Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Nausea And Chills
Question: I wanted to get an opinion on whats been happening lately. I woke up from a sleep feeling like i could not breathe and also like my heart stopped or was not in rhythym. So sat up and my heart started racing like 130 bpm. I went and splashed cold water on my face and felt a little better but my heart continued to race for a bit around 108/110 bpm and i felt nausea, and then it started to calm down and i started to get extreme chills and chattering in my teeth. :(. Finally all subsiding after 30 minutes. This all has happened before. I see a cardiologist and have had multiple ekg's, stress echo, echocardiogram. Everything fine except occasional pac's and pvc's and some slight tachycardia occasionally. :( im so stressed about these episodes and dont know what is causing them. :(. My cardiologist suggested Atenolol but im afraid to take that. What is your opinion and plan if this was happening to your patient :(. Thank you!
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I understand your concern and would like to explain that several reasons may be responsible for your unpleasant feeling during waking up that morning.
As your cardiac tests have resulted normal, any important structural heart disease is excluded; also no complex rhythm or conductance disorder is concluded.
Though it is difficult to exactly predict your heart rate before waking up, it is quite possible that a vegetative nervous system imbalance be responsible during those moments.
Whether all the above has been triggered by a metabolic disorders such as morning hypoglycemia or presence of anemia, or a thyroid gland dysfunction it remains to be investigated.
In addition, also an anxiety disorder may be a common trigger of morning palpitations, but it could be blamed only in case no other reasons were responsible.
Coming to this point, it is necessary performing some additional medical tests as follows:
- complete blood count (for excluding possible anemia),
- fasting blood glucose level and glucose tolerance test,
- glycosylated hemoglobin (HbA1c),
- thyroid hormones levels,
- blood electrolytes level
If the above tests result normal, but the unpleasant feeling is repeated again, then I would suggest consulting a neurologist for a careful physical exam and eventually an electroencephalogram (EEG) to be sure that no abnormal brain electrical activity is responsible.
Regarding Atenolol, I would not be in favor of starting it immediately considering your young age (it may decrease your physical activity performance) and also because it may mask potential hypoglycemia symptoms (in case of an impaired glucose metabolism).
That's my opinion.
You need to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome on HCM!
I understand your concern and would like to explain that several reasons may be responsible for your unpleasant feeling during waking up that morning.
As your cardiac tests have resulted normal, any important structural heart disease is excluded; also no complex rhythm or conductance disorder is concluded.
Though it is difficult to exactly predict your heart rate before waking up, it is quite possible that a vegetative nervous system imbalance be responsible during those moments.
Whether all the above has been triggered by a metabolic disorders such as morning hypoglycemia or presence of anemia, or a thyroid gland dysfunction it remains to be investigated.
In addition, also an anxiety disorder may be a common trigger of morning palpitations, but it could be blamed only in case no other reasons were responsible.
Coming to this point, it is necessary performing some additional medical tests as follows:
- complete blood count (for excluding possible anemia),
- fasting blood glucose level and glucose tolerance test,
- glycosylated hemoglobin (HbA1c),
- thyroid hormones levels,
- blood electrolytes level
If the above tests result normal, but the unpleasant feeling is repeated again, then I would suggest consulting a neurologist for a careful physical exam and eventually an electroencephalogram (EEG) to be sure that no abnormal brain electrical activity is responsible.
Regarding Atenolol, I would not be in favor of starting it immediately considering your young age (it may decrease your physical activity performance) and also because it may mask potential hypoglycemia symptoms (in case of an impaired glucose metabolism).
That's my opinion.
You need to discuss with your attending doctor on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was diagnosed with reactive hypoglycemia and pre diabetes. I have had all the other blood work tests. I am not anemic but had low iron count. Not that off. It was not my blood sugar as i did check the level and i do so frequently. This also happened at 2 am not waking in the morning. I had an at home sleep study done and it said i had mild sleep apnea but my primary care thought maybe i would benefit from a sleep study at a place as it is more in depth. The heart issues and racing has gotten worse since i wad diagnosed with reactive hypoglycemia. I have been controlling it well with diet so i havent had too many lows. I do have depression and anxiety. Which has been worse since being diagnosed with the reactive hypoglycemia 5 months ago :( im just not sure what to do.
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
As you have performed a lot of diagnostic workup and reactive hypoglycemia has resulted, then it would be necessary some life-style changes including a balanced diet with high-fiber foods (whole grains, fruits and vegetables).
Also, eating several small meals and snacks throughout the day, no more than three hours apart during the waking hours would be beneficial.
Avoid sugary foods on an empty stomach.
As sleep apnea may adversely influence vegetative nervous system imbalances it is necessary to further explore in this regard. Arterial blood gas analyses should be check to exclude occasional hypoxemia.
The best strategy to afford with this situation (including anxiety) would be following a physically active daily profile (at least one hour daily walking, but also cycling, swimming, aerobics, yoga, etc).
Reducing body weight would be necessary to better control glycemic metabolism imbalances and avoid sleep disorders.
In conclusion, I would like to assure you that nothing so dangerous comes from reactive hypoglycemia; you just need to follow the adequate life-style recommendations and periodical followups by your attending doctor.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
As you have performed a lot of diagnostic workup and reactive hypoglycemia has resulted, then it would be necessary some life-style changes including a balanced diet with high-fiber foods (whole grains, fruits and vegetables).
Also, eating several small meals and snacks throughout the day, no more than three hours apart during the waking hours would be beneficial.
Avoid sugary foods on an empty stomach.
As sleep apnea may adversely influence vegetative nervous system imbalances it is necessary to further explore in this regard. Arterial blood gas analyses should be check to exclude occasional hypoxemia.
The best strategy to afford with this situation (including anxiety) would be following a physically active daily profile (at least one hour daily walking, but also cycling, swimming, aerobics, yoga, etc).
Reducing body weight would be necessary to better control glycemic metabolism imbalances and avoid sleep disorders.
In conclusion, I would like to assure you that nothing so dangerous comes from reactive hypoglycemia; you just need to follow the adequate life-style recommendations and periodical followups by your attending doctor.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I also have like a strange cold or sweat feeling on the back of neck/ upper back. This has been happening since being diagnosed . :(
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
This feeling in the neck, could be explained with the muscle tension from anxiety.
But, there is nothing to worry about!
Hope to have clarified some of your uncertainties!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
This feeling in the neck, could be explained with the muscle tension from anxiety.
But, there is nothing to worry about!
Hope to have clarified some of your uncertainties!
Wishing all the best,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
