Chronic Fatigue Syndrome (for Teens)

What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome (CFS) is a complicated disease for doctors to diagnose — and even fully understand.

CFS is a physical condition, but it can also affect a person psychologically. This means that someone with CFS may feel physical symptoms, such as being very tired and weak (extreme fatigue), headaches, or dizziness. But the person may also notice emotional symptoms, such as a loss of interest in favorite activities.

To make it even more complicated, different people with CFS can have different symptoms. And the symptoms of CFS often are similar those of other health conditions, like mono, Lyme disease, or depression. And the symptoms can vary over time, even in the same person.

This makes treating the illness complicated because no single medicine or treatment can address all the possible symptoms.

What Are the Signs & Symptoms of Chronic Fatigue Syndrome?

There’s a long list of possible symptoms that someone with chronic fatigue syndrome can have. The most common ones include:

• severe fatigue, which can make it hard to get out of bed and do normal daily activities
• sleep problems, such as trouble falling or staying asleep, or not having a refreshing sleep
• symptoms getting worse after physical or mental effort (this is called post-exertional malaise)
• symptoms or dizziness that get worse after standing up or sitting upright from a lying down position
• problems with concentration and memory
• headaches and stomachaches

What Causes Chronic Fatigue Syndrome?

Scientists have been researching chronic fatigue syndrome for many years, but they still don’t know for sure what causes it.

Many doctors believe that the way some conditions interact within the body and mind might leave some people at risk for CFS. For example, if someone has a

virusand is under a lot of stress, the combination of these two things might make them more likely to develop CFS.

These things are believed to interact with each other in this way, putting some people at risk for CFS:

• infections. Experts have wondered if infections like measles or Epstein-Barr virus (the virus that causes mono) might increase the risk for CFS. The role Epstein-Barr plays in CFS is not clear because studies have not confirmed it as a cause.
• problems with the immune system or the nervous system
• hormone imbalances
• emotional stress
• low blood pressure

Who Gets Chronic Fatigue Syndrome?

Chronic fatigue syndrome can affect people of all ethnicities and ages, but is most common in people in their forties or fifties. It’s very rare in kids. A few teens do get CFS, and it affects more girls than guys.

Sometimes different people in the same family get CFS. This may be because the tendency to develop CFS is genetic.

How Is Chronic Fatigue Syndrome Diagnosed?

Right now, there’s no test to tell if someone has chronic fatigue syndrome. Doctors ask a lot of questions (about a person’s

medical historyand the health of family members, medicines, allergies, smoking and drinking habits, etc.). They also will do a thorough physical exam.

Doctors also usually order blood, urine (pee), or other tests to check for conditions that cause similar symptoms. They may send a person to see other specialists (such as a sleep specialist or a neurologist) to help with the diagnosis.

A doctor may suggest meeting with a psychologist or a therapist who can see whether mental health disorders might contribute to or mask CFS.

How Is Chronic Fatigue Syndrome Treated?

There’s no known cure for chronic fatigue syndrome. But experts say that these lifestyle changes can help:

• Include regular, carefully planned exercise in your daily routine. Exercise can increase energy and make a person feel better. People with CFS should pace themselves while doing any physical activity that requires exertion. Talk with a doctor what’s right for you — you don’t want to overdo it and get discouraged. Studies show that “graded exercise” (which means starting with small activities and slowly working up to a higher level of exercise) is very helpful in CFS recovery.
• Follow stress-management and stress-reduction techniques. A doctor or therapist can teach these — they’re great ways to take control of some aspects of the illness.
• Ensure good sleep habits to overcome CFS-related sleep problems.
• Work on ways to keep track of important things, such as keeping lists and making notes, you have problems with concentration or memory.

Meeting regularly with a therapist or counselor can help in CFS treatment. (So can getting involved in a support group for people with CFS.) The main goals of therapy are to help people cope with the illness and to change negative or unrealistic thoughts or feelings into positive, realistic ones.

Having a positive feeling that you can get better is very helpful. Therapy and support groups can also help teens with CFS and their parents deal with the academic or social challenges brought on by the illness, such as missed school, falling grades, or withdrawal from friends and social situations.

Doctors may suggest over-the-counter or prescription medicines for some of these symptoms.

What Else Should I Know?

• Strong emotions can be a part of the illness, so it’s important to recognize and express your feelings. Feelings like sadness, anger, and frustration are completely normal — and it’s important to acknowledge how you feel and recognize that it’s not your fault. Recognizing emotions (rather than suppressing them or pretending you’re OK) can help you figure out what’s behind your feelings and help you manage problems.
• It can help to keep a daily diary of feelings and energy highs and lows. This also can let you share information that might help your doctor. You can also track trends — for example, if your energy is high at one time of day and low at another — that will help you figure out when to exercise or do other activities.
• Give yourself more time to do things, especially activities that take concentration or physical exertion.
• Get support from family, teachers, and friends.
• Get information about CFS from reliable sources. There’s a lot of misinformation and confusion about this disease. So it’s important to know and trust your sources.

Most important, don’t give up. Having chronic fatigue syndrome can be hard. But for most people, the symptoms are most severe in the beginning. Later, they may come and go. Teens with CFS generally get better faster and recover more completely than adults do. Most teens get partial or full recovery within 5 years after symptoms began.

It’s important to keep a positive approach to getting well and to not look for the reason why you have CFS. People who take action and stay positive can have a good outcome.

Addison’s Disease Symptoms

Addison’s disease has a wide range of specific and non specific symptoms. The symptoms may be mild and non-remarkable initially but may become more severe and debilitating as the disease progresses.

Some of the most common initial complaints include fatigue, muscle weakness and lack of energy. These symptoms are also seen with other conditions such as anemia, underactive thyroid function (hypothyroidism), chronic fatigue syndrome, flu or depression etc.

Initial symptoms

• Dehydration – this is one of the early signs of Addison’s disease. This condition is seen due to lack of the hormone aldosterone that balances salt and water.
• Fatigue and tiredness
• Excessive drowsiness and lethargy
• Weakness of muscles
• Loss of appetite and unexplained weight loss
• Frequent urination leading to worsening dehydration
• Severe thirst
• Low blood sugar contributing to dizziness and weakness
• Craving for salty foods as frequent urination leads to excessive salt loss from the body
• Fall in blood pressure
• Depressed mood and irritability

Long term symptoms

• More severe and frequent occurrences of the initial symptoms
• Symptoms brought about when the patient faces a stressful situation like an illness or an accident.
• Severe lowering of blood pressure especially when the patient rises to a standing position after sitting or lying down for some time. This is called postural or orthostatic hypotension.
• Dizziness accompanied by fainting spells
• Gastrointestinal disturbances like nausea, vomiting, diarrhea, abdominal pain etc.
• Back pain and joint pain
• Muscle cramps
• Reduced sexual drive or libido particularly in women. Women sufferers may also miss periods completely or have irregular periods.
• Chronic fatigue and depression along with tearfulness. Psychosis or other mental ailments are rare.
• Pigmentation of dark discoloration of the skin. There may be pigment spots over the lips, gums, creases of the palms, pressure points, scars, knuckles and knees. There may be excessive sweating as well.

Adrenal crisis

When left untreated, Addison’s disease may lead to adrenal crisis. This is a medical emergency that may be life threatening.

During an adrenal crisis the symptoms of Addison’s disease may appear suddenly and may affect the patient severely. Some of the symptoms of adrenal crisis include:-

• Profound dehydration
• Sudden and severe fall in blood pressure leading to a shock like state
• Shock that involves complete or near complete shutdown of blood flow to vital organs
• Extreme muscle weakness
• Severe headache
• Severe vomiting and diarrhea
• Severe abdominal pain
• Confusion and disorientation due to excessive loss of salt and water
• Drowsiness and coma and even death

Further Reading

Cardiac-related Syncope (Fainting) – Brigham and Women’s Hospital

The sudden, transient, loss of consciousness in an individual is known as syncope or fainting. Syncope typically lasts for seconds or minutes and is usually followed by a complete recovery. Although the act of syncope can be terrifying, it is usually harmless and most likely does not signify a serious disease or a life threatening problem.

For most people, syncope occurs once or twice in a lifetime; for others, various medical conditions may lead to numerous fainting spells throughout their life. Anyone who experiences syncope should always notify a doctor immediately. If physical injury occurs as a result of fainting, then one should call 911 and head to the closest emergency room.

Syncope Causes

There are numerous causes of syncope that fall into two broad categories:

• Cardiogenic syncope: This type of syncope is heart-related, caused by either an abnormal heart rhythm or structural damage to the heart. This is a dangerous form of syncope.
• Non-cardiogenic syncope: This type was not caused by a heart problem, but rather a transient drop in blood pressure, heart rate, or change in vagal tone, most of which is controlled by the autonomic nervous system. In some people, despite numerous tests, no obvious cause is ever found.

Syncope Diagnosis

It is always important to see a doctor if you have fainted. The doctor will need to know the history surrounding the event, which is very important when trying to determine the cause of the syncope. For example, symptoms such as dizziness, sweating, nausea, diarrhea, vomiting, headache, visual changes, abnormal body movements, loss of control of bowel or bladder, and chest pain are important clues. In addition, it is also helpful to convey what you were doing when the event occurred. Many benign fainting spells are triggered by a vasovagal reaction (a sudden, transient drop in blood pressure resulting in a temporary loss of consciousness), which typically occurs during activities such as eating, urinating , defecating, or standing for long periods.

Medical history (including medications) and age are also important when trying to determine the cause of syncope. Older people are at higher risk for serious conditions and diseases that may lead to syncope. People with known heart conditions, alcohol or drug problems, known seizure disorders, diabetes, or neurological disorders are more likely to have fainting spells.

A variety of tests, mostly cardiovascular, are used when trying to determine the cause of syncope. Treatment for the syncope will depend on the cause. These tests include:

• electrocardiogram (ECG or EKG)
• event/holter monitor
• echocardiogram
• neurologic testing
• tilt table testing
• electrophysiology study.
• implantable loop recorder (sometimes)

Dizziness – Clinical Methods – NCBI Bookshelf

Disequilibrium

As noted previously, a detailed general and neurologic examination are essential to the diagnosis of disequilibrium because the syndrome of multiple sensory deficits is so often the cause. The other keys to diagnosis of disequilibrium are:

1. Analysis of the patient’s gait.

2. Determining whether the patient’s disequilibrium is predictable or episodically unpredictable.

Begin the analysis of gait with the Romberg test. The patient stands upright, feet together, with the arms at the sides. The patient able to maintain balance in this position is asked to close his or her eyes. Loss of equilibrium only with the eyes closed usually suggests disordered proprioceptive and/or vestibular function, while an abnormal Romberg response with the eyes open or closed is usually cerebellar in origin. Next, watch the patient walk away from you, turn, and return.

The gait of the patient with multiple sensory deficits is usually merely hesitant and apprehensive, and minimal assistance from a cane or companion renders the gait fluid and confident. This type of gait in a patient with two or more major sensory deficits is usually diagnostic. A similar type of gait is seen in some very elderly people who do not have multiple sensory deficits. This “senile gait” is not associated with senility (dementia), but that unfortunate label remains popular. Such patients” gait, when unassisted, is “scared” and slow; when minimally assisted, it may be brisk and assured.

If the examiner is not observant, he may miss the patient with early parkinsonism or frontal lobe apraxia. Early in the course of parkinsonism—before the appearance of the classic tremor and “cogwheel” rigidity—disequilibrium and difficulty walking are common findings. At this stage the gait is slow, arm swing is diminished, and turning is disproportionately clumsy. At more advanced stages the parkinsonian gait is “festinating”: steps are short and tight, the feet shuffle along, the trunk is bent forward, the arms hang motionless at the sides. Some have likened this appearance to that of the lower body shuffling frantically forward to “catch up” with the rest of the body. Frontal lobe apraxia may be only subtly different in its gait, but thorough neurologic examination usually reveals evidence of dementia and other “frontal lobe” signs in such patients. This gait has been likened to “walking on ice”: from a standing position, the patient has difficulty initiating the walk. Steps shuffle to “get going” as if the patient knows how to walk but does not know how to begin. A gentle nudge at the elbow often is the greatest help to these people. Turning is especially instructive as the apraxic patient may appear stuck to the-floor, often pivoting around one stationary foot as if one-legged.

Cerebellar ataxia and severe peripheral neuropathy are always easy to recognize. The ataxic patient is not a bit subtle—the patient usually reels unsteadily with short, irregular steps, feet held wide apart as if straddling an invisible barrier, often lurching from side to side or falling, especially when attempting to stop, sit, or turn around. The Romberg test will be abnormal with eyes open or shut.

Peripheral neuropathy is only rarely severe enough itself to cause disequilibrium, but it is a common component of the multiple sensory deficit syndrome, especially in alcoholics or diabetics. The hallmark of the neuropathic gait is that the patient “must see to walk,” since proprioceptive function has deserted him. The patient often walks bent forward, watching his feet interact with the ground. This sight can be superficially comical: the legs are usually held apart, each foot is flung out and forward, often higher than necessary, and stomped to the ground as if the patient were wearing frogman’s flippers. This gait has been likened to that of a circus clown wearing oversized shoes.

Thus, patients with specific structural neurologic disorders will suffer from “predictable” disequilibrium, that is, their gait will always be abnormal when tested. The patient with multiple sensory deficits, parkinsonism, apraxia, or ataxia may have good and bad days, but the gait will never be normal. In contrast, some patients describe disequilibrium that is episodic and unpredictable; examination of such patients” gait may be unremarkable when the patient is asymptomatic. Common causes of such episodic disequilibrium are various vestibular disorders, transient cerebrovascular insufficiency, metabolic disorders, hyperventilation, and psychogenic disequilibrium.

Some patients with vestibular disease will neither describe nor admit to vertigo. This is especially true of “central” vestibular disease (see Chapter 123)—acoustic nerve neoplasms, multiple sclerosis, drug (alcohol, anticonvulsants, tranquilizers) toxicity, tumors of the brain stem or cerebellum. But the much more common peripheral vestibular disorders may also cause only a nonspecific sense of disequilibrium, especially in the elderly. Careful neurologic examination is always the clue to the central disorder; the history of disequilibrium induced by positional head changes will usually suggest the atypical presentation of a peripheral disorder.

Transient attacks of cerebrovascular ischemia may cause dizziness, and the risk of subsequent catastrophic stroke in such patients always makes the clinician worry about this diagnosis in the elderly or hypertensive patient with episodic disequilibrium. Fisher’s classic studies of transient ischemic attacks can help allay or heighten our worry if we remember several of his conclusions:

1. Carotid artery disease rarely causes dizziness or disequilibrium as an isolated symptom. In fact, only 8% of 140 patients with symptomatic carotid disease complained of dizziness as part of their symptom complex. Thus, for example, the elderly patient with a carotid bruit who describes episodic disequilibrium (in the absence of carotid ischemic symptoms) most likely has two unrelated problems.

2. Disease of the posterior circulation—the posterior cerebral artery and/or the vertebrobasilar system—does commonly cause dizziness, usually of the disequilibrium or presyncopal type. However, such dizziness is almost always accompanied by other symptoms—diplopia, vertigo, dysarthria, limb weakness, dysesthesias, ataxia, visual loss—that help incriminate the brainstem or posterior hemispheres. Occasionally, the earliest manifestation of transient ischemic attacks involving the posterior circulation will be episodic dizziness alone, but Fisher found that episodic dizziness that recurs for more than 6 weeks without other neurologic manifestations is “never vascular in origin.

3. Moreover, dizziness accompanied by only eighth cranial nerve symptoms (vertigo, tinnitus, deafness) is only rarely vascular in origin. Fisher did describe 10 patients with ischemic symptoms involving only the small internal auditory artery—isolated eighth nerve syndromes can occur in this situation.

4. Finally, positional vertigo or disequilibrium—an extremely common manifestation of peripheral vestibular disease—is “never” caused by cerebrovascular ischemia.

“Metabolic” disorders should be remembered in the patient with disequilibrium. Always ask about all prescription and nonprescription drugs used by the patient. Many people fail to make the connection between the onset of disequilibrium and the use of new (or higher doses of) medication. Hypothyroidism may cause dizziness, ranging from mild episodic disequilibrium to frank ataxia. Episodic hypoglycemia is a fashionable (and usually incorrect) diagnosis among neurotic dizzy patients, but vague dizziness that is always temporally postprandial should raise this legitimate question. Severe anemia may cause vague disequilibrium, as may hyponatremia, adrenal insufficiency, or any cause of hypotension.

Hyperventilation is an extremely common cause of intermittent disequilibrium, even though “lightheadedness” is the usual complaint of hyperventilators. This reminder reemphasizes two important caveats about the patient with disequilibrium or, in fact, any dizzy patient:

1. Because there is overlap among the different subjective sensations of “dizziness,” each specific disorder (e.g., hyperventilation) can cause more than one general type of dizziness. Thus, when a patient’s disequilibrium cannot be attributed to one of the common causes of disequilibrium described above, it is much more likely that the patient, in fact, suffers from a different “type” dizziness (e.g., vertigo, with its attendant differential diagnosis) than from some obscure cause of “disequilibrium.”

2. Thus, our initial hypothesis about the patient’s type of dizziness may be incorrect. Sometimes our initial hypothesis must be changed—based on further history, the dizziness simulation tests, findings on physical and neurologic examination, or because we cannot confirm the hypothesis and must then look elsewhere. Only this skeptical and circumspect approach will achieve the kind of results reported by Drachman and Hart in .

Dizziness and fainting in pregnancy

Dizziness is when you feel light-headed, weak, unsteady or as if you might faint.

Many pregnant women feel dizzy at times. It is sometimes the first sign that you are pregnant.

Dizziness is common in weeks 0 to 13 of pregnancy.

When to get medical help

Go to your GP immediately if you have fainted and hurt yourself, especially if you hit your head.

If a pregnant woman has fainted you should:

1. Gently put her on the ground and roll her onto her left side, with her left knee pulled up towards her chest.
2. Call 999 if she does not wake up after 2 minutes.
3. Stay with her until she wakes up or help arrives.

What to do if you feel faint

If you feel faint then you should:

• tell someone – they can support you and get help if needed
• sit down and lower your head towards your legs
• lie down on your side
• remove tight or warm clothing
• get someone to open a window – do not try to move or go outside
• drink some water
• have a snack

Signs you might faint

You might faint if you feel any of the following signs:

• blurred vision or spots in front of your eyes
• ringing sound in your ears
• sweating or feeling cold and clammy
• feeling sick
• fast or unusually deep breathing

If you faint you will usually be unconscious for 20 seconds. It is normal to feel disorientated for a few seconds after you wake. You may feel tired and weak for 30 minutes or more after fainting.

Prevent dizziness and fainting

You can help prevent dizziness and fainting by:

• getting out of bed slowly – sit on the side of the bed for a minute before standing
• avoiding very hot baths or showers
• getting out of the bath or shower slowly and carefully
• avoiding standing for long periods of time
• never skipping meals – even if you have morning sickness, eat small amounts of food often
• drinking plenty of fluids
• doing small amounts of exercise often, to improve your circulation
• avoiding lying on your back, especially from your second trimester onwards

Causes of dizziness and fainting

The main causes of dizziness and fainting during pregnancy are:

• hormone changes – this can cause your blood pressure to drop, allowing less blood to get to your brain
• overheating
• low blood sugar – keep a snack with you and avoid skipping meals
• low iron levels
• reduced circulation – as your womb grows it will put pressure on the blood vessels in the lower part of your body
• lying on your back

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 8.

Page last reviewed: 26 March 2019

Next review due: 26 March 2022

Fainting – Healthily

What is fainting?

Fainting (syncope) is a sudden temporary loss of consciousness that usually results in a fall.

When you faint, you’ll feel weak and unsteady before passing out for a short period of time, usually only a few seconds.

There may not be any warning symptoms, but some people experience:

• yawning
• a sudden, clammy sweat
• feeling sick (nausea)
• fast, deep breathing
• confusion
• lightheadedness
• blurred vision or spots in front of your eyes
• ringing in your ears

What to do if you or someone else faints

If you feel you’re about to faint, lie down, preferably in a position where your head is low and your legs are raised. This will encourage blood flow to your brain.

If it’s not possible to lie down, sit with your head between your knees. If you think someone is about to faint, you should help them lie down or sit with their head between their knees.

If a person faints and doesn’t regain consciousness within one or two minutes, put them into the recovery position .

You should call emergency services, ask for an ambulance and stay with the person until medical help arrives.

When to see your doctor

Most cases of fainting aren’t a cause for concern and don’t require treatment, but less common types of fainting can be medical emergencies.

You should see your doctor after fainting if you:

• have no previous history of fainting
• experience repeated episodes of fainting
• injure yourself during a faint
• have diabetes – a lifelong condition that causes your blood glucose level to become too high
• are pregnant
• have a history of heart disease – where your heart’s blood supply is blocked or interrupted
• experienced chest pains , an irregular heartbeat , or a pounding heartbeat before you lost consciousness
• experienced a loss of bladder or bowel control
• took longer than a few minutes to regain consciousness

If your first episode of fainting occurs after 40, it may be a sign of a more serious underlying problem.

Causes of fainting

The brain relies on oxygen carried in the blood to function properly. Fainting can occur when the blood flow to the brain is reduced.

Your body usually corrects reduced blood flow to the brain quickly, but it can make you feel odd, sweaty and dizzy. If it lasts long enough, you may faint.

Reduced blood flow to the brain is often caused by a temporary problem with the part of your nervous system that regulates the body’s automatic functions, including heartbeat and blood pressure.

This type of fainting is called neurally mediated syncope. It can be triggered by:

• emotional stress
• pain
• prolonged standing
• physical processes, such as coughing , sneezing or laughing

Treatment for fainting

Treatment for fainting will depend on the type you’re experiencing. In many cases of neurally mediated syncope, no further treatment is needed.

If you’ve had a fainting episode, you can avoid it happening again by:

• avoiding triggers – such as hot and crowded environments, or emotional stress
• spotting the warning signs, such as feeling lightheaded, and lying down to increase blood flow to the brain

Fainting symptoms

When you faint, you’ll feel weak and unsteady before passing out for a short period of time, usually only a few seconds.

Fainting can occur when you’re sitting, standing, or when you get up too quickly.

Warning symptoms

You may not experience any warning symptoms before losing consciousness and, if you do, it may only be for a few seconds.

You may experience the following symptoms just before fainting:

• yawning
• a sudden, clammy sweat
• feeling sick (nausea)
• fast, deep breathing
• confusion
• lightheadedness
• blurred vision or spots in front of your eyes
• ringing in your ears

This will usually be followed by a loss of strength and consciousness.

When you collapse to the ground, your head and heart are on the same level. This means your heart doesn’t have to work as hard to push blood up to your brain.

You should return to consciousness after about 20 seconds.

Call emergency services and ask for an ambulance if someone faints and doesn’t regain consciousness within two minutes.

After fainting

After fainting, you may feel confused and weak for about 20-30 minutes. You may also feel tired and not be able to remember what you were doing just before you fainted.

Fainting or stroke?

Fainting can sometimes be mistaken for a serious medical condition, such as a stroke . A stroke is a medical emergency that occurs when blood supply to the brain is interrupted.

You should call emergency services immediately and ask for an ambulance if you think you or someone else is having a stroke.

The main symptoms of stroke can be remembered with the word FAST, which stands for Face-Arms-Speech-Time:

• Face – the face may have fallen on one side, the person may not be able to smile, or their mouth or eye may have drooped
• Arms – the person may not be able to raise both arms and keep them there because of weakness or numbness
• Speech – the person may have slurred speech
• Time – it’s time to call emergency services immediately if you see any of these signs or symptoms

Causes of fainting

Fainting (syncope) is caused by a temporary reduction in blood flow to the brain.

Blood flow to the brain can be interrupted for a number of reasons. The different causes of fainting are explained below.

A trigger

Fainting is most commonly caused by a temporary glitch in the autonomic nervous system. This is sometimes known as neurally mediated syncope.

The autonomic nervous system is made up of the brain, nerves and spinal cord. It regulates automatic bodily functions, such as heart rate and blood pressure.

An external trigger can temporarily cause the autonomic nervous system to stop working properly, resulting in a fall in blood pressure and fainting.

The trigger may also cause your heartbeat to slow down or pause for a few seconds, resulting in a temporary interruption to the brain’s blood supply. This is called vasovagal syncope.

The trigger may be:

• an unpleasant sight
• heat
• sudden pain
• coughing
• sneezing
• laughing
• sitting or standing up suddenly – known as postural tachycardia syndrome (PoTS)

Low blood pressure when you stand up

Fainting can also be caused by a fall in blood pressure when you stand up. This is called orthostatic hypotension , and tends to affect older people, particularly those aged over 65. It’s a common cause of falls in older people.

When you stand up after sitting or lying down, gravity pulls blood down into your legs, which reduces your blood pressure.

The nervous system usually counteracts this by making your heart beat faster and narrowing your blood vessels. This stabilises your blood pressure.

However, in cases of orthostatic hypotension, this doesn’t happen, leading to the brain’s blood supply being interrupted and causing you to faint.

Possible triggers of orthostatic hypotension include:

• dehydration – if you’re dehydrated, the amount of fluid in your blood will be reduced and your blood pressure will decrease; this makes it harder for your nervous system to stabilise your blood pressure and increases your risk of fainting
• diabetes – uncontrolled diabetes makes you urinate frequently, which can lead to dehydration; excess blood sugar levels can also damage the nerves that help regulate blood pressure
• medication – any medication for high blood pressure and any antidepressant can cause orthostatic hypotension
• neurological conditions – conditions that affect the nervous system, such as Parkinson’s disease , can trigger orthostatic hypotension in some people

Heart problems

Heart problems can also interrupt the brain’s blood supply and cause fainting. This type of fainting is called cardiac syncope.

The risk of developing cardiac syncope increases with age. You’re also at increased risk if you have:

• narrowed or blocked blood vessels to the heart (coronary heart disease)
• chest pain (angina)
• had a heart attack in the past
• weakened heart chambers (ventricular dysfunction)
• structural problems with the muscles of the heart (cardiomyopathy)
• an abnormal electrocardiogram – a test that checks for abnormal heart rhythms
• repeated episodes of fainting that come on suddenly without warning

See your doctor as soon as possible if you think your fainting is related to a heart problem.

Reflex anoxic seizures (RAS)

A reflex anoxic seizure (RAS) is a type of fainting that mainly occurs in young children. It’s caused by an involuntary slowing of the heart rate, to the extent that the heart actually stops beating for 5-30 seconds.

The child will often open their mouth as if they’re going to cry, but make no sound before turning pale grey and losing consciousness.

They’ll either become limp – or, more often, stiff – with their eyes rolling upwards and their fingers clawed. Their body may also jerk a few times.

The seizure usually lasts less than a minute. Afterwards, the child will regain consciousness, but may appear sleepy and confused for a few hours.

Reflex anoxic seizures can be frightening to witness, but they aren’t dangerous and don’t harm the child.

The seizures will become less frequent as the child gets older and usually disappear by the time they’re four or five years of age.

Fainting diagnosis

In some cases of fainting, you’ll need to see a healthcare professional after the fainting episode to investigate whether there’s an underlying health condition.

Your GP will be able to diagnose the cause and determine whether further investigation and treatment is needed.

When to see your doctor

Most cases of fainting aren’t a cause for concern and don’t require treatment, but you should see your GP if you’re at all concerned.

You should also see your doctor after fainting if you:

• have no previous history of fainting
• experience repeated episodes of fainting
• injure yourself during a faint
• have diabetes – a lifelong condition that causes your blood glucose level to become too high
• are pregnant
• have a history of heart disease – where your heart’s blood supply is blocked or interrupted
• experienced chest pains, an irregular heartbeat or a pounding heartbeat before you lost consciousness
• experienced a loss of bladder or bowel control
• took longer than a few minutes to regain consciousness

During an assessment, your doctor will ask about your fainting episodes and your recent medical history. They may also measure your blood pressure and listen to your heartbeat using a stethoscope.

Electrocardiogram (ECG)

If your doctor thinks your fainting episode may have been caused by a heart problem, they may suggest that you have an electrocardiogram (ECG) .

An ECG records your heart’s rhythm and electrical activity. A number of small, sticky patches called electrodes are placed on your arms, legs and chest. Wires connect the electrodes to an ECG machine.

Every time your heart beats, it produces tiny electrical signals. The ECG machine traces these signals on paper, recording any abnormalities in your heartbeat.

An ECG is usually carried out at a hospital or doctor surgery. The procedure is painless and takes about five minutes.

Carotid sinus test

If your doctor thinks your fainting episode was associated with carotid sinus syndrome, they may massage your carotid sinus to see whether it makes you feel faint or lightheaded.

The carotid sinus is a collection of sensors in the carotid artery, which is the main artery in your neck that supplies blood to your brain.

If the carotid sinus massage causes symptoms, it may indicate that you have carotid sinus syndrome – see causes of fainting for more information.

Blood tests

Blood tests may be carried out to rule out conditions such as diabetes or anaemia , a condition where the body doesn’t produce enough oxygen-rich red blood cells.

Your doctor may measure your blood pressure while you’re lying down and again after you stand up. You may have orthostatic hypotension if your blood pressure falls after you stand up.

If you have orthostatic hypotension, you may be asked further questions to help determine the cause. For example, it can sometimes occur as a side effect of taking some medications.

Next steps

If tests reveal an underlying cause of your fainting, such as a heart problem or orthostatic hypotension, your doctor may recommend treatment for fainting .

Treatment for fainting

Treatment for fainting (syncope) will depend on the type of fainting and whether there’s an underlying cause.

If someone you’re with has fainted and they haven’t regained consciousness within one or two minutes, put them into the recovery position .

After putting them into the recovery position, emergency services, ask for an ambulance, and stay with them until medical help arrives.

Treating the underlying cause

When you visit the doctor after a fainting episode, they’ll investigate the type of fainting you experienced and whether there’s an underlying cause.

If an underlying cause is found, treating it should help prevent further fainting episodes.

Read more about diagnosing fainting .

Treating fainting associated with the nervous system

Most fainting episodes are associated with a temporary malfunction of the autonomic nervous system, which regulates the body’s automatic functions, such as heartbeat and blood pressure.

This type of fainting is called neurally mediated syncope . Treatment for neurally mediated syncope involves avoiding any possible triggers.

If you’re not sure what caused your fainting episode, your doctor may suggest keeping a diary of any symptoms you experience.

It may help to identify possible causes by making a note of what you were doing at the time you fainted.

There are also steps you can take to avoid losing consciousness if you think you may be about to faint.

Fainting associated with an external trigger

Fainting can occur when an external trigger, such as a stressful situation, causes a temporary malfunction in your autonomic nervous system. This is called vasovagal syncope.

In most cases of vasovagal syncope, further treatment isn’t required. However, you may find it useful to avoid potential triggers, such as stress or excitement, hot and stuffy environments, and long periods spent standing.

If you know injections or medical procedures like blood tests make you feel faint, you should tell the doctor or nurse beforehand. They’ll make sure you’re lying down during the procedure.

Fainting associated with bodily functions

Fainting can occur when a bodily function or activity – such as coughing – places a sudden strain on the autonomic nervous system. This is called situational syncope.

There’s no specific treatment for situational syncope, but avoiding the triggers may help. For example, if coughing caused you to faint, you may be able to suppress your urge to cough and avoid fainting.

Carotid sinus syndrome

Carotid sinus syndrome is where pressure on your carotid sinus causes you to faint. It’s more common in older men.

Your carotid sinus is a collection of sensors in the carotid artery, which is the main artery in your neck that supplies blood to your brain.

You can avoid fainting by not putting any pressure on your carotid sinus – for example, by not wearing shirts with tight collars.

In some people, carotid sinus syndrome can be treated by having a pacemaker fitted. A pacemaker is a small electrical device that’s implanted in your chest to help keep your heart beating regularly.

Treating fainting associated with low blood pressure

Fainting can occur when your blood pressure drops as you stand up. This drop in blood pressure is called orthostatic hypotension .

Avoiding anything that lowers your blood pressure should help prevent fainting. For example, avoid becoming dehydrated by increasing your fluid intake.

Your doctor may also advise you to eat small, frequent meals rather than large ones, and increase your salt intake.

Taking certain medications can also decrease blood pressure. However, don’t stop taking a prescribed medication unless your doctor or another qualified healthcare professional in charge of your care advises you to do so.

Read more about treating low blood pressure .

Physical counterpressure manoeuvres

Physical counterpressure manoeuvres are movements designed to raise your blood pressure and prevent you losing consciousness.

One study found training in physical counterpressure manoeuvres can reduce fainting in some people.

Physical counterpressure manoeuvres include:

• crossing your legs
• clenching the muscles in your lower body
• squeezing your hands into a fist
• tensing your arm muscles

You need to be trained to carry out these movements correctly. You can then do them if you experience any symptoms that suggest you’re about to faint, such as feeling lightheaded.

Driving

If you’ve fainted, it could affect your ability to drive. Depending on what caused you to faint and whether you have any underlying health conditions, you may need to inform local driving authorities.

Safety at work

If you’ve fainted, it may affect your safety at work or the safety of others. For example, continuing to operate machinery may be dangerous if it’s likely you’ll faint again.

The healthcare professionals who diagnose and treat your condition can tell you whether it’s likely to affect your work. If it is, speak to your health and safety representative.

Fainting | La Plata Pediatrics & Family Health

Is this your symptom?

• Fainting is when a person loses consciousness for a short amount of time

Some Basics…

• Fainting is a brief loss of consciousness. It is also called syncope or “passing out”.
• Fainting happens when there is short-term decrease in blood flow to the brain.
• The causes of fainting can be serious or not serious. About 80% of all faints are simple faints and are not serious.
• People who are mildly dehydrated or fasting may be more likely to faint. Other factors include hot weather, lack of sleep, recent illness, being pregnant, or a change in altitude.
• A person should wake up and be alert less than 1 minute after fainting. They should feel normal within 10 minutes after fainting. If the person does not wake up within 1 minute, it is not just a fainting spell.

Symptoms

• Before: sometimes there are warning signs for 10-15 seconds right before fainting. Signs may include feeling dizzy, sweating, nausea, or blurred vision.
• Fainting: loss of consciousness. The person may slump over or fall to the ground.
• After: the person usually wakes up in less than 1 minute. The person may feel weak or tired for a few minutes afterwards.

Causes

• Anemia
• Dehydration
• Heart attack
• Heart beat is irregular, too fast, or too slow
• Internal bleeding
• Medications
• Simple faint
• Stroke

What is a Simple Faint?

Healthy adults can have simple faints. They can be caused by stress, pain, standing for a long time, or standing up too quickly. About 80% of all faints are simple faints. Simple faints are also called vasovagal or vasomotor syncope.

Some people are much more prone to having a simple faint than others.

A person often has warning sign before a simple faint: these signs include pale skin, blurry eyesight, nausea, and sweating. Others signs are feeling dizzy, cold, or warm. These last for 5-10 seconds before fainting.

Simple Faints – Why Do They Happen?

• Prolonged standing in one position before fainting: this is called orthostatic syncope. This is a common cause of simple faints. It most often happens at church, graduations, weddings, school assemblies, and parades. It happens more often to people who keep their knees “locked.” It is caused by blood pooling in the veins of the legs.
• Standing up suddenly before fainting: this is called orthostatic syncope. This can happen to most people if they stand up too quickly after lying down. Usually this just causes dizziness rather than fainting.
• Sudden fearful or disgusting event before fainting: this is called vasovagal syncope. This can happen after seeing someone vomit, bleed, or pass a stool. It can happen after seeing a badly hurt person or pet. It can also happen while getting an injection or performing in public.
• Sudden physical pain before fainting: this is called vasovagal syncope. This can happen after getting an injection or having stitches taken out or blood drawn. These faints are most likely caused by stress rather than pain.

When is Fainting Serious?

Each of these suggests that the fainting might be from a more serious cause.

• Also has chest pain, trouble breathing, palpitations, severe headache, or internal bleeding
• Has known cardiac disease
• Had a head or face injury from fainting
• Feels less alert or unwell after fainting
• Fainted during exercise
• People over 50 years old

When to Call for Fainting

Care Advice

Treatment for Fainting

1. Treatment:
   • Lie down with your feet up for 10 minutes. Simple fainting is caused by a short-term decrease in blood flow to the brain. Lying down helps blood flow to the brain.
   • Drink some fruit juice. This is important if you have missed a meal or not eaten in over 6 hours.

2. What to Expect: Most people feel better after lying down for 10 minutes.

3. Warning Signs for Fainting:
   • Fainting most often has early warning signs. These include feeling dizzy, cold, or warm. You may have blurry eyesight or a stomachache.
   • If you feel these warning signs, lie down right away. This will stop you from falling down. You only have 5 seconds to act. It is very unlikely that you will faint if you are lying down.
   • If you can’t lie down, you should sit down with your head between your knees.
4. Pregnancy Test, When in Doubt:
   • If there is a chance that you might be pregnant, use a urine pregnancy test.
   • You can buy a pregnancy test at the drugstore.
   • It works best first thing in the morning.
   • Follow all package instructions.
5. Call Your Doctor If:
   • Faint again on the same day
   • Pregnant
   • You think you need to be seen
   • You get worse

Simple Faint from Standing Up Too Quickly

1. What You Should Know:
   • Standing up too quickly after lying down may cause you to feel dizzy.
   • It is most often not serious and it can be prevented.
   • Here is some care advice that should help.
2. Prevention:
   • Most fainting can be prevented.
   • When getting out of bed, sit on the edge for a few minutes before standing. If you feel dizzy, sit or lie down.
   • Water and salt are key. If you faint often, drink extra fluids every day. Add some mildly salty foods like saltine crackers or soup to your diet.

Simple Faint from Standing for Too Long

1. What You Should Know:
   • Standing for too long in one position is a common cause of fainting.
   • It is most often not serious and can be prevented.
   • Here is some care advice that should help.
2. Prevention:
   • If you must stand for a long time, contract and relax your leg muscles. Do this every so often while you are standing. This will pump blood back to your heart.
   • Try to avoid standing in one place for too long with your knees locked.
   • Water and salt are key. If you faint often, drink extra fluids every day. Add some mildly salty foods like saltine crackers or soup to your diet.

Simple Faint from Fear, Stress or Pain

1. What You Should Know:
   • Some people faint if they go through a painful, frightening, or emotional event. Examples include getting an injection, having blood drawn for a test, or getting injured. Some people pass out just from seeing blood.
   • For some people, this is a normal reaction and shouldn’t cause any lasting effects.
   • It is caused by blood pooling in the legs. It is also caused by a short-term decrease in blood flow to the brain.
   • It is most often not serious and can be prevented.
   • Here is some care advice that should help.
2. Prevention: You cannot always prevent fainting from stressful events. Here are some tips that may help:
   • If you know you faint under certain circumstances, lie down in advance.
   • Try thinking about something else. Think of yourself on the beach or with a friend.
   • You can also learn relaxation exercises. This is where you relax all of the muscles in your body.

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

90,000 Causes of shortness of breath, weakness

Shortness of breath and weakness is an alarming combination of symptoms that may indicate the development of diseases of various organs and systems. These manifestations are accompanied, among other things, by some rare pathologies, for example, Pompe disease.

In Pompe disease, due to a mutation that is inherited, there is a deficiency of the enzyme acidic alpha-glucosidase (or acidic maltase). The task of this enzyme is to break down glycogen. With a deficiency of acid maltase, undigested glycogen accumulates in the muscles, affecting them. ¹

Despite the fact that the mutation that causes Pompe disease is genetically established and has been present since the prenatal period, the disease can first manifest itself at any age, including in adulthood. With a late onset, the first symptom of Pompe disease is often muscle weakness, which slowly increases. ¹

Along with a decrease in muscle tone, general weakness, rapid fatigability, muscle pain, as well as difficulty breathing – shortness of breath – may appear.The reason for its appearance is a progressive decrease in the tone of the respiratory muscles. ¹ Weakness in combination with shortness of breath can occur in a number of other diseases, and the leading symptom, as a rule, becomes just a feeling of lack of air.

What pathologies can be signs of weakness and shortness of breath, and what to do in such cases?

Main causes of shortness of breath and weakness

A feeling of lack of air can appear both normally, for example, with heavy physical exertion, and with pathology.But weakness, which does not disappear after rest, suggests that some disturbances are taking place in the body. Consider what diseases can cause shortness of breath and weakness.

Respiratory system pathologies – acute and chronic. The first is pneumonia (pneumonia). Chronic lung pathologies that may be accompanied by shortness of breath are bronchial asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, lung cancer, and others. ²

Cardiovascular disease is another common cause of shortness of breath and weakness.The feeling of shortness of breath can occur in chronic diseases such as heart rhythm disturbances (arrhythmias), heart failure, hypertension. Sometimes a sharp lack of air in combination with sudden weakness is a symptom of acute conditions, in particular, myocardial infarction, stroke, pulmonary embolism. ^3.4

Carbon monoxide poisoning is a condition in which oxygen starvation occurs primarily. It contributes to the disruption of all links of oxygen transport and causes the appearance of a complex of symptoms, such as headache, weakness, dizziness, shortness of breath, chest pain.In severe poisoning, fainting, convulsions, stunning occur. ⁵

Diseases of the blood, in particular, iron deficiency anemia caused by iron deficiency in the body. Its classic signs are weakness, fatigue, headache, dizziness, shortness of breath during physical exertion, decreased appetite, increased heart rate. With anemia, the condition of the hair, nails worsens, and the taste changes. ⁶

When to see a doctor?

In some cases, when shortness of breath and weakness appear, emergency medical attention is needed.An ambulance should be called in the following cases ^2.7 :

• severe sudden shortness of breath, accompanied by severe weakness, sweating;
• the appearance of sharp chest pain, palpitations, fainting, nausea;
• convulsions;
• impairment or complete loss of vision;
• speech impairment.

In other cases, a planned consultation with a general practitioner or family doctor is necessary in order to find out the cause of the ailment, diagnose and begin the correct treatment.To establish a diagnosis, a doctor may order a number of tests:

• laboratory tests – blood and urine tests;
• instrumental examinations – ultrasound, sometimes MRI, CT.

If necessary, the doctor prescribes consultations of narrow specialists – a cardiologist, pulmonologist, hematologist, geneticist and others. After the diagnosis is established, treatment is prescribed.

References

1. Mukhambetova G.A. et al. Diagnostic criteria for Pompe disease // Bulletin of the Almaty State Institute for Advanced Medical Education, 2013. No. 3.
2. Shortness of breath. Mayo clinic. URL: https://www.mayoclinic.org/symptoms/shortness-of-breath/basics/causes/sym-20050890 (date accessed 10/18/2019).
3. Chikina S. Yu. Principles of dyspnea assessment in the practice of a pulmonologist // Practical Pulmonology, 2006. No. 2.
4. Avdeev S.N.Pulmonary embolism // Practical Pulmonology, 2009.No. 3.
5. Carbon monoxide poisoning. MSD Reference. URL: https://www.msdmanuals.com/ru/%D0%BF%D1%80%D0%BE%D1%84%D0%B5%D1%81%D1%81%D0%B8%D0%BE % D0% BD% D0% B0% D0% BB% D1% 8C% D0% BD% D1% 8B% D0% B9 /% D1% 82% D1% 80% D0% B0% D0% B2% D0% BC% D1% 8B-% D0% BE% D1% 82% D1% 80% D0% B0% D0% B2% D0% BB% D0% B5% D0% BD% D0% B8% D1% 8F /% D0% BE% D1% 82% D1% 80% D0% B0% D0% B2% D0% BB% D0% B5% D0% BD% D0% B8% D1% 8F /% D0% BE% D1% 82% D1% 80% D0 % B0% D0% B2% D0% BB% D0% B5% D0% BD% D0% B8% D0% B5-% D1% 83% D0% B3% D0% B0% D1% 80% D0% BD% D1% 8B% D0% BC-% D0% B3% D0% B0% D0% B7% D0% BE% D0% BC (date of circulation 24.10.2019).
6. Federal clinical guidelines for the diagnosis and treatment of iron deficiency anemia, 2015
7. Stroke. Mayo clinic. URL: https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113 (date accessed 10/24/2019).

GZEA.PD.18.09.0435t

Cardiac arrhythmia: sinus, atrial – causes, symptoms, treatment in Tyumen

Cardiac arrhythmia is a disease of the cardiovascular system in which the rhythm of cardiac contractions is disturbed.During normal functioning of the heart, a person practically does not feel his heartbeat, however, with arrhythmia, there is often a feeling of chaotic heartbeat or, conversely, its “fading”.

Cardiac arrhythmia can occur due to functional disorders and with various organic lesions of the heart.

Why is arrhythmia dangerous?

In some cases, heartbeat disorders can be extremely life-threatening, as they can result in clinical death.So with bradycardia, that is, with a slowdown in the normal heart rate, cases of short-term loss of consciousness are especially dangerous. Before such loss of consciousness, a person may experience a rush of blood to the head.

With tachycardia, that is, with an increase in heart rate, ventricular fibrillation may occur, which may also result in clinical death. Such a case requires immediate defibrillation measures.

Arrhythmia as a disease has an undulating character.This means that frequent bouts of heart rhythm disturbances can affect not only the work of the heart, but also lead to disturbances in the work of the central nervous system. Arrhythmia can lead to the development of diseases of many organs and tissues that are sensitive to blood “starvation”, and it manifests itself during an irregular heart rhythm.

What are the types of arrhythmias?

The following types of arrhythmias are found in patients with cardiac arrhythmias:

• Sinus arrhythmia, which is an increase in heart rate up to 120-150 beats per minute.In healthy people, this heart rate is observed after physical activity, but after its completion, the rhythm is restored to normal levels. People who suffer from sinus arrhythmia have a consistently high heart rate of 100-140 beats per minute. This type of arrhythmia can be the cause of diseases of the nervous system, and also occurs with anemia and dysfunction of the thyroid gland.
• paraxysmal tachycardia, in which the heart rate reaches 140-200 beats per minute.
• bradycardia, in which there is a slowing of the heartbeat to 40-60 beats. This type of arrhythmia occurs in various diseases of the nervous system and digestion.
• atrial fibrillation, in which there is an irregular heartbeat from 50 to 480 beats per minute. This is the most common type of tachycardia.

Symptoms

Often, heart rhythm disturbances can be asymptomatic. If the manifestation of arrhythmia is quite noticeable, then it should be noted that the symptoms of bradycardia and tachycardia may differ.

So, with bradycardia, the following clinical manifestations are observed:

90 056

When tachycardia is observed:

• heart palpitations;

90,057 shortness of breath;

• increased fatigue;
• weakness.

Causes of cardiac arrhythmias

The cause of arrhythmia can be organic lesions of the heart in defect, myocardial infarction and other pathologies.Often the cause of arrhythmia can be a change in the water-salt balance, as well as disruption of the normal functioning of the autonomic nervous system. Violation of the heart rhythm can be observed with various intoxications of the body.

Sometimes arrhythmia can occur even in absolutely healthy people due to a cold or severe fatigue. Excessive alcohol consumption can also cause abnormal heart rhythms.

The cause of arrhythmia can be various endocrine disorders, which include:

• an increase in the amount of adrenal hormones, for example, adrenaline;
• increase in the content of thyroid hormones in the blood;
• a strong decrease in blood glucose levels.

Various intoxications, for example, the use of drugs, lead to cardiac arrhythmias. Arrhythmia also occurs as a side effect of various drugs. Of course, heart failure and atherosclerosis lead to heart failure.

Arrhythmia treatment

Treatment of arrhythmias depends on the severity and type of this cardiac disorder. In any case, it is worth remembering that it is strictly forbidden to treat this disease on your own.It is best to entrust the treatment of this serious ailment to professionals from our clinic.

Doctor73 – News – Arterial hypotension

Arterial hypotension

Many people experience problems with high blood pressure. It is believed that those who suffer from hypertension are in the majority. But in fact, there are no fewer patients who are uncomfortable with low blood pressure. This disease is called arterial hypotension.Olga Troshenkina, a cardiologist at the Central City Clinical Hospital of the city of Ulyanovsk, Candidate of Medical Sciences, told us about how to behave during an illness and how to prevent its occurrence.
– What are the first signs of the disease?
– A person feels weakness, drowsiness, absent-mindedness, memory impairment, headache in the frontotemporal or fronto-parietal region, dizziness, emotional instability; sensitivity to weather changes appears.- If the disease is not treated, what consequences can it lead to?
– Arterial hypotension leads to daytime sleepiness, disturbed night sleep. It turns out that a person has a disorder of falling asleep and sleep rhythm. As a result, fatigue and general weakness increase. Patients with arterial hypotension have difficulty waking up in the morning, but even after a long sleep, there is usually no feeling of vigor and freshness. If you do not engage in treatment, then with arterial hypotension, fainting is possible.Most often, they occur in stuffy and hot rooms, as well as when driving in public transport, especially when you are in an upright position for a long time.
– What is the most optimal pressure for a person and how to control it?
– Arterial hypotension is diagnosed when blood pressure is below 105/65 mm Hg. Art. The presence of arterial hypertension is evidenced by a blood pressure level of more than 140/90 mm Hg. Art. It is necessary to independently monitor the level of blood pressure with a tonometer on a daily basis.Carrying out daily monitoring of blood pressure allows you to identify the initial deviations in the daily rhythm and the value of blood pressure.
– What products and vitamins can help make the life of those suffering from low blood pressure easier?
– Arterial hypotension can develop as a result of starvation and lack of vitamins B, C, E. You need a daily balanced diet, in which the frequency of food intake is at least 4-5 times a day without salt restriction, sufficient, but not excessive fluid intake.- How to treat?
– Non-drug methods of treating arterial hypotension include: normalization of work and rest, proper balanced nutrition, massage of the collar zone of the spine, physiotherapy procedures with a stimulating effect. We recommend water procedures aimed at increasing vascular tone: cool sea baths, Charcot’s shower, contrast and circular shower. Drug therapy should be carried out in the absence of an effect from a complex of non-drug measures.Herbal adaptogens are used: tinctures of Chinese magnolia vine, ginseng, eleutherococcus extract. These drugs have an exciting effect on the central nervous system, stimulate the cardiovascular system, eliminate mental and physical fatigue, and increase blood pressure. The following groups of drugs are also used: nootropics, anticholinergics, cerebroprotectors, antioxidants.
– What advice can you give to those who suffer from this disease?
– Patients with arterial hypotension need more time to sleep than is usually recommended, not 6-8, but already 8-12 hours.Normalization of the daily routine involves the alternation of mental and physical activity. In case of dizziness and a premonition of fainting, it is necessary to take a horizontal position or sit down so that your head rests on your knees. It is recommended to independently monitor the level of blood pressure on a daily basis and undergo regular preventive examinations with a therapist.
– How can the disease be prevented?
– A healthy lifestyle is the best way to prevent arterial hypotension. This is a balanced diet, physical activity, good rest and procedures that strengthen blood vessels: massage, contrast shower, hydromassage, swimming.Stress should be avoided. Negative emotions often become a decisive factor provoking a sharp and strong drop in blood pressure.

Reprint from the site http://mosaica.ru

90,000 Aortic defects. Part 2 Aortic regurgitation

Left ventricular hypertrophy is visible. With mitralization of the defect, hypertrophy of the left atrium can be seen and then, in the stage of decompensation, combined hypertrophy due to the fact that hypertrophy of the right ventricle will join.

Roentgen
On the X-ray one can see the aortic configuration of the heart: bulging of the left ventricular arch, bulging of the ascending aorta, the shadow of the heart is enlarged to the right and the pulmonary pattern is enhanced.

ECHOKG
The structure of the aortic valve – deformation, calcification, impaired valve movement. Description of aortic valve regurgitation and description of the chambers of the heart (dilatation and hypertrophy of the left ventricle).

Diagnostic criteria

• Valve (direct) criteria for aortic insufficiency: diastolic murmur, attenuation of 2 tones, aortic regurgitation, no closure of the AK valves
• Left ventricular (indirect ) criteria for ventricular hypertension criteria
• Peripheral criteria : low diastolic pressure, an increase in systolic pressure, heart pain due to hyperdistension of the coronary vessels, Traube murmur.

Degrees of aortic insufficiency according to Mukharlyamov

• 1st stage – insignificant severity. Small diastolic murmur at Botkin’s point, slight left ventricular hypertrophy
• 2 tbsp – moderate. The diastolic murmur is more intense, carried out to the apex, weakening of 2 tones, an increase in the end systolic size (up to 5.5 cm) and the end diastolic size (up to 7 cm)
• 3 tbsp. – sharp severity. Diastolic murmur over all points, absence of 2 tones, significant increase in end systolic and diastolic dimensions.

Treatment

Conservative treatment is reduced to the treatment of chronic heart failure. Surgical Treatment – Discusses valve implantation for clinical manifestations and severe left ventricular enlargement.

Combined aortic valve disease

Combined aortic valve stenosis is a combination of both stenosis and aortic valve insufficiency. On x-ray, you can see the aortic configuration of the heart. In addition, left ventricular hypertrophy, rough systolic murmur (a sign of aortic stenosis) and mild diastolic murmur (a sign of aortic insufficiency) are observed.Increased pulse pressure and volume overload (a sign of aortic regurgitation). If systolic overload is formed and left ventricular hypertrophy is concentric, and pulse pressure is normal, this is the predominance of aortic stenosis.

The decision is made on the basis of echocardiography or angiography. It is necessary to identify which defect prevails: stenosis or insufficiency. Choice of commissurotomy or valve replacement.

Recently, it is believed that the only effective and radical treatment for such patients is aortic valve replacement.

Differential diagnosis of heart defects according to physical examination

Neurological damage from COVID-19 in ophthalmology

The multisystem lesion of the SARS-CoV2 virus in ophthalmology is known for its effect, first of all, on the choroid – the retina, which is more often manifested by microthrombosis.

The British Journal of Ophthalmology has published a study on neurological damage from the eyes in the presence of prolonged COVID-19 (https: // bjo.bmj.com/content/early/2021/07/08/bjophthalmol-2021-319450).

COVID-19 is known to cause numerous neurological disorders (ranging from mild to death) affecting the central and peripheral nervous system in patients with severe or asymptomatic SARS-CoV-2 infection. Headache, dizziness, acute cerebrovascular accident (ACVA), encephalopathy, encephalitis, acute myelitis, anosmia, Guillain – Barré syndrome (GBS), skeletal muscle damage, and much more are described.Scientists have suggested that small fiber neuropathy may underlie long-term COVID-19 based on a case report of orthostatic cerebral hypoperfusion syndrome and painful small fiber neuropathy in a patient with COVID-19 (https://doi.org/10.1016/j. ensci.2020.100276).

Long-term COVID-19 (Long COVID-19) is characterized by prolonged neurological manifestations of the virus, such as headache, fatigue, constant fatigue, weakness, dizziness, fainting, impaired taste and smell.

Research carried out by ophthalmologists has shown that SARS-CoV2 damages not only the vessels of the eye, but also the nerve fibers of the cornea.

The cornea is the transparent part of the eye that covers the pupil, the iris, and the fluid-filled interior of the eyeball. Its main function is to focus light entering the eye. Dendritic immune cells on its surface play a key role in the primary response of the immune system by capturing and presenting antigens from invading organisms.

The study involved 40 people with varying degrees of severity of COVID-19. In the acute phase, 22 patients (55%) had no clinical signs of pneumonia, 11 (28%) had clinical signs of pneumonia that did not require oxygen therapy, four (10%) were hospitalized with pneumonia and received oxygen therapy, and three (8 %) patients with pneumonia were admitted to the intensive care unit (ICU) for respiratory support.

All participants, according to the questionnaire, persisted in symptoms of Long COVID-19. The median time after diagnosis of COVID-19 was 3.7 ± 1.5 months and> 12 weeks in 73% (29/40) of cases.

All subjects underwent CCM laser scanning using the Rostock Corneal Module / Heidelberg Retina Tomograph lll (Heidelberg Engineering, Germany) – confocal corneal microscopy.

Corneal confocal microscopy is a non-invasive laser imaging technique that allows you to see damage to the nerve fibers of the cornea with high resolution in real time.Typically, confocal microscopy of the cornea is used to detect nerve damage and inflammatory changes associated with diabetic neuropathy, multiple sclerosis, and fibromyalgia.

Photo shows CCM images of the central subbasal nerve plexus of the cornea in a healthy person (A) and patients with COVID-19 with and without neurological symptoms (B) and without them (C).

Neurological symptoms were present at 4 and 12 weeks in 22/40 (55%) and 13/29 (45%) patients, respectively.Subgroup analyzes showed that patients with neurologic symptoms at 4 weeks had lower corneal nerve fiber density (CNFD, CNBD, and CNFL) and an increased total dendritic immune cell count compared to controls who did not have COVID-19 patients. Patients without neurological symptoms had a comparable number of corneal nerve fibers with healthy people.

This means that patients with Long COVID-19, four weeks after the acute period of COVID-19, have significant damage to the nerve fibers of the cornea.

The researchers incorporated the identified changes into the neurological signs of Long COVID-19: damage to nerve fibers and an increase in the number of dendritic cells in the cornea of ​​the eye.

Corneal confocal microscopy has previously only been used to detect damage to small nerve fibers in various central and peripheral neurodegenerative disorders (eg, diabetic neuropathy). In this study, it was used to visually demonstrate the damage to the corneal nerve fibers by the SARS-CoV2 virus, and the focus was on patients with neurological symptoms.

This is the first study to report damage to corneal nerve fibers and an increase in dendritic cell density in patients who have recovered from COVID-19, especially Long COVID-19 patients.

Doctor Kuznetsova Tatyana Aleksandrovna and the White Product Team wish you good health!

City Clinical Hospital №31 – Treatment of cardiovascular diseases in Moscow City Clinical Hospital №31

Cardiovascular disease (CVD) is the leading cause of death.Therefore, if any heart problems arise, you must immediately contact a specialist to identify the existing ailment and timely treatment.

Looking for an experienced cardiologist? You have come to the address – the official website of the City Clinical Hospital №31. The cardiology department of the hospital has been dealing with CVD diagnostics for many years. Thousands of patients visit us every year for the following reasons:

• Modern equipment – all the necessary measures are carried out on the latest angiographic installations, which allows to achieve high efficiency of operations
I. Pirogova
• Comprehensive provision of medical services – diagnostic procedures, complex surgical interventions, provision of equipped wards for rehabilitation under the supervision of cardiologists.

When to see a cardiologist?

The following symptoms indicate the presence of cardiovascular disease / pathology:

• Pain or discomfort in the chest area
• Palpitations, decreased heart rate / decreased heart rate, or heart failure
• Increased blood pressure
• Presence of cardiovascular disease in relatives (genetic predisposition)
• High cholesterol level
• Difficulty breathing after little physical exertion and at rest (shortness of breath)
• Edema
• Weakness, fatigue, decreased exercise tolerance
• Dizziness
• Fainting.

When these symptoms appear, you should immediately contact the experienced cardiologists of the City Clinical Hospital No. 31.

The risk of cardiovascular events is high in people with diabetes mellitus, previous myocardial infarction, stroke, cancer, kidney disease. CVDs are often asymptomatic, so it is important for these categories of patients, as well as those over 40, to undergo a cardiac examination at least once a year.

What is included in a consultation with a cardiologist?

• Identification of existing patient complaints
• Analysis of the history of the disease and medical documentation
• Appointment of a set of laboratory and instrumental examinations (ECG, ECHOKG, MRI of the heart, etc.)
• Making a diagnosis
• Prescribing a course of treatment (taking medications, recommendations for stress and lifestyle).

What is the price for an appointment with a cardiologist in Moscow?

The cost of a paid consultation with a cardiologist and further treatment depends on:

• Patient diagnosis
• Scope of required diagnostic methods
• Format of rehabilitation measures.

For detailed information and an appointment for a paid appointment with a cardiologist at the consultation and diagnostic center under the KGB No. 31, call +7 (495) 700-31-31 or leave a request on the website.

Reception is conducted by employees of the Department of Propedeutics of Internal Diseases of the Faculty of Medicine of the Russian National Research Medical University named after N.I. Pirogov, under the leadership of the head of the department, doctor of medical sciences Reznik E.V., cardiologist, therapist, doctor of functional and ultrasound diagnostics, clinical pharmacologist

What tests should be taken for weakness and chronic fatigue | Blog Bioniq

• Asthenic syndrome, malaise and fatigue, chronic fatigue syndrome (CFS), immune dysfunction, post-viral weakness – these are identical names;
• Long-term fatigue that does not pass can act as an independent symptom complex, but also be a harbinger of a disease proceeding in a latent, latent form;
• It is possible to establish the true cause of rapid fatigue using a number of tests, of which blood tests are given priority;
• And in the absence of pathological processes, and within the framework of the therapy of detected diseases, a competently composed complex of micronutrients, with the right proportions, helps to fight fatigue.

DETAILS

How does chronic fatigue syndrome manifest

What diseases can hide behind constant fatigue

What blood tests to take if you feel unwell

Nutrients and chronic fatigue syndrome How

the syndrome of chronic fatigue manifests itself

About such a syndrome, our body always reports two of the brightest “signal lights” – a rapid loss and / or impossibility of recovery of strength: physical and psychological spectrum.At the same time, no lifestyle changes occur, the daily diet does not change, physical and mental stress also does not increase, and the examination does not reveal diseases that can explain attacks and states of constant fatigue. However, it is still impossible to regain vigor, energy, calmness and well-being, and it does not work out for quite a long time.

The syndrome is definitely worth suspecting after a month of unsuccessful struggle with fatigue. You can confidently talk about a stable, already chronic manifestation of imbalance after six months of constant fatigue.

The opinion of bioniq specialists – no need to wait for the first symptoms to go away on their own. If you notice disorders of health from this list, we recommend first of all donate blood for “biochemistry” and do a general blood test. These results will help you understand what is really wrong with your body.

SYMPTOMS OF CHRONIC FATIGUE by frequency of manifestations

Physical

Paroxysmal weakness

Fainting

Sleep disorders pain

Memory impairment

, concentration

Spasms minimum stress

Headaches

Sensitivity to light, sounds, smells

Swollen lymph nodes

Mental

Dullness, apathy

Frequent sharp changes in mood

Low temper

Depression

9000 resistance to emotional stress

9000 An “influx” of thoughts

Unreasonable anxiety

Excessive anxiety, up to a pathological conviction of an external threat (delusional states)

What diseases can be hidden behind a constant fatigue

The main danger of the syndrome is its insidiousness.Let’s be honest, medicine cannot give a definite answer regarding the etiology of this condition. However, experts are convinced of the enormous role of macro-micronutrient deficiency: their lack, of course, affects our ability to withstand physical and mental stress, infections, and poor sleep.

The main theory of the origin of the syndrome also stands in support of vitamin nutrition: according to researchers, the viral nature looks the most convincing. The trigger, the mechanism that triggers the processes of oppression in the body, are herpes, enterovirus, hepatitis C, Epstein-Barr virus, etc.The theory also brings us back to the fact that without micronutrients, it is much more difficult to fight diseases and their consequences, as well as with constant fatigue.

Raises many questions and the “blurring” of symptoms, since each of the manifestations can accompany a disease that has a completely different nature:

• Weakness and severe fatigue – hypothyroidism : in a latent form, thyroid hormone deficiency shows itself as a decline in health;
• The same signs, combined with irritability – anemia : anemia, as well as diseases of the hematopoietic system, vascular pathologies;
• Severe fatigue, dizziness, fainting – may indicate diabetes , cardiovascular diseases, disorders of higher nervous activity;
• Changes in the psyche can relate to anemia, hypertension, be the result of traumatic brain injury, intoxication, hypertension, atherosclerotic disorders, etc.e.

The only way to avoid confusing these diseases with fatigue is a blood test. Completing the basic testing program will help you find the exact cause of your ailments in time and choose effective measures to improve your well-being and quality of life.

What blood tests to take if you feel unwell

The first “filter” that allows you to differentiate symptoms and understand whether CFS is a full-fledged symptom complex or all manifestations refer to other diseases is a complex of studies consisting of general and biochemical blood tests.Based on their results, additional examinations are prescribed or it is established that there is no need for such.

UAC – complete blood count, previously known as clinical. Helps to identify any failures in the hematopoietic system, determines the quality, size of blood elements (leukocytes, erythrocytes, platelets). Knowing the KLA indicators, you can diagnose anemia or confirm the health of the circulatory, hematopoietic systems. Also, such a study will show a deficiency of some B vitamins responsible for the development of anemia, the performance of the nervous system (B9, B12, B6).

Biochemical method is a study that clearly shows the quality of the work of organs, systems, highly informative data for identifying various inflammations, ailments, disorders. With this blood test, hypothyroidism, diabetes mellitus, blood diseases, cardiovascular pathologies, etc. can be detected.

If the data of general and biochemical studies require clarification, blood tests for hormones, antibodies, vitamins, as well as other procedures not related to blood: fluorography, ultrasound, etc. can be prescribed.

Nutrients and Chronic Fatigue Syndrome

Vitamins, micronutrients and macronutrients play a decisive role in the fight against persistent fatigue, provided that the symptoms are not the result of one of the diseases. In this case, the priority is the therapeutic program, and nutritional compounds perform an important, but still auxiliary function.

Which nutrient compounds to give preference – they decide, oddly enough, all the same blood tests, pointing out everything that requires special attention.All the symptoms associated with fatigue, one way or another, lead to a weakened immune system. It is to restore its functionality that the main action of nutrients is directed.

What effect do vitamins have

Fat-soluble group (can accumulate in the body):

• Vitamin A – enhances and activates protective-oxidative processes, helps support healthy metabolism, participates in the synthesis of adenosine triphosphate (ATP), a source of energy for all, without exception, biochemical reactions in the body;
• Group D – helps prevent the development of diabetes and obesity, inflammatory bowel diseases: these pathological conditions also provoke increased fatigue;
• Vitamin E – a deficiency of this compound negatively affects muscle tone;
• Vitamin K is important for completing a complex chain of biochemical reactions, the result of which is normal blood clotting, the state of the skeletal system, peripheral vessels.