Breathing Difficulties: When to Seek Medical Help

Shortness of breath?

Hello Doctor, I currently have the following conditions: 1.
Occasionally, I need to slightly open my mouth and take a deep breath to feel a sense of lung expansion (I usually do not have significant stress or anxiety).
2.
I find myself yawning more frequently than before.
3.
I experience occasional severe pain around the area three fingerbreadths below my left nipple (near the first and second ribs).
4.
I sometimes have unilateral nasal congestion (alternating sides) without having a cold.
Given that I have multiple symptoms, I would like to know which specialty I should consult for further diagnosis or if I should undergo a health check-up.
Thank you in advance for your advice!

A Pei, 20~29 year old female. Ask Date: 2017/05/04

Dr. Chen Taicheng reply Family Medicine

● Considering your age, the likelihood of severe cardiopulmonary abnormalities is low.
The sensations of chest tightness and difficulty breathing should first rule out atopic conditions (such as asthma, allergic rhinitis, atopic dermatitis) that may cause respiratory discomfort.
Anxiety or stress can also lead to hyperventilation, which may create a feeling of breathlessness; based on your current description, this seems less likely.

● There are many reasons for yawning.
As referenced in my previous report, "Even after a good night's sleep, frequent yawning may occur if one is in an environment with poor ventilation, such as being in an air-conditioned office during the summer, which can restrict airflow.
Additionally, individuals with poor sleep quality—those who sleep for long durations but do not feel rested—may also yawn frequently.
Furthermore, those with sleep apnea may experience snoring and unrefreshing sleep, feeling tired and lethargic even after long hours of sleep."
● Pain under the left rib cage is most commonly associated with gastroesophageal reflux disease (GERD) or peptic ulcers; less frequently, it may be due to costochondritis or diaphragm spasms.

● Nasal congestion can fluctuate between both sides; sometimes one side may feel more open, which is not abnormal.
However, if nasal congestion is frequent, consider conditions such as turbinate hypertrophy, allergic rhinitis, or sinusitis (a comparative chart is available at https://goo.gl/5KTkl9).
Please consult an otolaryngologist for evaluation.

● Considering points 1, 2, and 4, it is advisable to first rule out nasal issues such as allergic rhinitis or sinusitis by visiting an otolaryngologist; for point 3, further evaluation can be done at a family medicine or gastroenterology clinic.
Wishing you good health, Dr.
Chen Tai-Cheng from Taoyuan Hospital Family Medicine Department is concerned about you~

Reply Date: 2017/05/04

More Info

When experiencing breathing difficulties, it is crucial to understand the underlying causes and know when to seek medical help. Based on your symptoms, which include the need to take deep breaths occasionally, frequent yawning, localized chest pain, and intermittent nasal congestion, it is advisable to approach this situation with a comprehensive evaluation.

Firstly, the need to take deep breaths can indicate a sensation of breathlessness or inadequate air intake, which may stem from various conditions. This could be related to anxiety, respiratory issues, or even cardiovascular problems. The fact that you mention not feeling stressed or anxious suggests that the cause may not be psychological, but rather physiological.

Frequent yawning can also be a sign of insufficient oxygenation or fatigue. While yawning is often associated with tiredness, it can also occur when the body is trying to increase oxygen intake. This symptom, combined with your other complaints, warrants further investigation.

The localized pain in the left chest area, particularly around the ribs, is another significant symptom. Chest pain can arise from various sources, including musculoskeletal issues, gastrointestinal problems (like acid reflux), or even cardiac conditions. Given the potential seriousness of chest pain, it is essential to take this symptom seriously and seek medical attention.

Intermittent nasal congestion, especially if it occurs unilaterally, can be indicative of sinus issues or allergies. Since you mentioned that this happens without a cold, it may be worth exploring potential allergic reactions or anatomical issues within the nasal passages.

Given the complexity of your symptoms, I recommend starting with a visit to a primary care physician or a pulmonologist (lung specialist). They can conduct a thorough evaluation, which may include a physical examination, a review of your medical history, and possibly some diagnostic tests such as pulmonary function tests, chest X-rays, or even a CT scan if deemed necessary.
If your primary care physician suspects a cardiac issue, they may refer you to a cardiologist for further evaluation, including an electrocardiogram (ECG) or echocardiogram. If allergies or sinus issues are suspected, an ear, nose, and throat (ENT) specialist may be appropriate.

In summary, your symptoms suggest a multifaceted issue that could involve respiratory, cardiovascular, or even allergic components. It is essential to seek medical advice promptly to rule out any serious conditions and to receive appropriate treatment. Early intervention can significantly improve outcomes and help alleviate your symptoms. Remember, your health is paramount, and addressing these concerns with a healthcare professional is the best course of action.

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