Symptoms: Breathlessness, Chest Tightness, and Anxiety

Q: Symptoms: Breathlessness, Chest Tightness, and Anxiety

Hello： It is recommended that you take cardiology medications along with expectorants, and if necessary, you may ask your physician to prescribe anti-anxiety medication. <br>If you continue to experience chest tightness and discomfort, consider consulting a psychosomatic speciali

Respiratory distress, chest tightness, sensation of a lump in the throat, and neck tightness?

Hello Doctor,
I would like to ask about my current symptoms, which include respiratory distress, chest tightness, a sensation of something stuck in my throat, neck tightness, difficulty breathing, and irregular heartbeats.
I have seen a pulmonologist who performed two chest X-rays, and the doctor reported no abnormalities.
I also underwent an electrocardiogram and pulmonary function tests, all of which were normal.
The doctor prescribed expectorants, antiarrhythmic medication, and allergy medication.
However, after taking these medications a few times, my symptoms continue to fluctuate, which is quite distressing.

In light of this situation, I consulted a cardiologist who performed an echocardiogram and diagnosed me with mitral valve prolapse.
The doctor explained that my symptoms may be related to autonomic nervous system dysfunction and prescribed additional medication.
Despite this, my symptoms still vary and are accompanied by discomfort.
I wonder if anxiety might also be a contributing factor, as these symptoms are affecting my work and daily life.

I also visited an otolaryngologist who examined my nasal passages and noted some tightness but found no abnormalities.
The doctor prescribed expectorants again.
By the way, my phlegm is green! It tends to be thicker in the morning and clears up at other times, which is quite bothersome.

Could you please advise me on how to address my condition and which specialty would be most appropriate for further evaluation? Thank you!

Ashley, 30~39 year old female. Ask Date: 2020/07/14

Dr. Yang Wenda reply Pulmonology

Hello: It is recommended that you take cardiology medications along with expectorants, and if necessary, you may ask your physician to prescribe anti-anxiety medication.
If you continue to experience chest tightness and discomfort, consider consulting a psychosomatic specialist.

Reply Date: 2020/07/14

More Info

Your symptoms of breathlessness, chest tightness, and feelings of anxiety can be quite distressing and are often interconnected. Based on your description, it seems that you have undergone a thorough evaluation by various specialists, including pulmonologists and cardiologists, which is a good first step in ruling out any serious underlying medical conditions.

Understanding Your Symptoms
1. Breathlessness and Chest Tightness: These symptoms can arise from a variety of causes, including anxiety, respiratory issues, or cardiac conditions. Given that your tests have come back normal, it is possible that these sensations are linked to anxiety or panic attacks. Anxiety can lead to hyperventilation, which can cause feelings of breathlessness and chest tightness.
2. Throat Tightness and Neck Tension: These sensations can also be manifestations of anxiety. When we are anxious, our body tends to tense up, which can lead to muscle tightness in the neck and throat, further contributing to the feeling of not being able to breathe properly.

3. Heart Palpitations: The sensation of an irregular heartbeat can be alarming and is often associated with anxiety. It’s important to note that while you have been diagnosed with mitral valve prolapse, which can cause palpitations, it is generally not life-threatening. However, the anxiety surrounding these symptoms can exacerbate the feeling of palpitations.

4. Green Phlegm: The presence of green phlegm can indicate an infection or inflammation in the respiratory tract. It’s important to consider whether you have any underlying respiratory conditions, such as chronic bronchitis or allergies, that could be contributing to this symptom.

Recommendations for Management
1. Anxiety Management: Since anxiety seems to be a significant factor in your symptoms, it may be beneficial to explore cognitive-behavioral therapy (CBT) or other forms of psychotherapy. These therapies can help you develop coping strategies to manage anxiety and reduce the physical symptoms associated with it.

2. Breathing Techniques: Practicing controlled breathing techniques can help alleviate feelings of breathlessness. Techniques such as diaphragmatic breathing or pursed-lip breathing can be effective in calming the nervous system and improving your sense of control over your breathing.

3. Medication Review: Since you are already on medications prescribed by your doctors, it’s essential to have a follow-up consultation to discuss their effectiveness and any side effects you may be experiencing. Sometimes, adjusting the dosage or trying a different medication can lead to better symptom management.

4. Lifestyle Modifications: Incorporating regular physical activity, a balanced diet, and adequate sleep can significantly impact your overall well-being. Additionally, mindfulness practices such as yoga or meditation can help reduce anxiety levels.

5. Follow-Up with Specialists: If your symptoms persist despite these interventions, consider revisiting your healthcare providers. A multidisciplinary approach involving a pulmonologist, cardiologist, and mental health professional may provide a more comprehensive understanding of your symptoms.

6. Monitoring Symptoms: Keeping a symptom diary can help you identify triggers for your anxiety and physical symptoms. This information can be valuable for your healthcare providers in tailoring a treatment plan that addresses both your physical and psychological needs.

Conclusion
Your symptoms are complex and multifaceted, and it’s crucial to approach them holistically. While it’s reassuring that serious medical conditions have been ruled out, the interplay between anxiety and physical symptoms can be significant. By focusing on anxiety management, lifestyle changes, and ongoing communication with your healthcare providers, you can work towards improving your quality of life and reducing the impact of these symptoms on your daily activities. If you find that your symptoms are not improving or worsening, do not hesitate to seek further medical advice.

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