Conversation: The conversation between human and AI assistant.
[|Human|] For the past 2 or 3 months, I have had very strong, pulsing heart beats and trembly feeling inside my chest that will not go away. Also, I have severe hypertensive periods, vertigo, and tinnitus. I have a history of Hashimoto s but TSH is normal, now. I have had brain MRI, Ct scans, EKGs, carotid dopppler, blood chemistries and all appear to be within normal range, with the exception of Vit D, I have added 5,000IU/day. However, about 2 weeks ago, I had an episode of hypocalcemia, confirmed by Trousseau s sign, periorbital parysthesia, etc.. (but total serum calcium was normal). I have since added calcium supplements. I am currently on 60 mg Cardizem 3x/day but BP is still 150/90. (I had an allergic reaction to carvedilol - hives, swelling.) Have been to ER 3x recently with hypertensive episodes 200/115 and palpitations. Have been to a cardiologist, endocrinologist, and PCP. Should I go to a neurologist? What other things can cause these conditions?
[|AI|]  Hello, I passed carefully through your question and would explain that these symptoms do not seem to be related to any neurological conditions, especially considering the high blood pressure values.  Coming to this point, I would recommend checking cortisol plasma levels, aldosterone plasma levels and urinary metanephrines in order to exclude a possible a Chat Doctor.  A panic disorder cannot be excluded either. For this reason, I would recommend trying low dose Alprazolam during these episodes and see if your situation improves.  Hope I have answered your query. Let me know if I can assist you further.