[57F] Experiencing headache, dizziness, and persistent cough with shaking

Patient Description

A 57-year-old female presents with a new onset of a throbbing headache rated 7/10 for intensity, located behind the forehead, and lasting 8 hours. She is also experiencing dizziness and disorientation when standing, which has been ongoing for the same duration. The patient reports a feeling of weakness and shaking throughout the body that worsens with standing or walking and improves with sitting. Additionally, she has been coughing up thick mucus for the past few days, a symptom that has persisted for several months, and she has recently developed fever or chills. The patient has a history of COVID-19 infection 5 months prior. She is not on any medications and has no known drug allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, here are a few possibilities:

  • Influenza (Flu): The flu is a common viral infection that can cause fever, headache, cough, and body aches. It's possible that your symptoms are due to the flu, especially if you've been in contact with someone who has the flu.

    • Treatment usually involves rest, hydration, and over-the-counter medication to manage symptoms. In some cases, antiviral medication may be prescribed.
  • COVID-19: Given your history of COVID-19, it's possible that you're experiencing post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. This condition can cause a wide range of lingering symptoms, including fatigue, headache, and cough.

    • Treatment typically involves managing symptoms and may require a multidisciplinary approach.
  • Dehydration: Dehydration can cause symptoms like dizziness, weakness, and confusion. If you've been coughing a lot and not drinking enough fluids, you could be dehydrated.

    • Treatment involves rehydrating by drinking fluids and eating foods high in water content.
  • Migraine: Migraines can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days.

    • Treatment is usually with over-the-counter pain relievers. However, if they're severe, prescription medications and self-care measures may help.

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

What you can do

  1. Rest and hydrate: Make sure you're getting plenty of rest and drinking enough fluids. This can help with many of the symptoms you're experiencing.
  2. Over-the-counter medication: Over-the-counter pain relievers can help with your headache and body aches. Over-the-counter cough suppressants can also help with your cough.
  3. Monitor your symptoms: Keep track of your symptoms and seek medical attention if they worsen or don't improve.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe headache or headache that worsens
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in your chest
  • New confusion or inability to arouse
  • Bluish lips or face

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

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People Also Ask


What are the common symptoms of long COVID and how can they be managed?

Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), can include symptoms such as fatigue, headache, cough, difficulty concentrating, and muscle pain. Management typically involves symptom relief, such as rest, hydration, and sometimes physical therapy or medications, depending on the symptoms.


How can dehydration contribute to dizziness and weakness, and what are the best ways to rehydrate?

Dehydration can lead to dizziness and weakness because it reduces blood volume, which can lower blood pressure and decrease blood flow to the brain. Rehydration can be achieved by drinking water, oral rehydration solutions, or consuming foods with high water content like fruits and vegetables.


What are the distinguishing features of a migraine compared to other types of headaches?

Migraines are often characterized by a severe throbbing or pulsing pain, usually on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. Unlike tension headaches, migraines can cause significant pain and may last from hours to days.


How can one differentiate between symptoms of the flu and COVID-19?

Both the flu and COVID-19 can cause fever, cough, and body aches, but COVID-19 may also include symptoms like loss of taste or smell, and more severe respiratory issues. Testing is the most reliable way to differentiate between the two, as symptoms can overlap significantly.


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