[40F] Experiencing shakiness and autonomic symptoms

Patient Description

A 40-year-old female presents with a sudden onset of shakiness, described as similar to a cold shiver, affecting the whole body but more pronounced in the hands. The episode has been ongoing for approximately 20 minutes. Accompanying symptoms include teeth chattering and a pins and needles sensation in the leg. The patient also reports a flushed face, dilated pupils, slight trouble breathing, and fatigue, but no chest tightness or pain. The patient has been trying to manage the shakiness by slowing her breathing, which provides minor relief. The patient has a history of Postural Orthostatic Tachycardia Syndrome (POTS) diagnosed 4 years ago and is currently taking Mytopelol. She reports allergies to steroids and seizure medications. No other medications or health issues were reported.

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Arora's Assessment

What might be happening

Based on your symptoms, several conditions could be considered:

  • Panic Attack: This is a type of anxiety disorder where you have sudden attacks of extreme fear and stress that trigger intense physical symptoms. Symptoms can include shaking, a feeling of shortness of breath, and a rapid heart rate. These symptoms can be very frightening and can make you feel like you're having a heart attack, losing control, or even dying. However, panic attacks aren't life-threatening.

    • Treatment typically involves psychological therapy, medication, or both.
  • Hyperthyroidism: This is a condition where your thyroid gland produces too much thyroid hormone. This can speed up your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat. Other symptoms can include trembling hands, feeling hot, and difficulty sleeping.

    • Treatment can involve medication, radioactive iodine, or surgery.
  • Postural Orthostatic Tachycardia Syndrome (POTS): This is a condition that affects circulation (blood flow). It involves the autonomic nervous system and sympathetic nervous system. Symptoms can include lightheadedness, fainting, and rapid heartbeat. You mentioned that you have been diagnosed with POTS, and your symptoms could be a flare-up of this condition.

    • Treatment typically involves lifestyle changes and medications.

Please note that these are potential explanations for your symptoms, but other conditions could also be responsible. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history in person.

What you can do

  1. Try to stay calm and take slow, deep breaths. This can help to reduce feelings of panic and anxiety.
  2. Stay hydrated and avoid alcohol and caffeine, which can trigger or worsen your symptoms.
  3. Continue taking your prescribed medication and follow your doctor's advice for managing your POTS.
  4. If your symptoms persist or worsen, seek immediate medical attention.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Chest pain or discomfort
  • Trouble breathing or shortness of breath
  • Feeling faint, lightheaded, or dizzy
  • Confusion or trouble speaking
  • Severe or worsening symptoms

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 professional for an accurate diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of a panic attack?

Common symptoms of a panic attack include sudden feelings of intense fear or discomfort, shaking or trembling, shortness of breath, rapid heartbeat, sweating, and a feeling of losing control or impending doom. These episodes can be very distressing but are not life-threatening.


How does hyperthyroidism affect the body?

Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone, leading to an accelerated metabolism. Symptoms can include weight loss, rapid or irregular heartbeat, increased appetite, nervousness, tremors, sweating, and difficulty sleeping.


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

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects blood flow and the autonomic nervous system, often causing symptoms like lightheadedness, fainting, and a rapid heartbeat when standing up. Management typically involves lifestyle changes such as increased fluid and salt intake, wearing compression garments, and medications to help regulate heart rate and blood pressure.


What should I do if I experience sudden shakiness and breathing difficulties?

If you experience sudden shakiness and breathing difficulties, try to stay calm and take slow, deep breaths. Avoid stimulants like caffeine and alcohol, and ensure you are hydrated. If symptoms persist or worsen, seek immediate medical attention, especially if accompanied by chest pain, severe shortness of breath, or confusion.


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