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What Could Be The Reason For Having Racing Heart, Dizziness And Nausea With Salmonella?

Posted on Mon, 30 Dec 2013

Question: I've written about my son having salmonella in july. several nice doctors made suggestions, which we followed. my son is 24 years old and is in California studying for his masters. I live in new Hampshire and we are trying to figure out what is going on with him cross country. he has all his blood work done again in california and stool sample and everything has come back negative (which is good in a way but still very frustrating because he continues to have symptoms). His hearts races at sporadic times, he gets dizzy and is pretty much naseaus every time he eats. he has been to a cardiologist and they say his heart is fine. they took blood for anemia, thyroid, kidney and all cam back negative. his stool sample has no salmonella!! he also got an ultrasound for his gallbladder and that was normal. please can anyone help a desperate mother with her son so far away and not enjoying the college experience because of this unknown illness. i'm starting to suspect that they my have misdiagnosed the salmonella issue and has something altogether different he had salmonella in july of 2013. can anybody help please. thank you

Answered by Dr. Rakesh Karanwal (1 hour later)

Brief Answer: Possibilities : Stomach infection or mental stress Detailed Answer: Hi Ma'am, Thanks for your query. Firstly, in order to PINPOINT the exact cause of your son's problems; give you a SOUND professional advice; and, TRUE VALUE FOR YOUR MONEY, I request you to kindly provide additional information as follows :- @ What were your son's symptoms (fever, diarrhea etc..) which was diagnosed as salmonella? @ Does he have chronic acidity problems, with or without episodes of watery diarrhea? @ How long (in minutes/hours) does he have a racing heart, that is, rapid beating of the heart? Does he feel dizzy ONLY DURING the racing heart? However, pending receipt of additional information as requested, I feel that he has either, two separate problems; OR, all symptoms are part of a single condition. The possible causes are :- * Infection of the stomach by H.pylori : which (in case he was diagnosed as having salmonella diarrhea in July) is characterized by acidity, nausea, occasional vomiting, loss of appetite, bloating and distension, abdominal fullness/discomfort; and sometimes, episodic watery diarrhea. A 2-weeks' course of anti-H.pylori therapy + Probiotics + Pro-kinetic (anti-nausea) drug + digestive enzymes; followed by, 3-4 months of anti-acid drug, such as esomeprazole or rabeprazole will lead to complete recovery. * Irritable Bowel Syndrome (IBS), which is aggravated by constant mental stress, anxiety and apprehensions. it is characterized by acidity, nausea, loss of appetite, abdominal discomfort and diarrhea alternating with constipation. In this case, a regular, long-term course of anti-depressant + anti-anxiety drug + Beta-blockers will show remarkable response. * Chronic mental stress occasionally precipitating Acute Panic Reactions (he is a student with inevitable mental stress) which are characterized by racing heart, palpitations, dizziness, nausea, trembling, sweating and confusion- to name a few. The treatment is same as for IBS. * Paroxysmal attacks of rapid beating of the heart "racing heart" - condition called Paroxysmal Tachycardia. This is characterized by episodes of sudden onset of "racing heart" lasting for 5-30 minutes and associated with dizziness. ECG and 2-D Echo of the heart may be normal. But, it can be diagnosed by 24-hour HOLTER MONITORING of the heart and, conclusively by Electrophysiological Study (EPS). Please ask your son to consult his doctor (as well as cardiologist) and apprise him of my opinion/recommendations. I am certain that he will agree with my opinion and clinical acumen; order required tests if necessary, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. In any case, I am keenly awaiting additional input as requested. Fond regards and have a nice day, Dr. Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (48 minutes later)

thank you doctor for your quick response. I am trying to contact my son to ask him your questions and I will get back to you as soon as possible. thank you again for your attention.

Answered by Dr. Rakesh Karanwal (7 minutes later)

Brief Answer: You are most welcome Detailed Answer: You are always welcome to write to me, ma'am! I will be happy to answer ALL queries. Am eagerly awaiting additional information. Have a nice day, Fond regards, Dr. Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (2 hours later)

1.very high fever for four days, bowel movements that were only liquid and very foul odor, severe headaches and body aches. blood pressure very low( 89/77 +/-) and very high pulse. 2. no acid problems or diarrhea 3. he says the racing or strange heart beats last minimum 5 seconds, maximum 2 minutes. Dizzy, not all the time with the heart, but most of time. Doctor, he said he was feeling fine this weekend and this morning but when he started his physical therapy sessions, just the warm, he started getting dizzy. My son was the epitome of health before july and now he gets out of breath climbing the stairs! He had a 24-hour holster and the cardiologist said his heart was fine. he's had several ekgs and they were all normal. Posted By : Paradisofamily he's also has had a treadmill running stress test and an ultrasound on his heart

Answered by Dr. Rakesh Karanwal (8 hours later)

Brief Answer: Heart & Lungs involvement due to salmonella toxins Detailed Answer: Hi ma'am, Thanks for the invaluable inputs, which have helped me in narrowing down the possibilities. 1. The July episode was apparently food poisoning, most likely due to salmonella; or, other bacteria. 2. Low Blood pressure with a rapid heart rate indicates that the infection had entered the blood stream, which spread the infection + toxins across the entire body (condition is called "Septicemia"). 3. Identification of causative organism is ONLY of academic interest at this stage. It was apparently the toxins released by the causative bacteria (including salmonella), which are well known to affect brain, heart, lungs, kidneys or any part of the body. 4. In view of the above-mentioned observations, the released toxins had apparently caused infectious myocarditis (inflammation of the heart muscle), as well as, the lungs. 5. The affected heart and lungs can be treated only symptomatically. There is NO ANTIDOTE for the causative toxins. 6. I am not in possession of the ECG, stress ECHO, TMT and Holter reports. Hence, cannot comment on the state of the heart. His cardiologist is the best person to monitor his heart and, start treatment as and when he detects any abnormality. The short bursts of racing heart can be controlled by certain drugs. However, the privilege is entirely that of his treating cardiologist. 7. Lastly, your son SHOULD UNDERGO Lung Function tests, CT/MRI of the lungs and, other relevant tests, to assess the lungs' status. it may be mentioned that breathlessness + dizziness on minimal exertion are due to either, heart or lung problems; OR both. The other possibility is deficiency of blood (Anemia) which- I am sure- must have been excluded by his treating doctors. Please ask your son to consult his doctor again and discuss my opinion/recommendations with him. I am sure that he will agree with me and order relevant workup. Hope you find my response helpful, informative and to your satisfaction. I will be happy to answer further clarifications, if any. Fond regards, Dr. Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (2 days later)

thank you, Dr. Karanwal, for your informative information, even though, as a mother, it makes me very scared for my son. Will he be ok, after almost 4 months of not addressing the problem immediately? If you are correct in your analysis, is it something that can be cured? He is coming home from California for Christmas break, what should we do first to starting a cure? I don't think I have been this scared in my life, I have never cried so much. Also, Dr. my son does mention that there are days that he feels "back to himself" that he feels no symptoms. With what you may be suggesting he has, is this normal - feeling fine for days and then going back to feeling awful?

Answered by Dr. Rakesh Karanwal (3 hours later)

Brief Answer: The cause narrows down to Mental Stress disorder Detailed Answer: Yes ma'am, If what you say is correct (that he feels awful only at times), then the possibility goes much in favor of Acute Panic Reactions, which can occur any time, while the individual remains normal rest of the time. Being a student who has aspirations and dreams to fulfill, puts in hard work, has deadlines to meet BUT, at times, when stress becomes too much to bear, he develops panic reactions. I would strong recommend that he first gets CT of chest done, which- if normal- starts STRAIGHTAWAY, stress-busting medicines- a combination of anti-depressant drug + anti-anxiety drug + Metoprolol or Propranolol. This course should be taken for at least 6-12 months, under supervision of a Psychiatrist. I am confident that, with these medicines, he will manage his stress and consequently be "back to himself" forever. With fond regards, Dr. Rakesh Karanwal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Karanwal (44 hours later)

Dr. you have been so kind, thank you from the bottom of my heart. I will not stop till he is back to himself, with you wisdom and expertise, you have brought me closer to finding a solution so that my son can continue his young life with hope and happiness. You shall be in my prayers. Many blessings to you, your family, friends and staff, wherever you may be on this wonderful planet. Again, many, many thanks. Sincerely, XXXX

Answered by Dr. Rakesh Karanwal (2 hours later)

Brief Answer: Thanks tons for the kind words Detailed Answer: Hi Mrs. XXXX, I am feeling honored with your kind words. I was merely doing my duty. Shall always pray for son's earliest recovery. I am highly confident that with the advised medicines, he will be as normal as before. Thank you very much for your magnanimous temperament. I will always be by your side whenever you need me. May God Bless you all, particularly your dear son. Kind regards and best wishes, Dr. Rakesh Karanwal

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar