OpenHealth Q&A

Seeking Clarity on Ongoing Symptoms

In December last year, I found myself in a local emergency room due to alarming symptoms, including a racing heartbeat that fluctuated between 160 to 190 beats per minute, clammy skin, dizziness, and difficulty breathing. The episode began while I was simply resting in bed after a trip to the bathroom, prompting me to call 911. Despite being administered beta-blockers, my heart rate remained elevated, leading to a series of diagnostics. Initial x-rays revealed an anomaly in my lungs, which prompted further investigation through three CT scans—one of which did not capture the lower portions of my lungs. These scans identified three obscure spots in my lower lungs. Given my use of 50 mg of testosterone gel and elevated D-Dimer levels, there was uncertainty about the nature of the findings. The following day, I underwent a lung perfusion test and was put on IV antibiotics that caused nausea. An echocardiogram and an ultrasound of my legs both returned normal results. I spent three nights in observation, during which the pulmonologist and my primary physician diagnosed me with a pulmonary embolism induced by testosterone. They initiated treatment with Eliquis and advised me to halt testosterone therapy until New Year’s. Unfortunately, I soon experienced shortness of breath again and visited a different hospital associated with Kaiser Permanente, driving myself there. Initially, the doctor contemplated discharging me but, upon reviewing my medical history, decided otherwise. I was subjected to additional blood tests and another CT scan. Notably, the previous scans included a note suggesting an infectious cause for the lung spots, and the recent imaging showed signs of the blotches shrinking. The physician expressed confidence that I had never actually suffered a blood clot and discontinued my blood thinner medication. Approximately six weeks later, I had another CT scan—this time without contrast—where the pulmonologist confirmed that I was completely fine and had never experienced a clot. The ambiguity surrounding the origin of the spots persisted, but the clear ultrasound of my legs further ruled out clot concerns. Planned Parenthood, which had facilitated my hormone replacement therapy, also believed it was not a clot, as my hematocrit and hemoglobin levels were normal prior to my hospital stay. Since these events unfolded, my physical condition has dramatically changed. Whereas I used to be able to briskly walk for hours, I now find myself gasping for breath even on uphill ascents. After my second discharge, I endured episodes where, at the same time every day, my heart rate would inexplicably surge from 80 to 110 beats per minute—even while at rest. These instances left me feeling flushed, anxious, and clammy. Although this pattern persisted consistently until around March, it has since transformed into sporadic episodes. I wore a Holter monitor for nine days, which reported normal findings. As of now, I am not diagnosed with any chronic physical condition. On the mental health front, I have been diagnosed with ADHD and anxiety and am currently undergoing evaluation for autism. So, what could possibly be causing all these symptoms? My physician does not believe it to be a heart-related issue, although there is a slight consideration for an overactive thyroid. I have been entertaining the idea that I might be experiencing some variant of POTS (Postural Orthostatic Tachycardia Syndrome), but this remains uncertain since I do not frequently faint or endure symptoms continuously. What am I dealing with here?

Answers (1)

8/5/2025, 5:31:17 PM

OpenHealth AI

Your symptoms and medical events are understandably concerning and complex, involving a range of physical and mental health factors. Based on your detailed history, it seems that you are experiencing a combination of physiological reactions that could be linked to a few potential causes, including anxiety, Thyroid dysfunction, or possibly even a form of Dysautonomia such as POTS.

Summary of Main Points:

• Your symptoms include episodes of elevated heart rate, shortness of breath, and episodes of anxiety.
• Previous medical evaluations indicate no blood clots, and normal heart function.
• Concerns about potentially overactive thyroid and a need to explore POTS as a possibility.

Understanding Your Symptoms:

1. Anxiety and Physical Symptoms: Anxiety can cause or exacerbate physical symptoms like increased heart rate and breathing difficulties. The body’s fight-or-flight response can trigger these sensations, especially in moments of stress or strain.
2. Thyroid Function: An overactive thyroid (hyperthyroidism) can lead to symptoms like a rapid heartbeat, anxiety, and difficulty breathing. Blood tests that evaluate your thyroid (like TSH, Free T4, and T3) can be essential in this case.
3. Dysautonomia/POTS: While POTS typically involves consistent symptoms, it can manifest with episodes of rapid heart rate and dizziness, especially when changing position (from sitting to standing), though this doesn’t mean you have POTS definitively if you don’t commonly experience fainting.

Next Steps for You:

1. Communicate with Your Doctor: Follow up with your physician regarding the potential for hyperthyroidism. Request blood tests to evaluate your thyroid levels if they haven’t been done recently.
2. Monitor Symptoms: Keep a detailed diary of your symptoms, including frequency, duration, and triggers for your heart rate surges and breathing difficulties. This can help identify patterns and assist your healthcare provider in making decisions.
3. Physical Activity Gradual Resumption: Gradually resume physical activity, starting with lighter exercises such as walking or stretching. Monitor how your body responds, and report any significant changes to your doctor.
4. Mental Health Integration: Since you have existing anxiety and ADHD diagnoses, consider discussing the impact of anxiety on your physical symptoms with a mental health provider. Techniques such as cognitive-behavioral therapy (CBT) or mindfulness may help manage your anxiety response.
5. Stay Informed: Learn about POTS and other dysautonomia conditions. Understanding your body’s responses may empower you to advocate for your health effectively.

While the uncertainty surrounding your health can be challenging, working collaboratively with your healthcare team and taking proactive steps can aid in finding clarity and support. Remember to take care of your mental health while navigating these physical challenges, and feel free to reach out if you need more tailored guidance on specific aspects.