Chest Pain, Dizziness, Loss of Appetite, and Fatigue

Chest pain, dizziness, loss of appetite, and feeling fatigued?

Hello, Doctor! I am the first lady of the universe from the Flowering Years.
I would like to seek your guidance on the following cases:
Case 1: I started experiencing left chest pain in middle school, and it has become more frequent recently.
The pain can occur in any situation, sometimes while exercising, sometimes while eating, and even while sleeping, which can wake me up.
The pain feels like a tearing sensation.
The duration of the pain varies; it usually lasts less than a minute, but there are times when it persists for a longer period.
Case 2: For the past six months, I have often felt dizzy, even while lying in bed.
There was an incident where I fell and injured my head due to dizziness.
When I feel dizzy, my vision suddenly becomes black and white and blurry, accompanied by a ringing in my ears, making it difficult to hear the music I play; all I can hear is a buzzing sound in my head.
Case 3: In the past few weeks, I have lost my appetite and often go 24 hours without eating or even drinking water.
This is not due to a desire to lose weight or diet; I simply have no appetite.
I don't feel like eating anything, and even when I force myself, I can only eat a small amount—at most three dumplings in one meal.
If I eat more than that, I feel nauseous and may vomit, but it's usually just a small amount.
Thank you, Doctor, for taking the time to address my concerns.

Yǔzhòu Dì Yī Xiǎojiě, 20~29 year old female. Ask Date: 2017/11/17

Dr. Liao Yaopan reply Family Medicine

Regarding the above situation, it is advisable to consult your family physician for an in-person evaluation.
Please note that online consultations are not equivalent to an in-person visit and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about your well-being.

Reply Date: 2017/11/17

More Info

Understanding the symptoms of chest pain, dizziness, loss of appetite, and fatigue is crucial, as these can be indicative of various underlying health issues. Your description of these symptoms raises several important considerations that warrant a thorough evaluation by a healthcare professional.

Chest Pain
The chest pain you describe, which has been occurring since middle school and has become more frequent, can be concerning. Chest pain can arise from various causes, including musculoskeletal issues, gastrointestinal problems, or cardiac conditions. The nature of your pain—sharp and tearing, sometimes occurring during physical activity or even while resting—suggests that it could be related to the heart or other serious conditions, especially if it is accompanied by other symptoms such as dizziness or shortness of breath.

Given that the pain can last from a few seconds to several minutes, it is essential to consider the possibility of angina, which occurs when the heart muscle does not receive enough blood. However, other non-cardiac causes, such as anxiety or panic attacks, can also manifest as chest pain. It is crucial to consult a healthcare provider to rule out any serious cardiac conditions, especially if you have risk factors such as a family history of heart disease, smoking, or high blood pressure.

Dizziness
Your episodes of dizziness, particularly the one that resulted in a fall, are also concerning. Dizziness can stem from various causes, including vestibular disorders, dehydration, low blood pressure, or neurological issues. The sensation of your vision becoming black and white, along with tinnitus (ear ringing), suggests that your dizziness may have a neurological component. Conditions such as migraines, vestibular neuritis, or even more serious issues like transient ischemic attacks (TIAs) should be considered.

Loss of Appetite
The loss of appetite you are experiencing, coupled with significant weight loss and nausea, is another red flag. A sudden change in appetite can be linked to psychological factors such as depression or anxiety, especially if you are under stress or experiencing emotional turmoil. However, it can also indicate gastrointestinal issues, infections, or metabolic disorders. The fact that you feel nauseated after eating suggests that there may be an underlying issue that needs to be addressed.

Fatigue
Fatigue is a common symptom that can result from a variety of factors, including physical health issues, mental health conditions, or lifestyle factors. Chronic fatigue, especially when combined with other symptoms like chest pain and dizziness, should not be overlooked. Conditions such as anemia, thyroid disorders, or chronic fatigue syndrome could be contributing to your overall sense of exhaustion.

Recommendations
1. Seek Immediate Medical Attention: Given the combination of chest pain, dizziness, loss of appetite, and fatigue, it is crucial to seek medical attention as soon as possible. A healthcare provider can perform a comprehensive evaluation, including a physical examination, blood tests, and possibly imaging studies, to determine the underlying cause of your symptoms.

2. Keep a Symptom Diary: Documenting when your symptoms occur, their duration, and any associated activities can provide valuable information to your healthcare provider.

3. Mental Health Evaluation: Considering the potential psychological components of your symptoms, it may be beneficial to speak with a mental health professional. Anxiety and depression can significantly impact physical health and may be contributing to your symptoms.

4. Lifestyle Modifications: While waiting for your appointment, consider making small changes to your lifestyle. Staying hydrated, eating small, frequent meals, and engaging in gentle physical activity, if tolerated, may help alleviate some symptoms.

In conclusion, the symptoms you are experiencing are complex and multifaceted. A thorough evaluation by a healthcare professional is essential to identify the underlying causes and develop an appropriate treatment plan. Your health is paramount, and addressing these symptoms early can lead to better outcomes.

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