[41F] With heart palpitations, constant headache, and cold feet

Patient Description

A 41-year-old female presents with heart palpitations that occur with any physical exertion and resolve with rest within 5-10 minutes. She reports a constant headache, described as a 'full' feeling and 'fuzzy' brain, mostly behind the eyes, which has been persistent for several years. The headache is constant, with a severity of 6/10, and not relieved by any measures. Additionally, the patient experiences cold feet that are distracting and sometimes interfere with sleep, a symptom that has been present for several months. She also reports recent acid reflux. The patient has gained a significant amount of weight due to limited activity stemming from her symptoms. She has a history of environmental allergies but no known drug allergies. No pre-existing conditions, chronic illnesses, or specific medication use was reported.

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Arora's Assessment

What might be happening

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

  • Anemia: A condition characterized by a lack of healthy red blood cells to carry adequate oxygen to your body's tissues. This can cause fatigue, headaches, and cold hands or feet.

    • Treatment typically involves taking iron supplements and eating iron-rich foods.
  • Hypothyroidism: A condition where your thyroid gland doesn't produce enough thyroid hormones. This can cause fatigue, weight gain, cold intolerance, and slow heart rate.

    • Treatment typically involves taking synthetic thyroid hormone.
  • Heart disease: Conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. This can cause chest pain and heart palpitations.

    • Treatment can involve lifestyle changes, medication, or surgical procedures.
  • Anxiety disorders: Mental health disorders characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with one's daily activities. This can cause heart palpitations and headaches.

    • Treatment can involve psychotherapy, medication, or both.
  • Acid reflux or gastroesophageal reflux disease (GERD): A digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. This can cause heartburn and chest pain.

    • Treatment typically involves lifestyle changes, medication, or surgery.

Please note that these are possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Try to maintain a balanced diet and regular exercise routine. This can help manage weight and improve overall health.
  2. Limit caffeine and alcohol, which can trigger heart palpitations.
  3. Try relaxation techniques, such as yoga, meditation, or deep breathing exercises, which can help manage stress and anxiety.
  4. Over-the-counter antacids can help manage acid reflux. However, if symptoms persist, a doctor may prescribe stronger medication.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or discomfort
  • Trouble breathing
  • Fainting
  • Severe and persistent headaches
  • Unexplained weight loss

Remember, it's important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of anemia and how is it treated?

Common symptoms of anemia include fatigue, weakness, pale or yellowish skin, irregular heartbeats, shortness of breath, dizziness, or lightheadedness. Treatment often involves taking iron supplements and consuming iron-rich foods like red meat, beans, and leafy green vegetables.


How does hypothyroidism affect the body and what are the treatment options?

Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression. Treatment typically involves taking synthetic thyroid hormone levothyroxine to normalize hormone levels.


What lifestyle changes can help manage acid reflux or GERD?

Lifestyle changes to manage acid reflux or GERD include eating smaller meals, avoiding foods and drinks that trigger reflux (such as fatty foods, coffee, and alcohol), not lying down immediately after eating, losing weight if overweight, and elevating the head of the bed.


What are the potential causes of heart palpitations during physical exertion?

Heart palpitations during physical exertion can be caused by anxiety, dehydration, anemia, heart disease, or an overactive thyroid. It's important to consult a healthcare provider to determine the underlying cause and appropriate treatment.


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