Chest Tightness: When to Seek Cardiac Care

Chest tightness and general discomfort?

Hello doctor, two weeks ago I experienced a feeling of pressure in my chest while breathing, similar to breathing underwater.
I went to the hospital and consulted a pulmonologist.
After an X-ray, the doctor said there were no issues and prescribed muscle relaxants and painkillers, but they didn't have much effect.
My symptoms include chest tightness, a feeling of pressure while breathing, and the urge to yawn even after a full night's sleep.
After taking several deep breaths, I experience chest pain.
This week, after lying down to sleep, I felt an irregular heartbeat, with sudden contractions.
I maintain a normal daily routine and have no significant stress in my life.
Could you please advise what might be the issue and which specialty I should consult for a diagnosis? Thank you, doctor.

Zhiwei, 20~29 year old female. Ask Date: 2016/11/30

Dr. He Dongjin reply Cardiology

Hello, Zhiwei.
It sounds like you may be experiencing autonomic nervous system dysfunction.
You can monitor your condition for now, but if there is no improvement, it would be advisable to visit a cardiology clinic for further evaluation.
Changhua Hospital cares about your well-being.

Reply Date: 2016/11/30

More Info

When experiencing chest tightness, especially with accompanying symptoms such as difficulty breathing, pain, or abnormal heart rhythms, it is crucial to seek medical attention promptly. Your description of feeling pressure in your chest, akin to breathing underwater, along with the sensation of your heart beating irregularly after waking up, raises concerns that should not be overlooked.

Given your symptoms, it is advisable to consult a cardiologist. A cardiologist specializes in diagnosing and treating conditions related to the heart and blood vessels. Your symptoms could be indicative of several potential issues, including but not limited to coronary artery disease (CAD), anxiety-related disorders, or even musculoskeletal problems. However, the nature of your symptoms—particularly the chest tightness and abnormal heart rhythms—suggests that a cardiac evaluation is warranted.

In your case, the initial evaluation by a pulmonologist and the subsequent X-ray did not reveal any immediate issues, which is a positive sign. However, the lack of improvement with muscle relaxants and pain medications indicates that the underlying cause of your symptoms may not be muscular or related to the lungs. The fact that you experience pain after deep breaths and have noticed irregular heartbeats further emphasizes the need for a thorough cardiac assessment.

A cardiologist may recommend several diagnostic tests to evaluate your heart's health. These could include:
1. Electrocardiogram (ECG): This test records the electrical activity of your heart and can help identify irregular heart rhythms or signs of ischemia (reduced blood flow to the heart).

2. Echocardiogram: An ultrasound of the heart that provides images of the heart's structure and function, helping to assess the heart's pumping ability and check for any abnormalities.

3. Stress Testing: This may involve exercise or medication-induced stress on the heart to evaluate how well it functions under stress and to identify any ischemic changes.

4. Blood Tests: These can help rule out other conditions and check for markers of heart damage, such as troponin levels.

5. Myocardial Perfusion Imaging: This test assesses blood flow to the heart muscle and can help identify areas of the heart that may not be receiving enough blood.

It is essential to communicate all your symptoms clearly to the cardiologist, including the nature of your chest tightness, any associated pain, and the irregular heartbeats you have experienced. This information will assist in guiding the diagnostic process and determining the most appropriate treatment plan.

In summary, while your initial evaluation did not indicate a serious issue, the persistence and nature of your symptoms warrant further investigation by a cardiologist. Early detection and treatment of any potential cardiac issues can significantly improve outcomes and provide peace of mind. Please do not hesitate to seek care, as timely intervention is key in managing heart-related conditions.

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