Heart Palpitations and Breathing Difficulties: Causes and Solutions

Often experience shortness of breath, and also have palpitations when feeling very anxious?

I have a family history of arrhythmia.
Last April, after drinking cocktails, I experienced palpitations and difficulty breathing.
I went to a major hospital where they performed an electrocardiogram and blood tests.
The doctor informed me that there was nothing serious, only arrhythmia.
However, I continue to experience shortness of breath, making it difficult to breathe.
Even while taking public transportation, my heart races, and I also feel a sense of detachment from my body and reality.
I am unsure if this is caused by the arrhythmia or if there is another underlying reason for these persistent episodes, which have made daily life somewhat challenging.

Han, 20~29 year old female. Ask Date: 2019/01/29

Dr. He Dongjin reply Cardiology

Hello, the discomfort you are experiencing is likely caused by autonomic nervous system dysfunction.
It is recommended that you consult with a psychiatrist or a cardiologist for further evaluation.
Changhua Hospital cares about your well-being.

Reply Date: 2019/01/29

More Info

Understanding heart palpitations and breathing difficulties can be quite complex, especially when there is a history of arrhythmias in the family. Your experience of feeling breathless and having a racing heart, particularly after consuming alcohol, raises several important considerations.

Firstly, it is essential to recognize that heart palpitations can be caused by a variety of factors. In your case, the history of arrhythmias suggests a potential genetic predisposition to heart rhythm disorders. Arrhythmias can manifest as irregular heartbeats, which may feel like fluttering, pounding, or racing in the chest. These sensations can be exacerbated by triggers such as stress, anxiety, caffeine, nicotine, and alcohol. Alcohol, in particular, can lead to dehydration and electrolyte imbalances, which may further contribute to palpitations and feelings of breathlessness.

The sensation of not being able to breathe properly, especially when accompanied by a racing heart, can also be linked to anxiety or panic attacks. The experience of feeling detached from reality, often described as derealization, can occur during episodes of heightened anxiety. This can create a vicious cycle where the fear of experiencing these symptoms leads to increased anxiety, which in turn exacerbates the symptoms. It is crucial to address both the physical and psychological aspects of your condition.

Given that you have undergone tests such as an electrocardiogram (ECG) and blood tests, and the results were deemed normal aside from the arrhythmia, it may be beneficial to explore further diagnostic options. Continuous monitoring of your heart rhythm through a Holter monitor or an event recorder can provide more insight into your heart's activity over an extended period. This can help identify any patterns or triggers associated with your symptoms.

In addition to monitoring, lifestyle modifications can play a significant role in managing your symptoms. Here are some strategies that may help:
1. Limit Alcohol and Caffeine: Both substances can trigger palpitations and exacerbate anxiety. Reducing or eliminating these from your diet may help alleviate symptoms.

2. Stay Hydrated: Dehydration can lead to electrolyte imbalances, which may contribute to palpitations. Ensure you are drinking enough fluids throughout the day.

3. Practice Relaxation Techniques: Techniques such as deep breathing exercises, meditation, or yoga can help manage anxiety and reduce the frequency of panic attacks. These practices can also promote a sense of calm and improve your overall well-being.

4. Regular Exercise: Engaging in regular physical activity can improve cardiovascular health and reduce anxiety. However, it is essential to consult with your healthcare provider before starting any new exercise regimen, especially given your history of heart issues.

5. Seek Psychological Support: If anxiety is a significant factor in your symptoms, consider speaking with a mental health professional. Cognitive-behavioral therapy (CBT) can be particularly effective in addressing anxiety and panic disorders.

6. Follow Up with a Cardiologist: Given your family history and ongoing symptoms, it may be beneficial to have regular follow-ups with a cardiologist. They can provide tailored advice and may recommend additional tests or treatments based on your specific situation.

In summary, while your symptoms may be linked to your history of arrhythmias, they could also be influenced by anxiety and lifestyle factors. A comprehensive approach that includes monitoring, lifestyle changes, and psychological support may help you manage your symptoms more effectively. Always consult with your healthcare provider before making any significant changes to your health regimen.

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