Shortness of Breath: Causes and When to Seek Help

Shortness of breath?

Hello, doctor.
I have been experiencing breathing difficulties since I was 19 years old, just before my military service.
At that time, I consulted a physician who conducted blood tests, X-rays, and an electrocardiogram, all of which showed no issues.
My blood pressure was recorded as low, but I generally do not have problems with low blood pressure, and there is no family history of such conditions.
My three siblings also have similar issues, and we have all seen doctors.
However, after my discharge from the military, I did not experience these symptoms for many years, but they have recently resurfaced.
When the symptoms occur, I feel chest tightness, loss of appetite, tingling in my hands and feet, dizziness, fatigue, and nausea.
I have a smoking habit, with about 10 years of smoking history.
I wonder if I might have an anxiety disorder, as I sometimes feel tingling in my heart and experience a compulsion to take deep breaths, which has not improved.
Which specialty should I consult? Could it be due to work-related stress? I usually wake up around 7:20 AM and go to bed around 1 or 2 AM, so could it be excessive tension? I do not experience chest pain, just a feeling of tightness and slightly rapid breathing.
I have stopped drinking alcohol.
Which medical specialty should I see for this issue? It is really troubling me, and I seek your advice.
Thank you.

Jacky, 30~39 year old female. Ask Date: 2016/08/05

Dr. Zhang Ziyan reply Pulmonology

Hello, since there are similar issues in your family and based on the symptoms described, in addition to anxiety, it is important to consider some airway problems.
It is recommended to consult a pulmonologist for further examination.
Changhua Hospital cares about you.

Reply Date: 2016/08/05

More Info

Understanding shortness of breath can be complex, especially when it is accompanied by symptoms like chest tightness, fatigue, and dizziness. Based on your description, it seems that you have been experiencing these symptoms intermittently since your military service at 19, and they have recently resurfaced. Despite previous medical evaluations showing normal results, your ongoing issues warrant further exploration.

Potential Causes
1. Anxiety and Stress: Given your symptoms of chest tightness, shortness of breath, and feelings of dizziness and fatigue, anxiety could be a significant factor. Anxiety disorders can manifest physically, leading to hyperventilation, which can cause sensations of breathlessness and chest discomfort. The fact that you mentioned feeling a need to take deep breaths suggests that you might be experiencing anxiety-related symptoms.

2. Respiratory Issues: Although previous tests (blood tests, X-rays, and ECG) have returned normal results, it’s important to consider that conditions like asthma or other respiratory issues can sometimes be overlooked. Your history of smoking could also contribute to respiratory problems, even if they are not immediately apparent on standard tests.

3. Cardiovascular Factors: While you mentioned that your heart tests were normal, the sensation of your heart feeling "numb" could indicate an underlying issue that might not have been detected in previous evaluations. Conditions like mitral valve prolapse (which you mentioned) can sometimes lead to palpitations or anxiety-like symptoms.

4. Lifestyle Factors: Your sleep schedule and work-related stress could also be contributing to your symptoms. Chronic sleep deprivation and high-stress levels can lead to fatigue and exacerbate feelings of anxiety, which in turn can affect your breathing.

When to Seek Help
Given the complexity of your symptoms, it would be advisable to consult with a healthcare provider who specializes in either pulmonary medicine or cardiology. A thorough evaluation by a pulmonologist can help rule out any underlying respiratory conditions, especially considering your smoking history. Additionally, a cardiologist can assess any potential heart-related issues that may not have been previously identified.

Recommendations
1. Mental Health Evaluation: Since anxiety seems to be a potential factor, consider seeking help from a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective for anxiety and panic-related symptoms.

2. Pulmonary Function Tests: Request a comprehensive pulmonary function test to evaluate your lung capacity and function more thoroughly. This can help identify any subtle respiratory issues.

3. Cardiac Assessment: Given your symptoms of dizziness and the sensation of your heart being "numb," a follow-up with a cardiologist may be warranted. They might suggest an echocardiogram or a Holter monitor to assess your heart's function over a period.

4. Lifestyle Modifications: Improving your sleep hygiene, reducing stress through relaxation techniques, and possibly quitting smoking can significantly improve your overall health and may alleviate some of your symptoms.

5. Regular Check-ups: Since your symptoms have recurred, regular follow-ups with your healthcare provider can help monitor your condition and make necessary adjustments to your treatment plan.

In conclusion, while your symptoms are concerning, they can often be managed effectively with the right approach. It’s essential to address both the physical and psychological aspects of your health to achieve the best outcomes. Don't hesitate to seek help, as early intervention can lead to better management of your symptoms and overall well-being.

Similar Q&A

Understanding Shortness of Breath: Causes and Solutions

Hello doctor, a few weeks ago my breathing was loud, and after a few days it started to become increasingly difficult. I need to take deep breaths to feel comfortable, otherwise my chest feels tight. It's hard to sleep at night because my breathing sometimes stops, which wak...

Dr. Yang Wenda reply Pulmonology
Hello: If you have a history of acute respiratory failure and are currently experiencing shortness of breath (including tightness, wheezing, or difficulty in taking a deep breath), it is advisable to visit a pulmonologist for examination or evaluation for your safety. Best wishes...

Understanding Shortness of Breath: Causes and When to Seek Help

Hello: I have been experiencing this shortness of breath for three days, and the frequency of episodes is increasing each day. The symptoms include feeling unable to catch my breath, and even taking a deep breath does not relieve the discomfort after a few seconds. Occasionally, ...

Dr. Cai Jueren reply Family Medicine
Hello: Based on your age, your condition can be assessed as follows: The first possibility is hyperventilation syndrome, which occurs when involuntary rapid breathing leads to a decreased concentration of carbon dioxide in the blood. This often results in symptoms such as numbnes...

Understanding Shortness of Breath: When to Seek Medical Help

I have not experienced any breathing difficulties before, but in the last day or two, I have been feeling a bit short of breath. It feels like my breath is being constricted, and I have to exert a lot of effort to inhale comfortably. Sometimes, it feels like I'm running out ...

Dr. Zhang Ziyan reply Pulmonology
Hello, if there are no other respiratory symptoms and the symptoms persist, it may be necessary to consider seeing a cardiologist or a pulmonologist. Changhua Hospital cares about you.

Understanding Shortness of Breath: When to Seek Medical Help

Hello doctor, I have recently been experiencing a sensation of not being able to breathe, a feeling of tightness in my throat, constriction in my airways, bloating in my stomach, and chest tightness (mostly in the front of my chest). When I take deep breaths, I still feel like I&...

Dr. Jian Shuntian reply Pulmonology
You can first visit the pulmonology outpatient clinic to have a chest X-ray and assess if there are any issues with lung function. If it is not a pulmonology issue, please consult the attending physician about which specialty to see next. It could potentially be related to gastro...