Thursday, March 7, 2013

9 Symptoms You Should Never Ignore

Courtesy of AARP Health Conditions-Treatments

You wake up one morning with a fever. Or maybe you have a really bad neck ache. How do you know if a symptom is serious or not? "The things that we doctors are most concerned about are new symptoms that develop quickly, rather than things that develop over a long period of time," says Keith L. Black, M.D., chair of neurosurgery at Cedars-Sinai Medical Center in Los Angeles.

Another warning sign? That uh-oh feeling that tells you something's not quite right. "You know your body best," says Len Lichtenfeld, M.D., deputy chief medical officer at the American Cancer Society. "When you see or feel something different or just feel 'off,' pay attention; don't dismiss it."

Here are nine symptoms and what they might mean.

1. Sudden Intense Headache

The big worries: If you experience head pain unlike any you've had before, especially if it peaks in seconds to minutes in any part of the head, it could signal a ruptured aneurysm, a blood vessel in your brain that suddenly bursts, requiring immediate attention.

In addition, your doctor will want to rule out three other conditions:
  • Cardiac cephalgia: A rare disorder in which reduced blood supply to the heart manifests as a headache and can also cause chest pain and exhaustion with exertion.
  • Meningitis: A headache often accompanied by a stiff neck, fever and confusion or other changes in mental status.
  • Temporal Arteritis: A rare illness in which a person's immune cells invade the walls of the arteries that carry blood to the head, causing headache, low-grade fever or pain upon speaking or chewing. "The reason temporal arteritis is such a concern is that it can result in the temporary or permanent loss of vision in one or both eyes," says Brian Grosberg, M.D., codirector of the Montefiore Headache Center in the Bronx, New York. Steroids usually take care of the problem if treatment is prompt.

2. Chest Pain

The big worries: Any intense discomfort, heaviness or pressure — like an elephant sitting on your chest — could spell heart attack. It may be combined with pain radiating down an arm, nausea and vomiting, sweating, and shortness of breath. Women can experience more subtle symptoms, like fatigue, a burning sensation or upper abdominal pain. In any case, call 911. "If it is a heart attack, a delay could cause the heart muscle to be damaged," says Eric Topol, M.D., a cardiologist at the Scripps Clinic in La Jolla, California. If these symptoms occur only during exertion, it could also be angina, which happens when the heart muscle temporarily doesn't get enough blood.

Sudden severe chest or upper-back pain (often described as a ripping sensation) can be caused by a tear in the aorta, known as aortic dissection, which requires immediate attention. Fortunately, this life-threatening condition occurs in only about three out of 100,000 people.

3. Unexplained Weight Loss

The big worries: Losing more than 5 percent of your body weight — without trying — over a period of six months could mean cancer: Weight loss is a symptom in up to 36 percent of cancers in older people. "If you or a family member is suddenly losing weight after trying 400 times before, you have to ask, 'Why is this time the charm?' " says Lichtenfeld.

4. Unusual Bleeding

The big worries: Ulcers and colon cancer can cause rectal bleeding or black or tarry stools, says Andres Pardo-Agila, M.D., a family medicine physician at the University of Texas Health Science Center at Houston. If you haven't had a colonoscopy recently, talk to your physician. Vaginal bleeding can be linked to gynecologic cancers. Bloody vomit can result from stomach or esophageal cancer, and people with lung cancer can cough up blood. "Whenever you see blood where it shouldn't be, see a doctor," says Lichtenfeld.

5. High or Persistent Fever

The big worries: Fever is your body's way of fighting infection. But "fever of 103 degrees and higher warrants a trip to the doctor — period," says David Bronson, M.D., president of the American College of Physicians. It may indicate a urinary tract infection, pneumonia, endocarditis (inflammation of the lining of the heart chambers and valves) or meningitis, which may require antibiotics to clear up. A persistent low-grade fever — for several weeks — with no obvious cause is characteristic of some infections, including a sinus infection, and some cancers, like lymphoma and leukemia. "Cancer is on the list of things we think about, but it is usually not the first thing," says Ronan Factora, M.D., a geriatrician at the Cleveland Clinic in Ohio.

6. Shortness of Breath

The big worries: Sudden shortness of breath can indicate a pulmonary embolism — when a blood clot forms in the body's deep veins (usually in the legs), travels to the lungs and gets lodged in the lung's blood vessels. Suspect an embolism if you've recently traveled, have undergone surgery or have been immobile, and/or your shortness of breath is accompanied by chest pain and coughing up blood. If you find yourself gasping after climbing two or three stairs or getting tired sooner than you used to, doctors will want to rule out chronic obstructive pulmonary disease (COPD), especially if it's accompanied by a cough and fatigue and you have a history of smoking. Irregular heart rhythm, congestive heart failure and other types of heart disease are additional possibilities. When organs aren't getting enough oxygen, breathlessness can result. See a doctor — stat.

7. Sudden Confusion

The big worries: If you're experiencing sudden confusion, personality changes, aggression or an inability to concentrate, it's important to see a doctor right away. "The mortality rate for severe confusion is pretty high. You have to figure out what's going on," says Bronson. In the worst case, a brain tumor or bleeding in the brain could be behind the delirium. If you're also experiencing slurred speech, difficulty finding the right words, or numbness or weakness in the face, hand or leg, stroke is a strong possibility. "You have a window of about two to three hours to get to the hospital," says Cedars-Sinai's Black. Beyond that, brain loss may be irreversible.

8. Swelling in the Legs

The big worries: An accumulation of fluid (called edema) in the extremities can be caused by a number of conditions, but the one that most concerns doctors is heart failure, when the heart cannot pump as much blood as the body needs. When that happens, blood backs up in the veins, causing fluid to accumulate in the body's tissues. "Swelling of the legs, especially if it is persistent, should never be ignored," says Gordon F. Tomaselli, M.D., director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore. Heart failure is suspected when both legs are affected and the patient also has shortness of breath, fatigue and chest tightness.

9. Sudden or severe abdominal pain

The big worries: Sudden abdominal pain could signal that an aortic aneurysm — a bulge that develops in the aorta, frequently in the abdominal area — has ruptured. "If the aneurysm ruptures, the pain tends to be sudden and severe and typically centralized around the belly button," says Richard Desi, M.D., a gastroenterologist with Mercy Medical Center in Baltimore. Alternatively, sudden pain can indicate a perforated viscus (a hole in the stomach, intestine or other hollow organ), often due to an ulcer. Intestinal ischemia, which happens when blood flow to the intestines slows or stops, starving tissues of oxygen, can be a culprit, too. "It's more common in older, sicker patients who have heart failure or atrial fibrillation," says Brian Putka, M.D., a gastroenterologist with the Cleveland Clinic. Each of these conditions is life threatening, requiring emergency surgery.

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