[56F] Experiencing leg weakness, fatigue, and episodes of heart racing

Patient Description

A 56-year-old female has been experiencing leg weakness, particularly in the right leg since a back surgery in 2019, with recent exacerbation in the past 4-6 weeks. The weakness is more pronounced in the mornings and is accompanied by shaking, especially when descending stairs, and a sensation of heavy legs after lying down. She also reports fatigue, anxiety, and episodes of heart racing that can lead to feelings of impending fainting, which began a couple of months ago. Additionally, she has noticed brief flashes of light in her peripheral vision off and on for several weeks. The patient has a history of anxiety and depression, managed with Wellbutrin and various supplements, and has an allergy to sulfa drugs. She is also a full-time caregiver for her mother with Parkinson's disease, which has been a source of significant stress for over two years.

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Arora's Assessment

What might be happening

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

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity but doesn't improve with rest. Other symptoms can include weakness, sleep disturbances, and cognitive difficulties.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It's often triggered by a stressful event, including physical stress or emotional (psychological) stress.

  • Anxiety Disorder: Given your history of anxiety and the symptoms you've described, it's possible that your physical symptoms are being exacerbated by anxiety. Anxiety can cause a variety of physical symptoms, including fatigue, heart palpitations, and feelings of being out of control or on edge.

  • Caregiver Stress Syndrome: This is a condition characterized by physical, emotional, and mental exhaustion. It often results from the unrelieved responsibility of caring for a long-term ill or disabled loved one. Symptoms can include fatigue, stress, anxiety, and depression.

  • Post-Acute Sequelae of SARS-CoV-2 infection (PASC): Given your mention of a virus in January, it's also possible that you're experiencing PASC, also known as Long COVID. Symptoms can include fatigue, cognitive difficulties, and heart palpitations.

What you can do

  1. Consult a healthcare professional: Given the range of possible explanations for your symptoms, it's important to consult a healthcare professional who can conduct a thorough evaluation and provide a diagnosis. They may suggest blood tests, imaging studies, or other diagnostic tests.

  2. Manage stress: Try to incorporate stress management techniques into your daily routine. This could include physical activity, relaxation exercises (like deep breathing, yoga, or tai chi), or talking things over with a counselor or psychotherapist.

  3. Maintain a healthy lifestyle: Try to eat a balanced diet, get regular exercise, and ensure you're getting enough sleep. Avoid caffeine and alcohol, as these can exacerbate feelings of anxiety and fatigue.

  4. Seek support: If you're feeling overwhelmed by your caregiving responsibilities, don't hesitate to ask others for help. Reach out to local community organizations, a social worker, or a healthcare provider to learn about respite care and other support services that may be available to you.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe chest pain or pressure
  • Trouble breathing
  • Confusion or difficulty waking up
  • Fainting or loss of consciousness
  • Any other symptom that is severe or concerning

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include extreme fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, sore throat, and cognitive difficulties such as memory or concentration problems.


How can anxiety disorders manifest physically?

Anxiety disorders can manifest physically through symptoms such as heart palpitations, sweating, trembling, shortness of breath, dizziness, fatigue, and gastrointestinal issues. These symptoms can vary in intensity and may be triggered by stress or anxiety-provoking situations.


What is Caregiver Stress Syndrome and how can it affect health?

Caregiver Stress Syndrome is a condition resulting from the prolonged stress of caring for a chronically ill or disabled loved one. It can lead to physical, emotional, and mental exhaustion, and symptoms may include fatigue, anxiety, depression, and a weakened immune system.


What are the potential causes of seeing flashes of light in peripheral vision?

Seeing flashes of light in peripheral vision can be caused by several factors, including migraines, retinal detachment, or vitreous detachment. It is important to consult an eye care professional to rule out serious conditions, especially if the flashes are persistent or accompanied by other visual changes.


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