Unusual Symptoms

Question

HI all, I'm 29 years old.  I'm here to see if anyone may have some help with some symptoms I've been experiencing the past few months.  It started in July one night I awoke to a fast heart rate, chest pain, flushing, hard time breathing and extreme dizziness that got worse when I tried to get up and walk around.  I called 911 and went to the hospital as I thought I was dying.  I was ruled out for cardiac issues, clot in my lung.  The remainder of the month I was evaluated by a cardiologist as I had a baseline abnormal EKG.  I had a 64 slice CT of my heart to rule out cardiac blockages, or problems with the heart vessels that may have been from birth.  Needless to say all the tests were normal.  I had my thyroid checked, again normal.  I wore an event monitor for 30 days, again all normal, with the exception of a few times of regular rhythm, but fast heart rate.  So, I was put on Toprol XL (a BP med used to control heart rate too).  For the next few months I felt "normal".  I took my medication every morning and was doing well.  In November of 2008, one night I awoke to the exact same symptoms as in July.  This time I didn't call the ambulance, but waited it out at home with my husband.  After about 3 1/2 hours of feeling horrible, I finally fell back asleep.  Anyway, since that night I have not felt the same or "normal."  I have lost almost 15 pounds, will have days of such extreme fatigue I have to go lay down in bed.  I have days that I feel okay, and then days I don't.  When I get my "episodes" as I like to call them, I go from feeling okay to getting facial flushing, extreme fatigue, achey and in some instances I feel mild lightheadedness.  I have migraines, but have also experienced an increase in headaches the past few months, differing from my typical migraine.  In late November and early December I still had issues with my heart rate going from a normal rate of about 65 up to 145 (recorded again from an event monitor) that I had to wear a second time for 30 days in December.  At times, I do feel anxiety type symptoms, especially at night, or when I've been awoken in the middle of the night.  I don't feel anxiety symptoms though when I feel the fatigue, etc.  I even tried to go on Lexapro (a antianxiety medication) to see if this was all just anxiety or stress related, and it made me feel  horrible.  I only took 2 doses and stopped it immediately.  I'm seeing an endocrinologist right now who has ruled out pheochromocytoma, again thyroid all normal.  She's now ruling out some more serious conditions such as an endocrine tumor, etc.  I have no idea what is going on, but would like to know if anyone has any suggestions or has had any similar symptoms.  Thanks for any help, it would be greatly appreciated.

Rosi3e · Answer

I have the same "attacks".  I wake up suddenly, my heart racing, feel nausious.  All the other things losing weight and being fatigue too.  I noticed this all happens at the same time when I'm extremly stressed out.  They also happen when i hear a bang, like a door slam and i wake up the same way, i always just assumed it was a panic attack because thats what it feels like.

BBoo79 · Answer

Thanks for the suggestion.  They did actually check the first time this happened my magnesium level and it was normal.

caregiver222 · Answer

Very good Drnee.  Another cause of atrial sensitivity is magnesium deficiency. A magnesium glycinate supplement will sometimes cure atrial fibrillation and resolve bouts of tachycardia.

BBoo79 · Answer

Thanks for commenting!! My h/h were normal. My B12 levels were low normal, around 320. I have had some issues since the birth of my second child with GERD. I occasionally will take Pepcid OTC twice a day, when I feel it, which usually will help. When it's reflux I usually will get a "full sensation" in my throat and some chest discomfort, different from the other chest pain I've felt. I have a great PCP, who has truly listened to my symptoms and we are trying to look at all possibilities. I've even tried GI cocktails to see if I was having esophogeal spasms, since I do have GERD from time to time, and I didn't get any relief when I felt the other chest pain. I'm pending some recent tests that were ordered by my endocrinologist, an am cortisol, ACTH, CBC, CMP, and a urine HIAA and creatinine. If this all comes back okay, I'm leaning more towards the idea that this may be stress related despite no real anxiety symptoms, except for occasionally at night. I just want to go back to feeling somewhat "normal" again. The only other thing I did not mention above is I do have a cyst on my left ovary that I'm following up with my gyn next week on. I have a history of endometriosis and have had surgery to remove an endometrioma that ruptured on my right ovary a few years back. If this is a complex cyst or endometrioma could this cause any of the above mentioned symptoms? I've had some discomfort in my left lower pelvic area for a while, but because of everything else going on I just put off going to my gyn and figured it was probably a cyst and it would eventually go away, but it hasn't and it's become more uncomfortable. I didn't think that this would be related, but I figured I would ask! Thanks again for your help!

KMathurMD · Answer

Hi 
Thanks for writing to the forum! 
There are a few other causes of increased heart beat that should be looked into. One is acidity. Since you have ‘attacks’, usually at night, chances of acidity are very high. It could also be due to low blood glucose at that time. Fatigue and anxiety can be explained by low blood glucose. GERD and hiatal hernia too can present this way. Anxiety and panic attacks too can cause similar symptoms. Anemia is another reason for increased heart rate, fatigue and thus anxiety.
It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!