Chest tightness, pain, and difficulty breathing?
Hello Doctor, I have a history of arrhythmia (paroxysmal tachycardia) and often experience palpitations.
Since last week, I have been experiencing chest tightness and pain, night sweats, and weakness, and now my breathing is quite labored.
Last night, I got home around 8 PM and fell asleep, but I was awakened three times in the early morning due to palpitations.
This morning, I woke up feeling weak and was also experiencing palpitations.
The pain is located on the left side, under my armpit and directly above my heart.
I haven't taken any heart medication for a year because I was concerned about the long-term use of "antiarrhythmic medication," which can lead to severe respiratory failure.
I stopped taking it because I had been on it for two and a half years, and during the summer after my sophomore year, I experienced acute respiratory failure and was hospitalized for intubation treatment for 10 days before being transferred to a larger hospital.
Thank you for your response, Doctor.
Niming, 10~19 year old female. Ask Date: 2016/03/22
Dr. He Dongjin reply Cardiology
Hello, you should continue taking heart rate control medications.
If you are concerned about the long-term use of antiarrhythmic drugs potentially leading to severe respiratory failure, please visit a cardiology clinic to discuss this with your physician.
They can prescribe a medication that is suitable for your condition.
Changhua Hospital cares about your well-being.
Reply Date: 2016/03/22
More Info
It sounds like you are experiencing a complex set of symptoms that can be quite distressing. Given your history of paroxysmal tachycardia and the recent onset of chest pain, shortness of breath, and other associated symptoms, it is crucial to approach this situation with a comprehensive understanding of potential underlying causes.
First, let's address the symptoms you are experiencing: chest pain, shortness of breath, palpitations, and fatigue. These symptoms can be indicative of various conditions, including cardiac issues, respiratory problems, or even anxiety-related disorders. Given your history of heart rhythm disorders, it is essential to consider the possibility that your symptoms may be related to your heart condition. Paroxysmal tachycardia can lead to episodes of rapid heart rate, which may cause discomfort in the chest, feelings of breathlessness, and even sweating.
The chest pain you describe, particularly if it is localized to the left side and associated with shortness of breath, should not be overlooked. While your previous cardiac evaluations, including echocardiograms and stress tests, may have returned normal results, it is important to remember that heart conditions can sometimes present in atypical ways. Additionally, the fact that you have experienced acute respiratory failure in the past raises concerns that your respiratory system may also be contributing to your current symptoms.
In terms of the specific areas of pain you mentioned—under the armpit and above the heart—this could suggest a few possibilities. Musculoskeletal issues, such as costochondritis or rib dysfunction, can cause localized pain that mimics cardiac pain. However, given your history, it is prudent to rule out any cardiac involvement first.
Your concern about the long-term use of heart medications is valid. Many patients worry about the side effects of long-term medication use, especially with drugs that can affect respiratory function. However, it is crucial to weigh the risks and benefits of medication with your healthcare provider. If you have been off your heart medication for a year and are experiencing worsening symptoms, it may be time to revisit this decision with your cardiologist. They can provide guidance on the safest options for managing your heart rhythm disorder while considering your respiratory history.
Additionally, the symptoms of fatigue and feeling weak upon waking can be related to several factors, including poor sleep quality, anxiety, or even the body's response to chronic stress. If you are waking up multiple times at night due to palpitations, this can significantly impact your overall well-being and energy levels during the day.
Given the complexity of your symptoms and history, I recommend the following steps:
1. Follow-Up with a Cardiologist: It is essential to have a thorough evaluation by a cardiologist who can assess your heart rhythm disorder and determine if any adjustments to your medication are necessary. They may also consider additional testing, such as a Holter monitor, to capture any arrhythmias that may occur during your daily activities or sleep.
2. Pulmonary Evaluation: Since you have a history of respiratory issues, a consultation with a pulmonologist may be beneficial. They can evaluate your lung function and determine if there are any underlying respiratory conditions contributing to your symptoms.
3. Mental Health Support: Given the anxiety that can accompany heart rhythm disorders, consider speaking with a mental health professional. They can help you develop coping strategies for managing anxiety and stress, which may alleviate some of your symptoms.
4. Lifestyle Modifications: Incorporating regular physical activity, a balanced diet, and stress-reduction techniques such as mindfulness or yoga can be beneficial for both your heart and overall well-being.
In summary, while your symptoms may be related to your heart rhythm disorder, it is essential to consider a holistic approach that includes both cardiac and respiratory evaluations, as well as mental health support. Open communication with your healthcare providers will be key in managing your symptoms effectively and improving your quality of life.
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