Heart Palpitations and Breathing Issues: When to Seek Further Evaluation?

Palpitations and shortness of breath?

Previously, during a health check-up, an electrocardiogram (ECG) showed a short PR interval.
However, the doctor advised that if there were no other discomforts, further examination was not necessary, so it was left as is.
In mid-February of this year, there was a mycoplasma infection, and after taking antibiotics for a week at a clinic without improvement, I went to the emergency room where pneumonia was diagnosed.
After eight days of antibiotic treatment, I was discharged.
One month post-discharge, my breathing difficulties have significantly improved, and I have continued to engage in running and cycling without any notable discomfort.

About a week ago, one night while lying down to sleep, I suddenly experienced a rapid heartbeat and felt short of breath.
I initially thought it was just anxiety.
After resting while sitting, the symptoms persisted, making it difficult to fall asleep.
In the past few days, I have experienced similar episodes at night, making it challenging to sleep.
During the day, I occasionally feel my heart racing and experience mild headaches, but otherwise, I do not have significant discomfort, and I am still able to run and exercise.

I would like to know if my current condition warrants further examination or if I should continue to monitor the situation.

Tian Ju, 20~29 year old female. Ask Date: 2020/04/19

Dr. He Dongjin reply Cardiology

Hello, it seems that the palpitations and short PR interval are more likely related to autonomic nervous system dysfunction and should not be a concern.
You can observe your condition for now, and if you still feel unwell, you may visit a cardiology clinic for further examination.
Taking some medication should help.
Changhua Hospital cares about you.

Reply Date: 2020/04/19

More Info

When experiencing heart palpitations and breathing issues, it is essential to evaluate the situation carefully to determine whether further medical assessment is necessary. Based on the symptoms you've described, including episodes of rapid heartbeat, difficulty breathing while lying down, and occasional headaches, it is advisable to consider a few key factors before deciding on the next steps.

Firstly, it is important to recognize that heart palpitations can be caused by a variety of factors, including anxiety, stress, physical exertion, or underlying medical conditions. In your case, you mentioned a history of a recent mycoplasma infection that progressed to pneumonia, which could have lingering effects on your respiratory system and overall health. While it is encouraging that your breathing has improved significantly since your hospitalization, the recent episodes of palpitations and breathing difficulties warrant closer attention.

Given that you have a history of a short PR interval on your ECG, it is crucial to monitor any new or worsening symptoms. A short PR interval can sometimes be associated with conditions such as pre-excitation syndromes, which may lead to episodes of tachycardia. Although your doctor previously advised against further testing in the absence of symptoms, the recent changes in your condition—specifically the palpitations and breathing issues—suggest that it may be time to revisit this decision.

Here are some recommendations for your situation:
1. Keep a Symptom Diary: Document the frequency, duration, and intensity of your palpitations and any associated symptoms, such as shortness of breath or headaches. Note any triggers you may identify, such as stress, physical activity, or changes in body position.

2. Consult Your Healthcare Provider: Given your recent symptoms and medical history, it would be prudent to schedule an appointment with your healthcare provider. Discuss your current symptoms in detail, including the episodes of rapid heartbeat and difficulty breathing. Your provider may recommend further evaluation, such as an echocardiogram, a Holter monitor to assess your heart rhythm over 24 hours, or additional blood tests to rule out any underlying conditions.

3. Consider Anxiety Management: Since you mentioned that some episodes may be related to anxiety, it may be beneficial to explore strategies for managing anxiety. Techniques such as deep breathing exercises, mindfulness, or cognitive behavioral therapy (CBT) can be effective in reducing anxiety-related symptoms.

4. Lifestyle Modifications: Continue engaging in regular physical activity, as it can improve cardiovascular health and reduce anxiety. However, listen to your body and avoid overexertion, especially if you notice that certain activities trigger your symptoms.

5. Emergency Signs: Be aware of any warning signs that would necessitate immediate medical attention, such as severe chest pain, fainting, or persistent shortness of breath. If you experience these symptoms, seek emergency care.

In conclusion, while it may be tempting to wait and see if your symptoms resolve on their own, the combination of your recent health history and the new onset of palpitations and breathing difficulties suggests that further evaluation is warranted. Engaging with your healthcare provider will help ensure that any potential underlying issues are addressed promptly, allowing you to manage your symptoms effectively and maintain your overall health.

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