Symptoms of Anxiety: Chest Tightness, Dizziness, and Rapid Heartbeat

Chest tightness, dizziness, and rapid heartbeat?

I have been experiencing chest tightness and a rapid heartbeat (around 110 beats per minute) for the past week or two, which makes me feel dizzy and like my brain is lacking oxygen, almost to the point of not being able to breathe.
I went to the emergency room on August 1st because I couldn't tolerate it anymore.
They performed an X-ray, an electrocardiogram, and blood tests, and the doctors said everything was generally normal.
They mentioned that if it were a pulmonary embolism, it wouldn't come and go like this.
They prescribed me Propranolol to take when I feel uncomfortable and referred me to a cardiologist, pulmonologist, and endocrinologist in Zhuxiang.
They said if all tests come back normal, it might not rule out symptoms of early menopause.
However, after looking into the symptoms of autonomic nervous system dysfunction, I feel like I have most of them, and I have been feeling really unwell lately with intermittent chest tightness, rapid heartbeat, shortness of breath, and fatigue.
Doctor, what do you think is wrong with me? If it is autonomic nervous system dysfunction, which specialist should I see? Thank you.

Ting Ting, 40~49 year old female. Ask Date: 2016/08/02

Dr. Chen Wenke reply Psychiatry

Hello, based on your description, I have a few observations for your reference.
Your numerous physiological symptoms seem to be causing you significant discomfort and are clearly affecting your emotions, leading to heightened anxiety.
Even though initial examinations did not reveal any major abnormalities, you still feel uneasy.
This situation is often considered a symptom of autonomic nervous system dysregulation.
However, if these issues have not occurred before, it is important to consider what might be causing them.

Your age does not seem to indicate that you are in menopause, but clinically, some women do experience symptoms earlier.
Therefore, I believe it is necessary to consult with a gynecologist for evaluation and examination.
Additionally, it would be wise to check your thyroid function, as thyroid dysfunction can also lead to symptoms similar to autonomic nervous system dysregulation.
Finally, autonomic nervous system dysregulation is often referred to as anxiety disorders in the field of psychiatry.
If you have a predisposition to anxiety and are frequently under various life and work pressures without appropriate stress relief mechanisms, it is understandable that acute anxiety may arise over time.
If this is the case, I suggest you carefully assess whether you have long-term or recent sources of stress.
If so, it is important to address and manage that stress, and you may also consider seeking external support.
I believe that the medical resources in Taipei are very abundant, and you can seek appropriate medical assistance nearby.
If physiological examinations do not reveal significant issues, you might want to talk to a psychiatrist, which could be very helpful.
Although it is concerning, it is essential to address these issues step by step, cooperate closely with your physician, and document your discomfort to help them understand your situation.
I believe you will stabilize.
Wishing you peace, Dr.
Chen Wenkai.

Reply Date: 2016/08/02

More Info

It sounds like you are experiencing a range of distressing symptoms, including chest tightness, rapid heartbeat, dizziness, and feelings of breathlessness. These symptoms can be quite alarming and may lead to significant anxiety about your health. Based on your description, it seems that you have already sought medical attention, which is a crucial first step in addressing your concerns.

From a medical perspective, the symptoms you are experiencing can be associated with several conditions, including anxiety disorders, panic attacks, and autonomic nervous system dysregulation. Anxiety can manifest physically in various ways, leading to symptoms such as rapid heart rate (tachycardia), chest tightness, and dizziness. These physical manifestations can sometimes mimic more serious conditions, which is why it is essential to rule out any underlying medical issues through appropriate testing, as you have done.

Your recent visit to the emergency department, where you underwent chest X-rays, an electrocardiogram (ECG), and blood tests, is a good approach to exclude serious conditions such as pulmonary embolism or cardiac issues. The fact that these tests returned normal results is reassuring, but it does not necessarily explain the persistent symptoms you are experiencing.

The medication Propranolol, which your doctor prescribed, is a beta-blocker that can help manage physical symptoms of anxiety, such as rapid heart rate and tremors. It is often used in situations where anxiety leads to significant physical symptoms, and it can be effective in reducing the intensity of these symptoms. However, it is essential to follow your doctor's instructions regarding its use and to communicate any ongoing or worsening symptoms.

Given your concerns about autonomic nervous system dysregulation, it may be beneficial to consult with a specialist in neurology or a psychiatrist who has experience with anxiety disorders and related conditions. They can provide a more comprehensive evaluation of your symptoms and help determine if there is an underlying anxiety disorder or if your symptoms are related to another condition.

In addition to seeking medical advice, consider implementing lifestyle changes that can help manage anxiety and improve your overall well-being. Regular physical activity, mindfulness practices such as meditation or yoga, and adequate sleep can significantly impact your symptoms. Additionally, cognitive-behavioral therapy (CBT) is an effective treatment for anxiety disorders and can help you develop coping strategies to manage your symptoms.

It is also important to monitor your symptoms and keep a journal of when they occur, their intensity, and any potential triggers. This information can be valuable for your healthcare provider in understanding your condition better and tailoring a treatment plan that suits your needs.

In summary, while your symptoms are concerning, the normal results from your recent medical evaluations are a positive sign. It is crucial to continue working with your healthcare providers to explore the underlying causes of your symptoms and to develop a comprehensive treatment plan that addresses both the physical and psychological aspects of your condition. Remember, you are not alone in this, and there are effective treatments available to help you manage your symptoms and improve your quality of life.

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