[41F] Experiencing cardiac arrhythmias and related symptoms

Patient Description

A 41-year-old female presents with a 2-year history of cardiac symptoms, including irregular heartbeat, bradycardia, tachycardia, dizziness, exercise intolerance, low blood pressure, and narrow pulse pressure. The symptoms began suddenly after starting an SNRI, with no prior cardiac issues. The patient experiences bradycardia with heart rates in the low 40s and tachycardia with rates ranging from 100-160 bpm, often occurring during rest and exacerbated around day 18 of her menstrual cycle. Blood pressure readings have been notably low, with narrow pulse pressure (e.g., 90/80, 95/75, 90/60). Additional symptoms include muscle twitches in hands, tinnitus, and migraines. The patient's medical history is unremarkable except for obesity and migraines, and there are no known drug allergies. Current medications include Metoprolol succinate 25mg and vitamin D 2000 IUs daily.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Dysautonomia: This is a broad term that describes any disease or malfunction of the autonomic nervous system. This includes conditions such as Postural Orthostatic Tachycardia Syndrome (POTS), which is characterized by a rapid increase in heart rate upon standing, and Neurocardiogenic Syncope, which is characterized by fainting or lightheadedness.

    • Treatment options typically involve lifestyle changes and medications to manage symptoms.
  • Cardiac Arrhythmia: This refers to abnormal heart rhythms, which can include tachycardia (fast heart rate) and bradycardia (slow heart rate). Arrhythmias can be caused by a variety of factors, including heart disease, changes in the heart muscle, injury from a heart attack, or certain medications.

    • Treatment options can include medications, lifestyle changes, and in some cases, surgical procedures.
  • Hormonal Imbalances: Conditions such as thyroid disorders or adrenal insufficiency can cause symptoms like those you're experiencing. Hormonal changes related to the menstrual cycle can also affect heart rate and blood pressure.

    • Treatment typically involves addressing the underlying hormonal imbalance, often with medication.

Please note that these are potential explanations based on the symptoms you've described, but only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. Consult with a healthcare professional: Given the complexity and potential seriousness of your symptoms, it's important to consult with a healthcare professional who can provide a thorough evaluation and guide treatment.

  2. Monitor your symptoms: Keeping a symptom diary can be helpful. Note when your symptoms occur, their severity, and any potential triggers (such as changes in activity level, meals, stress, etc.).

  3. Stay hydrated and maintain a balanced diet: Dehydration and malnutrition can exacerbate many of the symptoms you're experiencing.

  4. Avoid triggers: If you notice certain activities or foods worsen your symptoms, try to avoid them.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain
  • Fainting or loss of consciousness
  • Severe shortness of breath
  • Rapid or irregular heartbeat that doesn't resolve with rest

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

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11 mo ago

People Also Ask


What is dysautonomia and how is it related to my symptoms?

Dysautonomia refers to a disorder of the autonomic nervous system, which controls involuntary bodily functions like heart rate and blood pressure. It can lead to symptoms such as irregular heartbeat, dizziness, and exercise intolerance, similar to what you're experiencing.


Can medications like SNRIs cause cardiac symptoms such as irregular heartbeat?

Yes, medications like SNRIs can sometimes cause cardiac symptoms, including irregular heartbeat, as a side effect. It's important to discuss any new symptoms with your healthcare provider, especially if they began after starting a new medication.


How can hormonal changes during the menstrual cycle affect heart rate and blood pressure?

Hormonal changes during the menstrual cycle can influence heart rate and blood pressure due to fluctuations in hormones like estrogen and progesterone. These changes can exacerbate symptoms such as tachycardia and low blood pressure.


What lifestyle changes can help manage symptoms of cardiac arrhythmia?

Lifestyle changes that can help manage cardiac arrhythmia include maintaining a healthy diet, staying hydrated, avoiding caffeine and alcohol, managing stress, and engaging in regular, moderate exercise. It's important to work with a healthcare provider to tailor these changes to your specific needs.


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