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What Causes Tachycardia, Dizziness, Pain In The Temple And Low Grade Fever?
Question: Low blood pressure and rapid heart rate.
I have been suffering vision impairment and slight dizziness for the past 6 weeks. Starting approximately 4 weeks ago, I started to experience palpitations and worsening dizziness.
Since then, I have had constant increased heart rate - 90 bpm resting and 115 to 125 while standing -, vision impairment, low blood pressure - 101/53 to 80/58 -, swollen temporal arteries, headache above temples, sharp pain near temples, decreased circulation and tingling, low grade fever, ringing in ears, confusion, dizziness while lying down, and constant tremulousness. While I am sleeping, my heart will wake me up because it begins to beat so fast. Once I'm awake it takes a while to slow down and I will experience shakiness. These symptoms are all ongoing. I also experience occasional feelings of warm flush through my abdomen and pelvis. I have not been able to sit up or stand longer than going to the bathroom, and have mostly been in bed.
I have had numerous EKGS and they all looked fine except for the fast heart rate. I have had repeat CBC that show an increase in RBC and MPV, and elevated bilirubin which has gone from 2.1 to 1.8 to 2.4 to 2.7. I've had an ultrasound of my liver which appeared to look "beautiful." I have had Hep A, B, and C tested and negative. Anxiety has been ruled out since I was given anti-anxiety medication and it did not lessen symptoms. I saw a cardiologist who is setting me up on a 30 day monitor and a sleep study because of the night episodes. He says this doesn't seem like a heart problem, though. I feel as though I'm not getting adequate blood flow to my brain. Could this be because of the low BP and high rbc?
I have been suffering vision impairment and slight dizziness for the past 6 weeks. Starting approximately 4 weeks ago, I started to experience palpitations and worsening dizziness.
Since then, I have had constant increased heart rate - 90 bpm resting and 115 to 125 while standing -, vision impairment, low blood pressure - 101/53 to 80/58 -, swollen temporal arteries, headache above temples, sharp pain near temples, decreased circulation and tingling, low grade fever, ringing in ears, confusion, dizziness while lying down, and constant tremulousness. While I am sleeping, my heart will wake me up because it begins to beat so fast. Once I'm awake it takes a while to slow down and I will experience shakiness. These symptoms are all ongoing. I also experience occasional feelings of warm flush through my abdomen and pelvis. I have not been able to sit up or stand longer than going to the bathroom, and have mostly been in bed.
I have had numerous EKGS and they all looked fine except for the fast heart rate. I have had repeat CBC that show an increase in RBC and MPV, and elevated bilirubin which has gone from 2.1 to 1.8 to 2.4 to 2.7. I've had an ultrasound of my liver which appeared to look "beautiful." I have had Hep A, B, and C tested and negative. Anxiety has been ruled out since I was given anti-anxiety medication and it did not lessen symptoms. I saw a cardiologist who is setting me up on a 30 day monitor and a sleep study because of the night episodes. He says this doesn't seem like a heart problem, though. I feel as though I'm not getting adequate blood flow to my brain. Could this be because of the low BP and high rbc?
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms (changes in blood pressure and heart rate) seem to be related to orthostatic intolerance.
From the other hand the other symptoms (low grade fever, confusion, sharp pain near the temples, elevated bilirubin levels) could be related to an infection or an inflammatory disorder.
Orthostatic intolerance can also be caused by a chronic infection or an inflammatory disorder.
Coming to this point, I would recommend performing further tests to investigate for the possible underlying causes:
-PCR, sedimentation rate, fibrinogen levels for an inflammatory disorder
- screening for Lyme disease
- LDH levels
- a chest X ray study
- a brain CT scan may be necessary to exclude other possible causes of the headache.
You should consult with an infectious disease specialist to investigate for a possible chronic infection underlying your symptoms, especially in case of elevated inflammation tests. Further tests may be needed to establish the cause.
I agree with your cardiologist that the problem seems to be more related to an autonomic nervous system dysfunction than a cardiac disorder. But the prolonged ECG monitoring will help too.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would explain that your symptoms (changes in blood pressure and heart rate) seem to be related to orthostatic intolerance.
From the other hand the other symptoms (low grade fever, confusion, sharp pain near the temples, elevated bilirubin levels) could be related to an infection or an inflammatory disorder.
Orthostatic intolerance can also be caused by a chronic infection or an inflammatory disorder.
Coming to this point, I would recommend performing further tests to investigate for the possible underlying causes:
-PCR, sedimentation rate, fibrinogen levels for an inflammatory disorder
- screening for Lyme disease
- LDH levels
- a chest X ray study
- a brain CT scan may be necessary to exclude other possible causes of the headache.
You should consult with an infectious disease specialist to investigate for a possible chronic infection underlying your symptoms, especially in case of elevated inflammation tests. Further tests may be needed to establish the cause.
I agree with your cardiologist that the problem seems to be more related to an autonomic nervous system dysfunction than a cardiac disorder. But the prolonged ECG monitoring will help too.
Hope you will find this answer helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello, doctor. Thank you for answering my questions.
I have had three CT scans of the brain done and they all seem to be unremarkable. Chest x-ray as well. I had a full panel for Lymes disease and other tick related illnesses drawn and I am just waiting the results. I had an ESR and CRP run last night to check for Giant Cell Arteritis since I have giant platelets present in my blood. I was told they were negative, but also that you can still have GCA with those results.
I previously had symptoms, such as nerve pain across the chest and tingling on my face, head, and bottom of feet, that have subsided. They seem to be replaced by sharp headache, throbbing/pulsing in my head, and sleep disturbances. The shaking/tremors have gotten so bad that I have them even sitting in bed.
Thank you for taking the time to look over my symptoms.
I have had three CT scans of the brain done and they all seem to be unremarkable. Chest x-ray as well. I had a full panel for Lymes disease and other tick related illnesses drawn and I am just waiting the results. I had an ESR and CRP run last night to check for Giant Cell Arteritis since I have giant platelets present in my blood. I was told they were negative, but also that you can still have GCA with those results.
I previously had symptoms, such as nerve pain across the chest and tingling on my face, head, and bottom of feet, that have subsided. They seem to be replaced by sharp headache, throbbing/pulsing in my head, and sleep disturbances. The shaking/tremors have gotten so bad that I have them even sitting in bed.
Thank you for taking the time to look over my symptoms.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
I agree with you that Giant cell arteritis can cause severe headache in the temporal regions.
That is one of the reasons, why I recommended performing PCR and ESR.
But, as your symptoms are more generalized, showing a dysfunction of the autonomic nervous systems, I would recommend checking for a more generalized problem like Lyme or any other infection.
All your performed tests will help orient toward the possible underlying cause.
A brain MRI would help examine better your brain and brain covering layers (called meninges) and would give more information compared with the CT scan (including temporal arteritis).
An EEG would help exclude possible seizures, which could explain the shaking or tremors.
You should discuss with your doctor on the above issues.
Hope you will find this answer helpful!
Best wishes,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello again!
Thank you for the additional information.
I agree with you that Giant cell arteritis can cause severe headache in the temporal regions.
That is one of the reasons, why I recommended performing PCR and ESR.
But, as your symptoms are more generalized, showing a dysfunction of the autonomic nervous systems, I would recommend checking for a more generalized problem like Lyme or any other infection.
All your performed tests will help orient toward the possible underlying cause.
A brain MRI would help examine better your brain and brain covering layers (called meninges) and would give more information compared with the CT scan (including temporal arteritis).
An EEG would help exclude possible seizures, which could explain the shaking or tremors.
You should discuss with your doctor on the above issues.
Hope you will find this answer helpful!
Best wishes,
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
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