[49F] With sudden fatigue, shortness of breath, and heart palpitations

Patient Description

A 49-year-old female presents with sudden onset of extreme fatigue lasting for two days, accompanied by weakness, lightheadedness, and shortness of breath. The patient reports heart fluttering and a slight headache located in the temples and on top of the head. She describes her legs as feeling heavy and experiences some abdominal and back pain. The patient denies recent illnesses, infections, new medications, or travel. Her medical history includes fibromyalgia, migraines, ulcerative colitis (in remission), and IBS, diagnosed within the last 10 years. She is allergic to sulfa-based medications, Erythromycin, Reglan, and Compazine. Current medications include Gabapentin 600mg three times a day, Amytriptaline 50mg twice a day, Tylenol Arthritis 1300mg twice a day, Hydroxyzine 300mg twice a day, Omeprazole 20mg twice a day, Cymbalta 300mg at night, Lamictal 150mg at night, Suboxone 4mg every morning and 8mg every night, Klonipin, Imitrex, and Albuterol as needed. The patient has been on these medications for many years.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, here are some possibilities:

  1. Fibromyalgia Flare-Up: Your fatigue, weakness, and pain could be related to a fibromyalgia flare-up. This condition can cause widespread pain, fatigue, and cognitive difficulties. Stress or changes in routine can sometimes trigger these symptoms.

  2. Medication Side Effects: Some of your medications, like Gabapentin and Cymbalta, can cause fatigue and dizziness. It's important to review these with your healthcare provider.

  3. Anemia or Electrolyte Imbalance: These can cause fatigue, weakness, and lightheadedness. Blood tests can help rule these out.

  4. Heart-Related Issues: The heart fluttering and shortness of breath could indicate a cardiac issue. It's important to have this evaluated, especially if symptoms persist.

What you can do

Fatigue and Weakness:

  • Rest as needed, but try to maintain a regular sleep schedule.
  • Stay hydrated and eat balanced meals.
  • Use MDandMe to track your symptoms and identify any patterns.

Breathing and Heart Fluttering:

  • Avoid caffeine and alcohol, which can exacerbate palpitations.
  • Practice deep breathing exercises to help with shortness of breath.
  • Seek medical attention if symptoms worsen.

Headache and Pain:

  • Apply a cold pack to your head for relief.
  • Consider over-the-counter pain relief, but consult your doctor first due to your medication regimen.

What you should look out for

Seek medical attention if you experience:

  • Severe chest pain or pressure.
  • Fainting or severe dizziness.
  • Worsening shortness of breath.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. Use MDandMe to journal your symptoms and share insights with your provider.

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3 mo ago

Top picked over-the-counter products for Tingling or Cold Sensations at the Back of Your Head

People Also Ask


Can fibromyalgia cause sudden extreme fatigue and weakness?

Yes, fibromyalgia can cause sudden extreme fatigue and weakness, often triggered by stress or changes in routine.


What are common side effects of Gabapentin and Cymbalta?

Common side effects of Gabapentin and Cymbalta include fatigue, dizziness, and sometimes lightheadedness.


How can anemia or electrolyte imbalance be diagnosed?

Anemia or electrolyte imbalance can be diagnosed through blood tests that check for hemoglobin levels and electrolyte concentrations.


What symptoms might indicate a heart-related issue?

Symptoms like heart fluttering, shortness of breath, severe chest pain, or fainting might indicate a heart-related issue and should be evaluated by a healthcare provider.


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