Academic literature on the topic 'Fatigue and palpitations'

Every woman will experience menopause later in her life. The menopause symptoms affecting the quality of life are hot flashes, sweating, palpitations, headache, insomnia, muscle-bone pain, fatigue, depression, loss of attention, forgetfulness, decreased libido, vaginal atrophy and urinary problems. Complementary and alternative therapies (CAM) have a very important place among the methods to be used. CAM methods frequently preferred by women in menopause are acupuncture, acupressure, yoga, phytoestrogen, reflexology, diet and exercise.

An older patient presents with fatigue, exertional dyspnea, exertional chest tightness, and palpitations. Cardiopulmonary exercise testing (CPET) showed low biventricular filling pressure and poor peripheral oxygen extraction as a cause of dyspnea, consistent with preload failure. Tilt test demonstrated postural tachycardia syndrome (POTS), neuropathic form.

Abstract Due to the underlying cause or to the anemia itself: Fatigue, dyspnea, palpitations, headache, tinnitus, anorexia, dyspepsia, bowel disturbance and angina if there is pre-existing coronary artery disease. Patients who have developed their anemia rapidly are often more symptomatic than those who have developed anemia slowly, in which case there has been time for physiologic compensations for their anemia to occur.

Although some patients are concerned that their critical organs are involved in fibromyalgia, chest area symptoms infrequently are related to heart or lung disease. Palpitations, noncardiac chest pain, and subjective swelling or edema are important symptoms and signs of fibromyalgia. Reflux from the esophagus, gastrointestinal complaints, and female organ-related problems are also reviewed in this chapter in the context of fibromyalgia-associated concerns. The pounding in her chest was becoming unbearable, and Georgia was sure she would pass out. The sensation had been noticed before, but it usually stopped after several seconds. After several minutes, Georgia no longer felt lightheaded or dizzy. She broke into a cold sweat and heaved a sigh of relief. Her internist was aware of Georgia’s intermittent musculoskeletal aches and spasms and fatigue, which were managed with ibuprofen and occasional cyclobenzaprine (Flexeril) at night. When Georgia mentioned her fatigue to Dr. Baker, her comments were greeted with silence and not immediately pursued. Consequently, she drank four Diet Cokes to make it through the workday in addition to her morning coffee. Dr. Baker ordered a two-dimensional echocardiogram (a heart image in ultrasound) that demonstrated evidence of mitral valve prolapse. He told Georgia that the palpitations were brought on by drinking too much caffeine, and said that if she could not reduce her caffeine intake substantially, he would have to prescribe a beta-blocker to control her heart rate. The sense of having extra heartbeats, or palpitations, is reported in l0–20 percent of patients with fibromyalgia. Although heart disease, caffeine intake, anxiety, and other factors are associated with palpitations, many otherwise healthy young women have mitral valve prolapse. The prevalence of mitral valve prolapse is clearly increased in fibromyalgia. The mitral valve, one of the four valves of the heart that lies between its right-sided chambers, can become more floppy under ANS influence and produce palpitations. Patients feel as though they will pass out but rarely do. Mitral valve prolapse is also associated with chest pains and shortness of breath and can be easily diagnosed by a heart ultrasound known as a two-dimensional echocardiogram.

Dysfunctional breathing encompasses a range of breathing pattern abnormalities with breathlessness and overbreathing in the absence of or in excess of any physiological abnormality. Hyperventilation syndrome is a form of dysfunctional breathing and the terms are often used interchangeably. Dysfunctional breathing may occur as part of a spectrum of physical symptoms (e.g. chest pain, palpitations/tachycardia, fatigue, dizziness, paraesthesiae, headache, diarrhoea, inappropriate sweating, etc.) from anxiety or panic disorder.

Post-acute COVID-19 syndrome (PACS) describes the clinical condition of some SARS-CoV-2-infected patients in which a wide range of signs and symptoms that persist for several months after the acute phase of the disease. Cardiovascular symptoms including chest pain, dyspnea, elevated blood pressure, palpitations, inappropriate tachycardia, fatigue, and exercise intolerance are common in this condition. Some infected patients develop cardiovascular diseases such as myocarditis, pericarditis, new or worsening myocardial ischemia due to obstructive coronary artery disease, microvascular dysfunction, stress cardiomyopathy, thromboembolism, cardiovascular sequelae of pulmonary disease, arrhythmias, while others have cardiovascular symptoms without objective evidence of cardiovascular abnormalities. In the present chapter, definition, spectrum of manifestations, clinical scenarios, diagnosis, management, and therapy of cardiovascular PACS will be discussed.

We present a 31-year-old male without any comorbidities who presented to the emergency room (ER) with a 2-week history of polyuria, polydipsia, constipation, and fatigue. He also reported a weight loss of 40 lb over the last 3 months. During the interview, he mentioned having oily skin and acne all of his life. He denied palpitations, hyperhidrosis, or difficulty with sexual activity. Physical exam was striking for frontal bossing, prognathism, hypertrichosis, and large hands and feet, suggesting acromegaly. No acanthosis nigricans or acrochordons was noted. Initial lab work revealed the following: blood glucose 241 mg/dL, serum bicarbonate 12 mEq/L, anion gap 31, β-hydroxybutyrate >8 mmol/L, ketonuria on urinalysis, and HbA1c of 13.1%. Islet cell anti-GAD antibodies were negative.

PHT is a haemodynamic and pathophysiological state that can be found in multiple clinical conditions. Each group has differing characteristic pathological features, but vasoconstriction, remodelling of the pulmonary vessel wall, medial hypertrophy of distal pulmonary arteries ± fibrotic change, and thrombosis lead to raised pulmonary vascular resistance and ultimately right heart failure. The symptoms of PHT are primarily due to RV dysfunction. The symptoms are non-specific, often leading to a delay in diagnosis from first symptoms, which include exertional breathlessness, due to the inability to increase cardiac output with exercise. WHO functional assessment classification is used to quantify the condition. Other symptoms include chest pain (right heart angina), fatigue and weakness, syncope or pre-syncope, due to a fall in systemic BP on exercise, palpitations, peripheral oedema and other signs of right-sided fluid overload.

Graves’ disease (GD) is an autoimmune disorder characterized by presence of TSH receptor autoantibody. It is most common cause of hyperthyroidism worldwide. Though GD can occur any age but peak incidence is seen during adulthood in between 20 to 50 years of age. GD is more commonly seen in female. GD is primarily disease of thyroid gland but affects multi organ system i.e. heart, liver, muscle, eye and skin. Symptoms and signs are result from hyperthyroidism or a consequence of underlying autoimmunity. Weight loss, fatigue, heat intolerance, tremor, and palpitations are the most common symptoms. Diffuse goiter presents in most of younger patients with thyrotoxicosis but less common in older patients. Graves’ ophthalmopathy and pretibial myxedema are extrathyroidal manifestations of GD which results from action of TSHR autoantibodies on TSHR present onfibroblast, adipocyte and T cells in extrathyroidal tissue. Treatment of GD remains in between antithyroid drugs, radioiodine or surgery. In this review we discuss the diagnosis and management of GD.

The diagnosis of hypertrophic cardiomyopathy (HCM) in adults is based on the presence of left ventricular wall thickness greater than 15 mm using any imaging modality on at least one myocardial segment and not explained solely by abnormal cardiac loading conditions; a 13 mm threshold should be applied for familial screening in first-degree relatives. Diagnosis in children, in the elderly, in hypertensive individuals, and in elite athletes may be challenging. Initial evaluation should include a family pedigree, evaluation of signs and symptoms, electrocardiogram, and 48 h Holter electrocardiogram monitoring, exercise testing, imaging, and biochemistry. The presence of an intraventricular left ventricular obstruction, present in two-thirds of the patients at rest, during Valsalva or exercise, should be systematically evaluated using echocardiography. Cardiovascular magnetic resonance imaging with late gadolinium enhancement should always be considered, particularly to assess apical hypertrophy, left ventricular aneurysms, and fibrosis. This systematic approach is recommended to assist in the detection of HCM not caused by mutations in cardiac sarcomere protein genes (up to 10% of patients). Genetic tests should be performed and interpreted after a careful and complete clinical evaluation and genetic counselling. HCM is characterized by symptoms of dyspnoea, fatigue, chest pain, palpitations, and syncope, which are highly variable. Functional limitation may be difficult to evaluate and often necessitates cardiopulmonary exercise testing.