Chest Tightness and Rapid Heartbeat: Seeking Answers Beyond Cardiology

Q: Chest Tightness and Rapid Heartbeat: Seeking Answers Beyond Cardiology

Note： Symptoms of chest tightness and palpitations are somewhat related to obesity, and please pay attention to slightly elevated blood pressure. <br>Although X-rays and electrocardiograms show no abnormalities, it is still necessary to check cholesterol, blood lipids, liver, and

When lying down, I experience chest tightness and a sensation of a rapid heartbeat, with blood pressure readings around 60 to 70 bpm?

Hello doctor: I am 163 cm tall and weigh 150 kg.
At the beginning of July, I was still 160 kg, but I have recently lost 10 kg.
Lately, I often wake up suddenly while sleeping, feel chest tightness when lying flat, and experience body heat, although my temperature does not indicate a fever.
My blood pressure averages between 130-145 systolic and 67-85 diastolic.
I have dizziness, headaches, shoulder pain, and sometimes my hands and chin feel numb, which can extend to my entire face.
I visited a cardiologist who performed X-rays and an electrocardiogram, and the doctor said my heart is fine.
I also went to a neurologist for a CT scan of my brain, and they reported everything as normal.
Which specialty should I consult next for answers? I am concerned that I might have heart failure because I have most of the symptoms listed online, but I think my obesity may be preventing accurate assessments.

Xiao Ting, 30~39 year old female. Ask Date: 2018/07/31

Dr. Bai Xiyan reply Cardiology

Note: Symptoms of chest tightness and palpitations are somewhat related to obesity, and please pay attention to slightly elevated blood pressure.
Although X-rays and electrocardiograms show no abnormalities, it is still necessary to check cholesterol, blood lipids, liver, and kidney function.
If blood pressure readings remain consistently high or if blood tests show abnormalities, it is recommended to follow up with an outpatient visit.
Lifestyle modification is very important; dietary habits should focus on reducing salt, sugar, and oil intake.
Aim for at least three days of exercise per week, with each session lasting thirty minutes, along with adequate sleep to effectively control weight.
If there is no improvement after four to six weeks, please return for a follow-up appointment to discuss necessary interventions with your physician.
The Cardiology Department of Chiayi Hospital is dedicated to serving you and wishes you health and safety.

Reply Date: 2018/07/31

More Info

It sounds like you are experiencing a range of concerning symptoms, including chest tightness, rapid heartbeat, dizziness, and numbness in various parts of your body. Given that you have already consulted with cardiology and neurology, and both specialties have ruled out significant issues, it’s understandable that you are seeking further answers.

First, let's address your symptoms. Chest tightness and rapid heartbeat can be associated with a variety of conditions, not just cardiac issues. While it’s good that your heart has been evaluated and found to be normal, your symptoms could be related to anxiety or panic attacks, especially if they occur during sleep or when you are at rest. Anxiety can manifest physically, leading to symptoms such as rapid heartbeat, chest discomfort, and even sensations of heat.
Additionally, your reported symptoms of dizziness, headaches, and numbness could suggest a neurological or musculoskeletal issue. For instance, cervical spine problems can lead to shoulder pain and numbness in the arms and face due to nerve compression. Similarly, tension headaches can cause discomfort in the shoulders and neck, which may also contribute to feelings of dizziness.

Given your weight loss and the fluctuations in your blood pressure readings, it might also be worthwhile to consider metabolic or endocrine issues. Conditions such as hyperthyroidism can lead to symptoms like rapid heartbeat, anxiety, and weight loss, while also causing changes in blood pressure. A thorough evaluation of your thyroid function could be beneficial.

Since you have already consulted cardiology and neurology, I would recommend considering a visit to an internal medicine physician or an endocrinologist. An internal medicine doctor can provide a comprehensive evaluation of your overall health and may consider conditions that span multiple systems in the body. An endocrinologist can specifically assess for hormonal imbalances that might be contributing to your symptoms.

In the meantime, it may be helpful to keep a detailed diary of your symptoms, noting when they occur, their duration, and any potential triggers. This information can be invaluable for your healthcare providers in determining the underlying cause of your symptoms.

Lastly, lifestyle modifications can also play a significant role in managing your symptoms. Regular physical activity, a balanced diet, and stress management techniques such as mindfulness or yoga can help improve your overall well-being and may alleviate some of your symptoms.

In summary, while your cardiac and neurological evaluations have returned normal results, your symptoms warrant further investigation. Consulting with an internal medicine physician or an endocrinologist may provide additional insights. Keeping a symptom diary and making lifestyle changes can also be beneficial as you seek to understand and manage your health concerns.

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