ZocdocAnswersWhat are these attacks my friend keeps having?

Question

What are these attacks my friend keeps having?

Ok so my friend keeps having these attacks. She is overweight and in her 40s. What happens is all of a sudden she'll get very hot and break out into a cold sweat. Then her heart will start to race so hard that I can see her pulse in her neck and chest. She also has type 2 diabetes, which she keeps under control pretty well. So after the heat hits her, we'll give her some juice, food, and glucose pills. This works sometimes, but usually extreme pain will hit her in the chest. This plus she has to sometimes use the bathroom, and then rest for hours. The next day she's usually fine, or after a week she's better. We don't know what this is. She plans to see her doc soon so don't worry about it. But he says it has something to do with stress, that it could be a panic attack... but I'm very worried that it's more. Also for some reason it hits at the end of the month, usually the 20-26th. Why then? If anyone could help, it would be most appreciated. Thank you :)

Answer

There are a lot of things that can cause these kinds of attacks, and as you surmised it is definitely the right thing to go see the doctor to discuss the possibilities and whether your friend should undergo any further testing. In terms of possibilities, based on the history you gave one clear possibility is low blood sugar, which can cause people to get sweaty, shaking, and sometimes confused and disoriented. Those kinds of attacks improve with juice and glucose pills because that raises the blood sugar back to normal. One way to determine whether this is what's going on is to have your friend check her blood sugar when she's having one of these episodes (diabetics often have a glucose meter that they use). Panic attacks can also cause very similar sounding symptoms (along with chest pain). A condition called pheochromocytoma can cause people to get episodes of flushed and racing hearts, as can elevated thyroid hormone. If she has a heart condition that causes her to develop an abnormal rhythm (called an arrhythmia), this can make her heart beat very fast and can make her dizzy and sweaty. If she has any coronary artery disease she could have episodes of angina that could cause her chest pain, or if her heart is beating fast for another reason she could develop chest pain from the strain that it puts on her heart. I think it's great that she is going to see the doctor soon, and would recommend that you and she pay close attention to her blood sugar when she has these attacks and what she tends to be doing when they come on to help her doctor get to the bottom of this.

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