Is It Heart Trouble or Autonomic Nervous System Disorder?

Is it autonomic nervous system dysfunction or a heart problem?

Hello Doctor, since the end of 2017, I have frequently experienced palpitations.
Initially, I suspected hyperthyroidism, but after testing, my thyroid function was completely normal.
There was also a period when I experienced shortness of breath; however, my recent symptoms have shifted to gastrointestinal discomfort and decreased appetite.
I searched online and found that my symptoms do not closely resemble typical heart disease, as I do not feel any discomfort in my heart during exertion or exercise, only mild palpitations, and my heart rate remains below 75 beats per minute.
The search results suggest that my symptoms are more similar to autonomic nervous system dysfunction, but experiencing these symptoms consistently still worries me.
I am 20 years old, do not smoke, rarely drink alcohol, have a normal BMI, and my past health check-ups have not indicated any concerns regarding cholesterol or blood lipids.
I do not have issues with staying up late and exercise regularly (I am currently on a softball team).
I would like to ask the doctor whether this is a heart-related issue or a disorder of the autonomic nervous system.
Should I undergo any additional cardiac examinations? Thank you for taking the time to answer my questions, and Happy New Year!

Fan Tongxue, 20~29 year old female. Ask Date: 2018/02/11

Dr. He Dongjin reply Cardiology

Hello, your symptoms seem to indicate autonomic nervous system dysfunction.
It is advisable to observe your condition first.
If you still feel unwell, you can visit a psychosomatic medicine or cardiology department for further examination.
Pingan Changhua Hospital cares about you.

Reply Date: 2018/02/11

More Info

Hello! Thank you for sharing your concerns regarding your health symptoms. Based on your description, it seems that you have been experiencing a range of symptoms, including palpitations, shortness of breath, gastrointestinal discomfort, and decreased appetite. Given your age, lifestyle, and the normal results from your thyroid function tests, it is understandable that you are trying to differentiate between a potential heart issue and an autonomic nervous system disorder.

Firstly, it is important to recognize that palpitations can arise from various causes, including anxiety, stress, and autonomic nervous system dysregulation. In your case, since you have ruled out hyperthyroidism and have normal cardiovascular health checks, it is plausible that your symptoms may be linked to autonomic nervous system dysfunction, commonly referred to as dysautonomia. This condition can manifest in various ways, including heart palpitations, gastrointestinal issues, and even respiratory symptoms.

The autonomic nervous system (ANS) controls involuntary bodily functions, including heart rate, blood pressure, digestion, and respiratory rate. When the ANS is not functioning properly, it can lead to symptoms such as those you are experiencing. For instance, gastrointestinal discomfort and decreased appetite can be related to the ANS's role in regulating digestive processes. Additionally, the fact that your symptoms do not worsen significantly during physical activity suggests that there may not be a direct cardiac issue, as heart problems typically manifest with exertion.

Your normal heart rate during activity (below 75 beats per minute) is reassuring, as it indicates that your heart is functioning within a healthy range. However, it is still essential to monitor your symptoms closely. If you experience any new or worsening symptoms, such as chest pain, severe shortness of breath, or fainting, it is crucial to seek immediate medical attention.

Regarding further evaluations, if your symptoms persist or worsen, it may be beneficial to consult with a cardiologist for a thorough assessment. This could include an electrocardiogram (ECG), echocardiogram, or even a Holter monitor to assess your heart's rhythm over an extended period. Additionally, a referral to a neurologist or a specialist in autonomic disorders may provide further insights into your condition.

In the meantime, consider lifestyle modifications that may help alleviate your symptoms. Regular physical activity, a balanced diet, adequate hydration, and stress management techniques such as mindfulness or yoga can be beneficial. It may also be helpful to keep a symptom diary to track when your symptoms occur and any potential triggers, which can provide valuable information for your healthcare provider.

In summary, while your symptoms may suggest an autonomic nervous system disorder, it is essential to continue monitoring your health and consult with healthcare professionals as needed. Your proactive approach to understanding your symptoms is commendable, and I encourage you to maintain open communication with your healthcare team. Wishing you a happy and healthy New Year!

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