Breathing Difficulties and Fainting: Cardiovascular Issues

Shortness of breath and fainting?

Hello, for the past couple of years, I have been experiencing this condition every two to three months.
It feels very much like a muscle cramp.
This time, while riding my bike, I suddenly had a spasm in my right chest area extending to my right shoulder, which occurred after normal breathing.
After one inhalation and exhalation, I also felt a spasm at the xiphoid process.
I tried some stretching, but the pain persisted.
When I stopped at a traffic light, I took deep breaths, hoping it would alleviate the cramping sensation, but the spasm at the xiphoid process made it difficult to breathe, and I felt like I couldn't get enough air.
Then, my head started to feel numb, and my vision began to darken.
I pulled over to the side of the road, and just as the bike came to a stop, I fainted.
I lost consciousness for about two to three seconds, and when I woke up, my head was still numb, my breathing became very rapid, and my lips turned pale.
I crawled to the side of the road to rest, and it took several minutes for me to feel better.
Afterward, I went to the emergency room where I had an electrocardiogram, blood tests for glucose and blood pressure, a CT scan, and X-rays, all of which came back normal, except for a slight case of allergic rhinitis, but I hadn't taken any cold medication.
Each time, the sequence is spasm > inability to breathe > gradual darkening of my vision.
Previously, when I experienced this, resting would usually help, and sitting during an episode makes it even more uncomfortable because I can't get enough air.
I would also like to know which specialty I should consult.
Thank you.

Lü Lü, 20~29 year old female. Ask Date: 2017/03/21

Dr. He Dongjin reply Cardiology

Hello, you are advised to see a psychiatrist for hyperventilation syndrome.
Peace and care from Changhua Hospital.

Reply Date: 2017/03/21

More Info

Based on your description of symptoms, it appears that you are experiencing episodes of breathing difficulties, chest tightness, and fainting spells. These symptoms can be quite alarming and may indicate underlying cardiovascular or respiratory issues, but they can also be related to anxiety or panic attacks.
First, let's break down your symptoms. The sudden onset of chest tightness and the sensation of spasms in your chest and shoulder could be related to several factors. One possibility is a musculoskeletal issue, such as a muscle spasm or strain, particularly if you have been engaging in physical activity like cycling. However, the fact that you experienced fainting (loss of consciousness) is concerning and warrants further investigation.

The episodes you described, where you feel like you cannot breathe and your vision darkens, could be indicative of a few different conditions. One potential cause is hyperventilation, which can occur during anxiety or panic attacks. Hyperventilation leads to a decrease in carbon dioxide levels in the blood, which can cause symptoms such as lightheadedness, tingling in the extremities, and a feeling of breathlessness. This can create a vicious cycle where the fear of not being able to breathe leads to more anxiety and further hyperventilation.

Another possibility is that your symptoms could be related to a cardiovascular issue, such as arrhythmias or other heart conditions. Although your recent tests (ECG, CT scan, and X-rays) came back normal, it is essential to consider that some heart conditions may not always be evident in standard tests. For instance, certain arrhythmias may only occur intermittently, and a Holter monitor (a portable ECG device worn for 24 hours or longer) could provide more insight into your heart's rhythm during these episodes.

Given your symptoms, it would be advisable to consult with a cardiologist, who can perform a thorough evaluation, including a detailed history and possibly additional testing, such as an echocardiogram or a stress test. Additionally, if anxiety or panic attacks are suspected, a referral to a mental health professional may also be beneficial. They can help you develop coping strategies and possibly recommend therapy or medication if needed.

In the meantime, it may be helpful to keep a symptom diary. Note when the episodes occur, their duration, any triggers you can identify (such as stress, physical exertion, or certain environments), and how you feel before, during, and after the episodes. This information can be invaluable for your healthcare provider in determining the underlying cause of your symptoms.

Lastly, it's essential to prioritize your safety. If you experience severe symptoms, such as prolonged chest pain, significant shortness of breath, or fainting, seek immediate medical attention. Your health and well-being are paramount, and understanding the root cause of your symptoms is crucial for effective management.

Similar Q&A

Overcoming Anxiety: Managing Hyperventilation and Breathing Issues

I have fainted twice for no apparent reason, which scared everyone around me. Since then, I have experienced psychological stress related to fainting. I went to the hospital for various tests, and all the reports came back normal. Therefore, I suspect that the cause of my faintin...

Dr. Wu Menghuan reply Psychiatry
Hello: You mentioned that you have fainted twice in the past, and both hospital examinations were normal, which has caused you psychological stress. You also noticed that when interacting with unfamiliar people, you tend to pay attention to your breathing, which can lead to hyper...

Understanding Sudden Breathlessness, Dizziness, and Fainting: A Neurological Perspective

Hello, doctor! My mother suddenly became very short of breath in the kitchen today and then collapsed, but she was conscious. Afterward, she described the situation as feeling extremely breathless, dizzy, experiencing tinnitus, and feeling nauseous. Additionally, she sometimes ha...

Dr. Hong Weibin reply Neurology
Hello: Based on the situation you described, I recommend that you take your mother to a cardiology clinic as soon as possible. The combination of dizziness, shortness of breath, and chest pain necessitates prioritizing the exclusion of serious cardiovascular issues, such as angin...

Understanding Heart Issues: Symptoms of Weakness and Breathlessness

I experience weakness in my heart and shortness of breath whenever I am in a relatively hot and humid environment. It feels as if something is constricting my heart, leading to difficulty breathing. There have been instances where I felt nauseous and vomited, accompanied by overa...

Dr. Wu Xueming reply Cardiology
Based on your symptoms, it does not appear to be caused by heart disease. To rule out the possibility of heart disease, please go to the hospital for further evaluation.

Understanding Dizziness and Breathing Difficulties: A Neurology Perspective

Hello, doctor. I have been experiencing frequent dizziness, chest tightness, and shortness of breath lately. These episodes usually last for about 10 to 20 seconds and resolve on their own after a short while, occurring approximately 2 to 3 times a day. I previously underwent an ...

Dr. Jiang Junyi reply Neurology
Hello, based on your description, it may be necessary to consider obstructive sleep apnea (OSA). A common cause is the obstruction of the airway by soft tissues near the throat, which narrows the upper airway and leads to snoring and breathing cessation. Abnormalities in upper ai...