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Dilated Pupils, shakiness, racing heart beat
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Dilated Pupils, shakiness, racing heart beat

My daugter has had 2 episodes in the past month which led us to the initial Dr.'s appointment which was followed up with the chest xray, electrocardiogram and ultra sound which showed the slightly dilated aortic root.  
It consists of first feeling like she is going to throw up, followed by dilated pupils, shakiness and racing heart beat.  She gets very frightened.  It lasts about 10 to 15 minutes, then goes completely away.  She was not physically active either time.
What could this be?

Please reply and thank you.  
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773637_tn?1327450515
Dear Losty,

You don’t give me her age, but based on the information that you give me, I presume that your daughter is old enough to be able to talk.  However, I don’t know if she is an adolescent, in which we see these findings commonly.  The most likely cause of her symptoms is that her blood pressure may be low, and her body is trying to increase her blood pressure by putting out more adrenaline.  Therefore, before doing any further evaluation, I would make sure that she is adequately hydrated.  I recommend that she have four 8-12 ounce glasses of fluid (water, juice, milk) per day as well as a salty snack (pretzels, saltines, pickles) in addition to everything she is eating and drinking.  Notice that I didn’t include chips—don’t want to give too much fat!  I also recommend that she not skip meals and that she eliminate caffeine intake (coffee, tea, soda, energy drinks), if she is doing either of these things.  Hopefully, this will fix her symptoms.  

Another possible cause is that she is having an arrhythmia, an abnormal heart rhythm.  However, arrhythmias usually start with the abnormal heart beat, while your daughter’s other symptoms start before the heart racing.  Finally, another potential cause for these symptoms is seizures, although I don’t think that these symptoms sound particularly like that.  If these symptoms do not resolve with the interventions that I mention above, you need to return to your doctor for consideration of further evaluation.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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