Why Am I Experiencing Shortness of Breath While Walking?

Experiencing shortness of breath and chest tightness while walking?

Hello Doctor, I have a history of hyperventilation leading to fainting and emergency medical care.
Occasionally, I wake up suddenly during sleep hearing my heartbeat, feeling like I can't catch my breath.
Recently, I've noticed that while walking, I often struggle to breathe and need to take deep breaths to feel better.
I have a habit of exercising and wear a heart rate monitor.
During intense workouts, my maximum heart rate has reached 225, with an average heart rate around 160-180.
I have also experienced a sensation of breathlessness during exercise due to a rapid heartbeat.
The most recent instance was during weight training, where my maximum heart rate was around 170, with an average of 120-140, and I felt breathless again.
I would like to ask if having such a high maximum heart rate during exercise is normal.
Is the frequent sensation of breathlessness related to lack of sleep? Thank you for your help.

Yangyang, 40~49 year old female. Ask Date: 2018/02/01

Dr. Liao Yaopan reply Family Medicine

Appropriate exercise is beneficial, but adjustments should be made if discomfort occurs.
For health guidelines on cardiovascular exercise, you can refer to the recommendations from the Health Promotion Administration: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=571&pid=882.
To estimate your maximum heart rate, use the formula (220 - age).
If you consistently experience significant exercise intolerance, it is advisable to seek an evaluation from a cardiologist.
Please note that online consultations do not equate to in-person medical visits and cannot provide accurate diagnoses or treatment recommendations.
Changhua Hospital cares about your health.

Reply Date: 2018/02/01

More Info

Experiencing shortness of breath while walking can be concerning, especially given your history of hyperventilation and episodes of feeling like you can't catch your breath. It's important to understand that shortness of breath can stem from various factors, including physical conditioning, anxiety, and underlying medical conditions.
From your description, it seems you have a history of anxiety and panic attacks, which can significantly contribute to feelings of breathlessness. When you experience anxiety, your body enters a state of heightened alertness, often leading to rapid breathing (hyperventilation). This can create a cycle where you feel short of breath, which in turn increases your anxiety, leading to even more hyperventilation. This cycle can be particularly exacerbated during physical activities, such as walking or exercising, especially if you're already feeling anxious about your heart rate or breathing.

Regarding your heart rate during exercise, it's crucial to note that maximum heart rates can vary significantly among individuals. The general formula for estimating maximum heart rate is 220 minus your age. However, trained athletes or individuals with high fitness levels may experience higher maximum heart rates. A maximum heart rate of 225 is quite high and could indicate that your body is under significant stress during exercise. It's essential to monitor how you feel during these activities. If you consistently feel short of breath or experience discomfort, it may be wise to consult with a healthcare professional.

Your mention of waking up suddenly to your heartbeat and feeling short of breath could also be related to sleep disturbances. Sleep apnea, for instance, can cause interruptions in breathing during sleep, leading to feelings of breathlessness upon waking. Sleep deprivation can exacerbate anxiety and affect your overall physical performance, including your ability to exercise without feeling breathless.

To address your concerns, consider the following steps:
1. Consult a Healthcare Professional: Given your history and current symptoms, it would be prudent to consult with a healthcare provider, preferably a cardiologist or a pulmonologist. They can conduct a thorough evaluation, including tests to rule out any underlying conditions such as asthma, sleep apnea, or cardiovascular issues.

2. Monitor Your Heart Rate: While exercising, keep track of your heart rate and how you feel. If you notice that your heart rate is consistently high and you're experiencing discomfort, it may be necessary to adjust your exercise intensity or type.

3. Incorporate Breathing Techniques: Learning and practicing breathing techniques can help manage anxiety and improve your breathing patterns. Techniques such as diaphragmatic breathing or paced breathing can be beneficial.

4. Gradual Exercise Increase: If you're returning to exercise after a break, gradually increase your intensity and duration. This can help your body adapt without overwhelming it.

5. Focus on Sleep Hygiene: Ensure you're getting adequate sleep and maintaining good sleep hygiene. This includes establishing a regular sleep schedule, creating a restful environment, and avoiding stimulants before bedtime.

6. Consider Psychological Support: If anxiety is a significant factor in your symptoms, consider seeking support from a mental health professional. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help manage anxiety and improve your overall well-being.

In summary, while shortness of breath during walking can be linked to various factors, including anxiety and physical conditioning, it's essential to approach this symptom holistically. Consulting with healthcare professionals and addressing both physical and psychological aspects can lead to better management of your symptoms and improved quality of life.

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