Which Specialist Should My 72-Year-Old Mother See for Her Symptoms?

Which department should I see?

Hello, doctor.
My mother is 72 years old and has been experiencing symptoms such as chest tightness, shortness of breath, palpitations, and dizziness over the past few months.
These symptoms become more pronounced, especially when walking a short distance or doing light physical activity.
She recently visited a cardiologist for a resting electrocardiogram, X-ray, and blood tests, but the doctor did not indicate any significant abnormalities.
My mother also has a history of gastroesophageal reflux disease and usually takes medication for it.
Given her symptoms, which specialty should she consult, or what tests and treatments should she pursue? Thank you.

fa wen zhe, 40~49 year old female. Ask Date: 2016/08/24

Dr. Zhang Hongwei reply Family Medicine

Hello, if these symptoms occur after labor or exercise, they may be related to heart issues.
It is advisable to return to a cardiologist for further examinations such as echocardiography or a stress electrocardiogram.
However, if these symptoms occur randomly or worsen when lying down or after eating, they could be caused by gastroesophageal reflux leading to chest discomfort.
These two conditions can sometimes be difficult to differentiate based on symptoms.
I recommend considering further evaluation by a cardiologist to rule out any cardiac issues before addressing potential gastrointestinal problems.
Thank you for your inquiry.

Reply Date: 2016/08/24

More Info

Given your mother's age and the symptoms she is experiencing—chest tightness, shortness of breath, palpitations, and dizziness—it's crucial to approach her healthcare needs comprehensively. While she has already seen a cardiologist and undergone tests such as an electrocardiogram (ECG), chest X-ray, and blood tests without significant findings, her ongoing symptoms warrant further investigation.

1. Cardiology: Since your mother has a history of cardiovascular symptoms, it’s essential to continue monitoring her heart health. If her symptoms persist or worsen, consider a follow-up appointment with a cardiologist. They may recommend additional tests, such as a stress test or echocardiogram, to evaluate her heart function under exertion.

2. Gastroenterology: Given her history of gastroesophageal reflux disease (GERD), it’s important to ensure that her gastrointestinal issues are not contributing to her symptoms. Sometimes, GERD can mimic cardiac symptoms, leading to confusion in diagnosis. A gastroenterologist can assess her condition and adjust her medication if necessary.

3. Pulmonology: If your mother experiences shortness of breath, especially during physical activity, a pulmonologist should evaluate her lung function. Conditions like chronic obstructive pulmonary disease (COPD) or asthma could be contributing factors. Pulmonary function tests (PFTs) can help determine if there are any underlying respiratory issues.

4. Neurology: Dizziness can also be related to neurological issues. If her dizziness is severe or accompanied by other neurological symptoms (like headaches, vision changes, or weakness), a neurologist may need to assess her for conditions such as vestibular disorders or transient ischemic attacks (TIAs).

5. Internal Medicine: An internist can provide a holistic view of her health, considering all her symptoms and medical history. They can coordinate care among specialists and ensure that all aspects of her health are being addressed.

6. Psychiatry/Psychology: Emotional and psychological factors can also contribute to physical symptoms. If your mother is experiencing anxiety or depression, which is common in older adults, a mental health professional can provide support and treatment options.

Additional Recommendations:
- Lifestyle Modifications: Encourage your mother to maintain a healthy lifestyle, including a balanced diet, regular physical activity (as tolerated), and stress management techniques. These can significantly impact her overall health and well-being.

- Medication Review: Ensure that her medications are reviewed regularly, as interactions or side effects can contribute to her symptoms. This is particularly important if she is taking multiple medications for different conditions.

- Regular Monitoring: Keep a log of her symptoms, noting when they occur, their severity, and any potential triggers. This information can be invaluable for her healthcare providers in diagnosing and managing her condition.

- Support System: Ensure that she has a strong support system in place. Family members can help monitor her symptoms, encourage her to attend appointments, and provide emotional support.

In conclusion, your mother should consider seeing a cardiologist for her heart-related symptoms, a gastroenterologist for her GERD, a pulmonologist for her breathing issues, and potentially a neurologist if her dizziness persists. An internist can help coordinate her care among these specialists. Addressing her symptoms holistically will provide the best chance for improvement in her quality of life.

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