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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From Stress, Feeling Exhausted, Difficulty In Sleeping, Fast Beating Sound On Head. Normal Scan Results. Suggestions?

Hi. I have been very stressed, can't sleep, and exhausted for about 4 months, was very stressed one night and started getting a loud, fast beating on the left side of my head, about 190 beats per second. This went on all night and left the next day. The diastolic blood pressure reading ranges around 95 when that happens. This goes on every night and is so loud and fast that I very rarely get more than maybe 3 hours sleep a night. This has been going on for over a month and it started last night at 8PM and is still going today at 5PM. I had a cat scan and an ultrasound on the carotid arteries in my neck and they are okay. Any suggestions?
Mon, 15 Jul 2013
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  User's Response
You are suffering from severe headache at present as I understand from the history you provide. It is important to rule out serious neurological diseases in your case. As you seem to suggest, your CT scan of the head was normal.

Your heart rate of 195 per minute (hope it is checked accurately) is very high. Such high headaches along with diastolic BP of 195 mmHg require investigation into the cause of headache. Hyperthyroidism, high BP itself, pheochromocytoma (rare tumour of adrenal gland) can cause such a condition as you are now suffering. You must consult a general physician (internal medicine) for detailed evaluation.

Finally, severe attacks of migraine can cause severe headaches.
If you have had migraine in the past or if any of your family members have migraine, this is likely to be migraine (provided you have ruled out other causes mentioned above).

Internal Medicine specialist is the best doctor to consult for your problems.

If the doctor also finds no serious disease causing headaches or if he says it is related to stress or depression, you may then consult a psychiatrist.
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Psychiatrist,  Dr. Dr.Nehal's  Response
Hi,
Thanks for using healthcare magic.

I have gone through your available history.

It seems that you are having depression. You should consult psychiatrist for detailed evaluation and management. Doctor may rule out physical causes like thyroid dysfunction or vitamin b 12 deficiency, etc.

Doctor may advise you to start anti-depressant drugs like escitalopram or agomelatine or desvenlafaxine etc.

You may also get benefit by doing stress management and relaxation therapy like yoga, meditation or breathing exercise.

Thanks.
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Suffering From Stress, Feeling Exhausted, Difficulty In Sleeping, Fast Beating Sound On Head. Normal Scan Results. Suggestions?

You are suffering from severe headache at present as I understand from the history you provide. It is important to rule out serious neurological diseases in your case. As you seem to suggest, your CT scan of the head was normal. Your heart rate of 195 per minute (hope it is checked accurately) is very high. Such high headaches along with diastolic BP of 195 mmHg require investigation into the cause of headache. Hyperthyroidism, high BP itself, pheochromocytoma (rare tumour of adrenal gland) can cause such a condition as you are now suffering. You must consult a general physician (internal medicine) for detailed evaluation. Finally, severe attacks of migraine can cause severe headaches. If you have had migraine in the past or if any of your family members have migraine, this is likely to be migraine (provided you have ruled out other causes mentioned above). Internal Medicine specialist is the best doctor to consult for your problems. If the doctor also finds no serious disease causing headaches or if he says it is related to stress or depression, you may then consult a psychiatrist.