Symptoms: When to Seek Medical Help for Breathing Issues

Shortness of breath, rapid heartbeat, insomnia, constipation?

I am currently a high school student with no obesity issues and no history of congenital heart disease or asthma.
A few years ago, a traditional Chinese medicine practitioner suggested that I might have an arrhythmia, but I did not pay much attention to it at the time.
However, in the past few months, I have frequently experienced shortness of breath while walking or climbing stairs, and I can noticeably feel my heart beating strongly.
Even when I am not exercising, I sometimes experience rapid breathing and a feeling of chest tightness.
My deep breaths feel normal, but my exhalations can be shaky and not smooth.
I also have insomnia; when lying down, I can distinctly feel my heart beating, accompanied by rapid breathing, which has caused me to lie awake for several hours without being able to sleep.
My eating habits and daily routine are normal.
I drink at least 1500 milliliters of water daily and do not often consume rice, meat, fried foods, or dairy products; I mostly eat vegetables and pasta.
I experience constipation and sometimes have abdominal pain, but I am unable to have a bowel movement.
Due to my shortness of breath and low stamina, I often seek rest from the school nurse during physical education classes.
The nurse suggested that I ask my parents to take me to the hospital for an examination, but I am concerned that I might be overreacting and that my parents may think my condition does not warrant a hospital visit.
Therefore, I would like to ask the doctor if you think I should schedule a hospital examination or if I should continue to monitor my symptoms.
If an examination is necessary, which department should I visit? Thank you, doctor.

Zhang Tongxue, 10~19 year old female. Ask Date: 2020/08/30

Dr. Huang Hongshuo reply Family Medicine

Please measure your blood pressure and heart rate once or twice a day, noting the time and any activities prior to measurement, as well as whether you are experiencing any discomfort at that time.
Your current diet is significantly unbalanced; please consult a nutritionist about "balanced nutrition." Overall symptoms should consider electrolyte imbalances, thyroid dysfunction, and autonomic nervous system disorders, and arrhythmias should be ruled out.
For constipation, adjustments should be made to your dietary intake and hydration levels, and blood tests should be conducted to exclude the aforementioned issues.
It is recommended to seek a comprehensive evaluation from a family medicine specialist as soon as possible to prevent the worsening of symptoms.

Reply Date: 2020/08/30

More Info

When it comes to breathing issues, especially in a young individual like yourself, it is crucial to take symptoms seriously, even if they seem mild or sporadic. Your description of experiencing shortness of breath, noticeable heartbeats, and chest tightness during physical activities, along with difficulty sleeping, suggests that there may be underlying issues that warrant further investigation.

Firstly, the symptoms you describe, such as shortness of breath during exertion (like walking or climbing stairs), could indicate a few potential conditions. While you mentioned that you do not have a history of asthma or congenital heart issues, it is important to consider that symptoms can develop over time, and new conditions can arise. The fact that you have experienced these symptoms consistently over the past few months is a significant indicator that you should seek medical attention.

Your mention of feeling your heart beating strongly, especially when lying down, could suggest a few things, including anxiety or a possible arrhythmia (irregular heartbeat). While you noted that a traditional Chinese medicine practitioner once suggested a possible arrhythmia, it is essential to have this evaluated by a healthcare professional who can perform the necessary tests, such as an electrocardiogram (ECG) or a Holter monitor, to assess your heart's rhythm and function.

Additionally, the breathing difficulties you experience, particularly the sensation of not being able to take a full breath or feeling like you are gasping for air, could be related to anxiety or panic attacks, especially if they occur in conjunction with your sleep disturbances. However, it is also possible that there could be a respiratory issue, such as exercise-induced bronchoconstriction or even allergic reactions, particularly if you have a history of allergies.

Given your symptoms and the impact they have on your daily life, including your ability to participate in physical activities and your sleep quality, it is advisable to seek medical evaluation. You should consider visiting a primary care physician first, who can perform a thorough assessment and may refer you to specialists such as a cardiologist for heart-related concerns or a pulmonologist for respiratory issues.

In terms of what to expect during your visit, the doctor will likely take a detailed medical history, perform a physical examination, and may order tests such as blood tests, chest X-rays, or pulmonary function tests to evaluate your lung capacity and function. If there are concerns about your heart, they may also conduct an ECG or an echocardiogram.

It is understandable to feel hesitant about seeking medical help, especially if you worry about being perceived as overreacting. However, your health and well-being are paramount, and it is always better to err on the side of caution. Early diagnosis and intervention can lead to better management of any potential conditions and improve your quality of life.

In summary, I strongly encourage you to discuss your symptoms with your parents and seek medical attention. It is important to address these issues sooner rather than later, as they can significantly affect your daily activities and overall health. Don't hesitate to advocate for yourself and ensure that you receive the care you need.

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