[55F] Experiencing palpitations, joint pain, and difficulty swallowing

Patient Description

A 55-year-old female reports experiencing daily palpitations described as heart skipping beats, particularly during the daytime and exacerbated by physical activity. These symptoms have been present for approximately 5 years and are accompanied by fatigue. The patient also has difficulty swallowing, which has been ongoing since 2018, and presents with coughing when consuming liquids and occasional near-choking episodes. Joint pain is described as an ache in both knees, left heel, left wrist, and both hips, with a severity of 4 out of 10, which is alleviated by rest. The patient had a fall resulting in injury to the left wrist. There is no chest pain, shortness of breath, lightheadedness, dizziness, fainting, swelling, redness, or warmth in the affected joints. The patient consumes 1.5 glasses of red wine weekly. Medical history includes cervical syringomyelia, Hashimoto's disease, osteoarthritis, fibromyalgia, and chronic fatigue, all diagnosed in 2019. The patient is on Synthroid for Hashimoto's disease but did not specify the dosage. No known drug allergies or family history of cardiovascular conditions was reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Thyroid Disease: Given your history of Hashimoto's disease and your symptoms of palpitations, fatigue, and difficulty swallowing, it's possible that your thyroid hormone levels may be imbalanced. Hashimoto's disease can cause hypothyroidism (low thyroid hormone levels), but in some cases, it can also cause periods of hyperthyroidism (high thyroid hormone levels), which could explain your palpitations.

    • Treatment typically involves medication to balance thyroid hormone levels.
  • Fibromyalgia: Your joint pain and fatigue could be related to your fibromyalgia, a chronic condition characterized by widespread pain and fatigue.

    • Treatment typically involves a combination of medication, exercise, stress management, and healthy lifestyle habits.
  • Osteoarthritis: This is a common form of arthritis that can cause joint pain and stiffness. Your knee, hip, and wrist pain could be related to this condition.

    • Treatment typically involves a combination of medication, physical therapy, and in some cases, surgery.
  • Dysphagia: This is a term for difficulty swallowing, which can be caused by various conditions, including neurological disorders, muscular disorders, or issues with the esophagus. Given your history of cervical syringomyelia, this could be a contributing factor.

    • Treatment depends on the underlying cause and can range from dietary changes to medication, to swallowing therapy, to surgery in some cases.

What you can do

  1. Schedule an appointment with your doctor to discuss your symptoms. They may want to adjust your Synthroid dosage or check your thyroid hormone levels.
  2. Continue to take your Synthroid as prescribed.
  3. Try gentle exercises, like walking or swimming, to help manage your joint pain. Rest when you need to.
  4. Stay hydrated and eat a balanced diet to help manage your fatigue.
  5. If you're having difficulty swallowing, try eating softer foods and take smaller bites. If you're choking on liquids, try thicker liquids or purees.

What you should look out for

Seek immediate medical attention if:

  • Your palpitations are accompanied by chest pain, shortness of breath, or fainting.
  • Your difficulty swallowing worsens or you're unable to swallow at all.
  • Your joint pain becomes severe or is accompanied by swelling, redness, or warmth.
  • You develop new or worsening symptoms.

Remember, while I strive to provide accurate information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago


People Also Ask


Can thyroid imbalances cause heart palpitations and fatigue?

Yes, thyroid imbalances, such as those caused by Hashimoto's disease, can lead to symptoms like heart palpitations and fatigue. Hypothyroidism can cause fatigue, while hyperthyroidism can cause palpitations. Treatment typically involves medication to balance thyroid hormone levels.


What are common symptoms and treatments for fibromyalgia?

Fibromyalgia is characterized by widespread pain, fatigue, and often sleep disturbances. Treatment usually includes a combination of medication, physical therapy, exercise, stress management, and lifestyle changes to help manage symptoms.


How can osteoarthritis affect daily activities and what are the treatment options?

Osteoarthritis can cause joint pain and stiffness, affecting mobility and daily activities. Treatment options include medication, physical therapy, lifestyle changes, and sometimes surgery to relieve symptoms and improve joint function.


What are the potential causes of difficulty swallowing and how is it treated?

Difficulty swallowing, or dysphagia, can be caused by neurological disorders, muscular issues, or esophageal problems. Treatment depends on the cause and may include dietary changes, medication, swallowing therapy, or surgery.

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