Hi everyone! Hopefully someone may be able to provide some insight/direction. I'm a 27 y/o F with weird symptoms that have led to 5 ER visits and 2 admissions since March 6. My symptoms have been nearly constant, but they definitely fluctuate in severity. At my worst, I was convinced I had a PE, or even a pheo, but obviously those have both been ruled out. I am currently being seen by a PCP and cardiologist for my symptoms, and now have referrals for endocrinology, pulmonology, and dermatology. I apologize in advance for how much is in this post, but I appreciate any and all thoughts!
Current Symptoms
-palpitations
-dyspnea (worse on exertion or when laying flat)
-tachycardia (managed with atenolol)
-significant fatigue, worsening
-night sweats, worsening
-enlarged submandibular lymph nodes
-difficult sleeping
-fluctuating blood pressure (typically hypertensive, managed with atenolol)
-dizziness and lightheadedness (one syncopal episode attributed to dehydration by MD)
-chest pain and pressure (diaphragm area, midsternum area)
-throbbing pain in L leg, R neck (R neck throbbing attributed to muscle spasm by MD)
-rash (small red bumps on arms, back, chest, stomach)
-brain fog
-generalized aches
-reduced appetite
-horizontal "dent" in upper L thigh
-worsened reflux
Ongoing Issues/PMHx
-IBS
-kidney stones (basket procedure x 1)
-duplicated ureter on L kidney
-ovarian cysts (cystectomy x 1)
-headaches and migraines (improved on nexplanon)
-acne
-severe dysmenorrhea (improved on nexplanon)
-depression (stable with therapy, duloxetine)
-anxiety (was relatively stable with therapy, currently worse)
-overweight (190 lbs, 5' 7")
Current Medications
-duloxetine 60 mg
-atenolol 25 mg
-vitamin D 4000 IU
-ativan .5 mg PRN
-vistaril .25 mg PRN
-nexplanon implant
Pertinent/Incidental Findings?
-negative cardiac workup (EKG, ECG, stress echo, cardiac MRI, continuous cardiac monitoring)
-negative COVID PCRs
-clear chest x-rays, CT angiogram, CT abdomen/pelvis
-normal PFT
-elevated D-dimer x 4 (.52 - .96)
-mildly calcified aorta
-mild multilevel degenerative disc disease in thoracic spine
-mild narrowing of L iliac vein, poor phasicity of L femoral artery (not May-Thurner per MD)
-chronic borderline hypercalcemia (10.0-10.8 mg/dL)
-chronic borderline hyponatremia (136 mmol/L)
-low vitamin D (now on supplement per MD)
-negative ANA
-normal peripheral blood smear