[38F] Experiencing a range of symptoms including blurred vision and headaches

Patient Description

A 38-year-old female presents with a constellation of symptoms, including blurred vision particularly when standing up, severe headaches located behind the eyes, fatigue, irritability, dark circles under the eyes, heart palpitations, insomnia, constipation, and generalized weakness. The blurred vision has been occurring for a week and is temporarily improved by blinking. The patient experiences irritability, which worsens at night, and severe aching headaches 4-5 times a week. Palpitations have been present for a few months, accompanied by a sensation of weakness and occasional dizziness upon standing. The patient has been dealing with constipation for years, requiring laxatives to facilitate bowel movements. The patient reports muscle spasms and has been feeling increasingly weak for the past month. She is currently taking Famotidine 40mg twice a day and Azstarys 7.8mg once a day for ADHD. There is no known family history of cardiovascular or endocrine diseases, and the patient denies any allergies, recent injuries, or substance use.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible causes for your symptoms include:

  • Orthostatic Hypotension: This condition, characterized by a sudden drop in blood pressure when standing up, could explain your blurred vision and dizziness upon standing. It can also cause weakness and fatigue.

    • Testing typically involves a physical examination and blood pressure measurements in different positions. Treatment usually involves lifestyle modifications and sometimes medication.
  • Anemia: This condition, characterized by a lack of healthy red blood cells to carry adequate oxygen to your body's tissues, could explain your fatigue, weakness, and dark circles under your eyes.

    • Testing typically involves a complete blood count (CBC) to check your red blood cell levels. Treatment depends on the cause and severity of the anemia, but may include dietary changes, supplements, or medications.
  • Chronic Fatigue Syndrome (CFS): This condition, characterized by extreme fatigue that can't be explained by any underlying medical condition, could explain your fatigue, weakness, headaches, and insomnia.

    • Diagnosis is typically made by ruling out other potential causes. Treatment usually involves a combination of lifestyle changes, psychological therapy, and medication to manage symptoms.
  • Irritable Bowel Syndrome (IBS): This common disorder affects the large intestine and can cause constipation, as well as other digestive symptoms. It could be exacerbated by stress or certain foods.

    • Diagnosis typically involves a physical exam, discussion of symptoms, and may involve tests to rule out other conditions. Treatment usually focuses on long-term management of symptoms through diet, lifestyle changes, and stress management.
  • Stress or Anxiety: These conditions can cause a variety of physical symptoms, including irritability, headaches, insomnia, and heart palpitations.

    • Diagnosis is typically made through a psychological evaluation. Treatment can involve a combination of therapy, lifestyle changes, and medication.

Please note that these are potential explanations based on the symptoms you've reported, and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They may wish to conduct some tests to help determine the cause of your symptoms.
  2. Keep a symptom diary, noting when each symptom occurs, its severity, and any potential triggers. This can be helpful information to share with your healthcare provider.
  3. Try to maintain a healthy lifestyle. This includes eating a balanced diet, getting regular exercise, ensuring you get enough sleep, and managing stress. These steps can help improve many of the symptoms you're experiencing.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache or a headache accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Chest pain or difficulty breathing
  • Fainting or loss of consciousness
  • Severe abdominal pain or bloody or black stools

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What is orthostatic hypotension and how is it diagnosed?

Orthostatic hypotension is a condition where there is a sudden drop in blood pressure when standing up, leading to symptoms like blurred vision and dizziness. It is diagnosed through a physical examination and blood pressure measurements in different positions.


How can anemia cause symptoms like fatigue and dark circles under the eyes?

Anemia is a condition where there is a lack of healthy red blood cells to carry adequate oxygen to the body's tissues, leading to symptoms like fatigue and dark circles under the eyes. It is diagnosed with a complete blood count (CBC) test.


What are the common symptoms and treatment options for Chronic Fatigue Syndrome (CFS)?

Chronic Fatigue Syndrome (CFS) is characterized by extreme fatigue that cannot be explained by any underlying medical condition. Common symptoms include fatigue, weakness, headaches, and insomnia. Treatment involves lifestyle changes, psychological therapy, and medication to manage symptoms.


How can stress or anxiety lead to physical symptoms like heart palpitations and headaches?

Stress or anxiety can cause physical symptoms such as heart palpitations and headaches due to the body's response to stress, which can include increased heart rate and muscle tension. Treatment often involves therapy, lifestyle changes, and sometimes medication.


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