healthy lifestyle. Eat a balanced diet, get regular exercise, and ensure you're getting enough sleep. This can help manage some of your symptoms and improve your overall health.
  4. If you're feeling anxious or stressed, consider techniques such as deep breathing, meditation, or yoga to help manage your anxiety.

What you should look out for

Seek immediate medical attention if you experience:

  • Chest pain or pressure
  • Trouble breathing
  • Sudden severe headache
  • Sudden weakness or numbness on one side of your body
  • Sudden loss of balance or coordination
  • Sudden difficulty speaking or understanding speech
  • Sudden changes in vision

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

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People Also Ask


What are the common symptoms of autonomic dysfunction?

Common symptoms of autonomic dysfunction include erratic heart rate, dizziness, fainting, numbness or tingling in the extremities, and digestive issues. It affects the autonomic nervous system, which controls involuntary bodily functions.


How can anxiety disorders affect heart rate and vision?

Anxiety disorders can lead to an increased heart rate, palpitations, and changes in vision due to heightened stress responses. These symptoms occur because anxiety triggers the body's fight-or-flight response, affecting cardiovascular and visual systems.


What are the typical treatments for gout?

Typical treatments for gout include medications like nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain, colchicine to reduce inflammation, and allopurinol to lower uric acid levels. Lifestyle changes, such as dietary modifications, can also help manage gout.


How can dermatitis be managed effectively?

Dermatitis can be managed by identifying and avoiding irritants, using moisturizers to keep the skin hydrated, applying topical corticosteroids to reduce inflammation, and taking antihistamines to alleviate itching. Consulting a dermatologist for personalized treatment is also recommended.


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