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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Are Tremors In The Hands Due To General Weakness In A Heart Patient?

I am caring for a 76 year old man with severe heart failure,and diet controlled diabetes. He had a moderate spell of his hands and arms shaking but his blood sugar was ok. He has been given about 6 more months to live and can get anxious, but didn t feel that he was at the time. I m wondering what could have caused the shaking. He does complain of getting weaker every day but does eat a balanced diet. He gets little exercise if any at all. Do you think the shaking can be due to his general weakness and failing health? He is seeing his cardiologist this week.
Tue, 16 Jan 2018
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Internal Medicine Specialist,  's  Response
hello welcome to healthcaremagic
shaking of hands can be either tremors or seizures.

i would need a little more history to reach a presumptive diagnosis.

1.does he have palpitations/tachycardia/dyspnoea during the episode of shaking.. if yes then this can be a tremor and it can be due to hypoglycemia.
now since he is diabetic(and you mentioned he is controlled on diet) i would still like to enquire history of metformin intake for diabetes. as metformin in heart failure patients can cause hypoglycemia. in such a case please see his physician because he needs to change his medicines.

2. does he has loss of consciousness, losss of bowel/bladder control, tongue biting/frothing from mouth during this shaking attack. if yes then this could be a GTCS seizure or a partial seizure. in this case i would advice you to follow up with a nearby doctor immediately as he need medications for this.

3. it could be asterexis due to hepatic encephalopathy. his LFT needs to be done in this case.

for symptomatic relief please give him some sugar next time he experiences such attack.

i hope this helps you.
please feel free to revert back in case of any doubts/concerns
thank you.
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Are Tremors In The Hands Due To General Weakness In A Heart Patient?

hello welcome to healthcaremagic shaking of hands can be either tremors or seizures. i would need a little more history to reach a presumptive diagnosis. 1.does he have palpitations/tachycardia/dyspnoea during the episode of shaking.. if yes then this can be a tremor and it can be due to hypoglycemia. now since he is diabetic(and you mentioned he is controlled on diet) i would still like to enquire history of metformin intake for diabetes. as metformin in heart failure patients can cause hypoglycemia. in such a case please see his physician because he needs to change his medicines. 2. does he has loss of consciousness, losss of bowel/bladder control, tongue biting/frothing from mouth during this shaking attack. if yes then this could be a GTCS seizure or a partial seizure. in this case i would advice you to follow up with a nearby doctor immediately as he need medications for this. 3. it could be asterexis due to hepatic encephalopathy. his LFT needs to be done in this case. for symptomatic relief please give him some sugar next time he experiences such attack. i hope this helps you. please feel free to revert back in case of any doubts/concerns thank you.