[41F] Experiencing a constellation of symptoms including nausea, palpitations, and blurry vision

Patient Description

A 41-year-old female presents with a complex array of symptoms that have been persisting for various durations. She reports constant nausea for almost a year, daily heart palpitations with a racing heart rate sometimes reaching 140-150 bpm while at rest, and sudden onset of palpitations that can be jolting or feel like a series of 'skips.' Additionally, she has been experiencing cloudy urine with a strong odor for approximately one month, blurry vision since around April or May 2023 despite corrective glasses, and a sensation of a lump in her throat since June 2023 following an episode of vomiting. She experiences dry heaving once a day and describes a feeling of shallow breath and difficulty catching her breath during palpitations. She has not engaged in exercise for months due to nausea. The patient has no known allergies and is currently on multiple medications including Clonazepam (0.5mg 3x/day), Zofran (8mg, less than 4x/day), Topamax (once daily, dosage unspecified), Ubrelvy (100mg as needed for 5-8 breakthrough migraines a month), and Emgality (dosage and frequency unspecified). She has no significant past medical history reported.

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Arora's Assessment

What might be happening

Based on the information you provided, possible explanations for your symptoms include:

  • Anxiety Disorder: This condition can cause a variety of physical symptoms, including a racing heart, palpitations, and a feeling of a lump in the throat (globus sensation). It can also cause nausea and changes in vision. Your history of anxiety and the fact that you're taking Clonazepam (a medication commonly used to treat anxiety) support this possibility.

    • Treatment for anxiety disorder can include medication, therapy, and lifestyle changes.
  • Hyperthyroidism: This condition, which involves an overactive thyroid gland, can cause symptoms like a racing heart, palpitations, and weight loss. It can also cause changes in vision and frequent bowel movements.

    • Treatment for hyperthyroidism typically involves medication to slow down the thyroid gland, and in some cases, surgery or radioactive iodine.
  • Urinary Tract Infection (UTI): This could explain your cloudy, strong-smelling urine. UTIs can sometimes cause nausea and a racing heart, especially if the infection spreads to the kidneys.

    • Treatment for a UTI typically involves antibiotics.
  • Migraine: This could explain your blurry vision and nausea. You mentioned that you have a history of migraines and are on medication for it.

    • Treatment for migraines typically involves medication to stop the headache and prevent future attacks.

Please note that these are possibilities based on the information you provided and not a definitive diagnosis.

What you can do

  1. Continue taking your prescribed medications as directed by your doctor.
  2. Keep a symptom diary. This can help identify any patterns or triggers to your symptoms, which can be useful information for your doctor.
  3. Stay hydrated and maintain a balanced diet. This can help manage your symptoms and overall health.
  4. Practice stress management techniques, such as deep breathing, meditation, and yoga. These can help manage symptoms of anxiety and improve overall well-being.
  5. Schedule an appointment with your doctor to discuss your symptoms. They can provide a formal assessment and order relevant tests if necessary.

What you should look out for

Seek immediate medical attention if you experience:

  • Chest pain or discomfort
  • Difficulty breathing or shortness of breath
  • Fainting or loss of consciousness
  • Severe abdominal pain
  • Blood in your urine or stool
  • Sudden, severe headache
  • Sudden weakness or numbness on one side of your body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance or coordination

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of anxiety disorder?

Common symptoms of anxiety disorder include a racing heart, palpitations, a feeling of a lump in the throat, nausea, changes in vision, restlessness, and excessive worry.


How can hyperthyroidism affect heart rate and vision?

Hyperthyroidism can cause an increased heart rate and palpitations due to the overproduction of thyroid hormones, which stimulate the heart. It can also lead to changes in vision, such as blurred vision, due to swelling of tissues around the eyes.


What are the signs of a urinary tract infection (UTI)?

Signs of a urinary tract infection (UTI) include cloudy or strong-smelling urine, a frequent urge to urinate, a burning sensation when urinating, and sometimes nausea or a racing heart if the infection spreads.


How can migraines cause blurry vision and nausea?

Migraines can cause blurry vision and nausea due to changes in blood flow and nerve signaling in the brain. These symptoms are often part of the aura phase or occur during the headache phase of a migraine.


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