[50F] Experiencing sharp headache, elevated heart rate, and shortness of breath

Patient Description

A 50-year-old female presents with a sudden onset of a sharp and throbbing headache on the top right side of her head, rated 8 out of 10 in intensity, lasting for about twenty minutes. The headache is associated with elevated diastolic blood pressure and a heart rate of over 100 bpm, which has since decreased to 92 bpm. The patient also noted a sensation of heart palpitations earlier. She reports a slight shortness of breath but no nausea, vomiting, or visual disturbances. The patient has a medical history of lupus, Graves’ disease, thyroid eye disease, chronic migraines for over twenty years, and fibromyalgia, with most conditions diagnosed approximately three years ago. Current medications include Plaquenil, lisinopril, Lyrica, Synthroid, folic acid, Trazadone, and Adderal XR. The patient has no known drug allergies.

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Arora's Assessment

What might be happening

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

  • Hypertensive Crisis: This is a condition where blood pressure becomes very high, very quickly. Symptoms can include severe headache, shortness of breath, and symptoms of organ damage, such as chest pain or changes in vision. However, some people may not experience any symptoms. It's important to note that a hypertensive crisis can lead to a stroke if not treated immediately.

    • Treatment typically involves medications to quickly lower blood pressure.
  • Migraine: Given your history of chronic migraines, it's possible that your headache could be a severe migraine. However, the sudden onset and high intensity of your headache could also suggest a more serious condition, such as a hypertensive crisis or stroke.

    • Treatment for migraines typically involves pain-relieving medications and preventive medications.
  • Anxiety or Panic Attack: These can cause symptoms such as rapid heart rate, shortness of breath, and feelings of fear or discomfort. However, these conditions would not typically cause a severe headache.

    • Treatment typically involves psychotherapy (talk therapy), medications, or both.

What you can do

Given the severity and sudden onset of your symptoms, it's important to seek immediate medical attention. Call 911 or go to the nearest emergency department. While waiting for help:

  1. Try to stay calm. Sit down and take slow, deep breaths.
  2. If you have a home blood pressure monitor, check your blood pressure.
  3. If you have medications for high blood pressure or migraines, take them as directed by your doctor.

What you should look out for

You should seek immediate medical attention if you experience:

  • A severe headache that comes on suddenly
  • High blood pressure
  • Rapid or irregular heartbeat
  • Shortness of breath
  • Any new or worsening symptoms

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always seek the advice of a healthcare professional for any medical concerns.

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10 mo ago

People Also Ask


What are the symptoms of a hypertensive crisis?

Symptoms of a hypertensive crisis can include a severe headache, shortness of breath, nosebleeds, severe anxiety, and symptoms of organ damage such as chest pain or changes in vision. It requires immediate medical attention.


How can chronic migraines be distinguished from other types of headaches?

Chronic migraines are typically characterized by headaches that occur on 15 or more days per month for more than three months, with at least eight of those days having migraine features. They often include throbbing pain, sensitivity to light and sound, nausea, and sometimes aura.


What are the common symptoms of a panic attack?

Common symptoms of a panic attack include a rapid heart rate, sweating, trembling, shortness of breath, feelings of impending doom, and chest pain. These symptoms can be intense and peak within minutes.


What should I do if I experience a sudden severe headache?

If you experience a sudden severe headache, it's important to seek immediate medical attention, as it could be a sign of a serious condition like a hypertensive crisis or stroke. While waiting for help, try to stay calm, sit down, and take slow, deep breaths.


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