Conditions Associated with Sudden Tiredness and Fainting
1. Hypoglycemia
Symptoms: Sweating, shakiness, hunger, confusion, irritability, blurred vision.
Differentiation: Low blood sugar (<70 mg/dL), often occurs in diabetics or after prolonged fasting.
2. Dehydration
Symptoms: Dry mouth, dizziness, decreased urine output, rapid heart rate.
Differentiation: Recent history of poor fluid intake, prolonged heat exposure, or diarrhea.
3. Orthostatic Hypotension
Symptoms: Lightheadedness on standing, dizziness, blurred vision.
Differentiation: Drop in systolic BP >20 mmHg or diastolic BP >10 mmHg upon standing.
4. Vasovagal Syncope
Symptoms: Nausea, pallor, sweating, preceded by emotional stress or pain.
Differentiation: Trigger event (e.g., standing for a long time, emotional shock), transient loss of consciousness.
5. Cardiac Arrhythmias (e.g., Atrial Fibrillation, Bradycardia)
Symptoms: Palpitations, chest discomfort, shortness of breath.
Differentiation: Irregular or slow heart rate on ECG; history of cardiac disease.
6. Acute Myocardial Infarction (MI)
Symptoms: Chest pain radiating to arm/jaw, sweating, nausea, breathlessness.
Differentiation: Elevated cardiac enzymes (Troponin I), ECG changes (ST elevation or depression).
7. Pulmonary Embolism
Symptoms: Sudden breathlessness, chest pain, hemoptysis.
Differentiation: Elevated D-dimer, CT pulmonary angiography showing embolus.
8. Anemia (Acute Blood Loss or Chronic)
Symptoms: Pallor, fatigue, tachycardia, shortness of breath.
Differentiation: Low hemoglobin levels, history of blood loss (e.g., menstruation, GI bleeding).
9. Seizures
Symptoms: Aura, tonic-clonic movements, postictal confusion.
Differentiation: Witnessed jerking movements, tongue biting, postictal drowsiness.
10. Electrolyte Imbalances (e.g., Hypokalemia, Hyponatremia)
Symptoms: Muscle cramps, confusion, fatigue, arrhythmias.
Differentiation: Abnormal serum sodium or potassium levels.
11. Stroke (TIA or Ischemic)
Symptoms: Sudden weakness, slurred speech, facial droop, limb paralysis.
Differentiation: Focal neurological deficits, confirmed with CT/MRI brain.
12. Adrenal Insufficiency (Addisonian Crisis)
Symptoms: Fatigue, abdominal pain, hypotension, hyperpigmentation.
Differentiation: Low cortisol levels, hyponatremia, hyperkalemia.
13. Panic Attack or Acute Stress Reaction
Symptoms: Palpitations, hyperventilation, chest tightness, dizziness.
Differentiation: Normal ECG, history of stress/anxiety trigger.
14. Carbon Monoxide Poisoning
Symptoms: Headache, confusion, dizziness, cherry-red skin (rare).
Differentiation: Elevated carboxyhemoglobin levels, history of exposure to smoke.
15. Drug or Alcohol Intoxication
Symptoms: Altered mental status, slurred speech, unsteady gait.
Differentiation: History of substance use, positive toxicology screen.
16. Hypercapnia (CO2 Retention)
Symptoms: Fatigue, confusion, shallow breathing, headache.
Differentiation: Elevated arterial CO2 levels, respiratory acidosis on ABG.
17. Sepsis
Symptoms: Fever, hypotension, confusion, tachycardia.
Differentiation: Positive blood cultures, elevated procalcitonin, leukocytosis.
18. Pheochromocytoma
Symptoms: Episodes of palpitations, sweating, headache, hypertension.
Differentiation: Elevated urinary/plasma metanephrines.
19. Hypoxia (e.g., from high altitude or respiratory failure)
Symptoms: Confusion, breathlessness, cyanosis, fatigue.
Differentiation: Low oxygen saturation (SpO2), arterial blood gas abnormalities.
Approach to Diagnosis
1. History: Onset, triggers, associated symptoms (e.g., chest pain, palpitations, stress).
2. Examination: BP, pulse, ECG, SpO2, blood sugar, hydration status, neurological exam.
3. Investigations: Blood tests (CBC, electrolytes, glucose, cardiac enzymes), imaging (ECG, CT/MRI, chest X-ray), and ABG if needed.
Timely differentiation and targeted management can prevent complications and improve outcomes.
