Chest Tightness and Breathing Difficulties: A Gastrointestinal Perspective

Q: Chest Tightness and Breathing Difficulties: A Gastrointestinal Perspective

Hello, you reported the following symptoms： 1. <br>Chest tightness, shortness of breath, and rapid heartbeat. <br>2. <br>Mild dizziness and nausea, which are common symptoms of gastroesophageal reflux disease (GERD), including heartburn and acid regurgitation. <br>Generally, ches

Chest tightness and difficulty breathing?

Hello Doctor: On November 21 (Saturday), I went to the emergency room because I suddenly experienced chest tightness, difficulty breathing, and rapid heartbeat shortly after taking a shower.
The hospital conducted chest X-rays, blood tests, urine tests, an electrocardiogram, and blood pressure measurements, all of which were normal.
However, I went to the emergency room again the following Sunday night.
The doctor suggested that I might be experiencing gastroesophageal reflux disease (GERD), which could be causing the chest tightness and difficulty breathing.
This was likely exacerbated by the fact that I had been mostly bedridden at home that day, and the symptoms occurred shortly after eating a normal meal.
Later, I consulted a gastroenterologist who diagnosed me with acute gastroenteritis, explaining that this could be the reason for my fever and diarrhea.
However, my mother mentioned that the emergency doctor said I could eat high-calorie foods, so from Monday to Wednesday, I was allowed to eat normally.
Despite this, my appetite was poor, and shortly after eating, I began to experience chest tightness and difficulty breathing again.
I then visited a pulmonologist who performed a second chest X-ray, which also came back normal, and auscultation was normal as well.
Now, I occasionally experience sudden chest tightness and difficulty breathing, often preceded by mild dizziness and a slight urge to vomit, which then leads to discomfort.
I am wondering if my GERD and gastritis medications wear off after four hours, or if it could be due to my eating only until I am three-quarters full at breakfast and lunch, leading to increased gastric acid secretion around 5 PM, which might have caused esophageal irritation.

I am unable to identify the cause of my chest tightness and difficulty breathing.
Could it be related to gastric nerve issues or gastric spasms affecting the inflamed esophagus? It has been six days since my initial emergency visit (I only started eating light foods and taking my medications regularly on the fourth day), and my condition has improved compared to the previous days, with only one episode occurring on the later days.
Is it possible that my lower esophageal sphincter has relaxed? (As a side note, I drink black coffee daily and have been eating spicy foods frequently, and I have also laid down shortly after eating several times.) I appreciate your patience in reviewing my situation and providing answers.
Thank you for your help.

Jie, 20~29 year old female. Ask Date: 2020/11/27

Dr. Zhang Kebin reply Gastroenterology and Hepatology

Hello, you reported the following symptoms: 1.
Chest tightness, shortness of breath, and rapid heartbeat.
2.
Mild dizziness and nausea, which are common symptoms of gastroesophageal reflux disease (GERD), including heartburn and acid regurgitation.
Generally, chest tightness, shortness of breath, and rapid heartbeat are less likely to be caused by gastrointestinal issues.
The mild dizziness and nausea may be related to irregular eating habits.
It is recommended that you visit a gastroenterology clinic to discuss your symptoms with a gastroenterologist, and you may need to undergo endoscopic evaluation.

Reply Date: 2020/11/27

More Info

Understanding chest tightness and breathing difficulties can be quite complex, especially when gastrointestinal issues are involved. Based on your description, it seems that you are experiencing a combination of symptoms that may be linked to gastroesophageal reflux disease (GERD) and possibly acute gastritis.
Firstly, it’s important to recognize that GERD can lead to a range of symptoms, including chest tightness, difficulty breathing, and a sensation of food or liquid backing up into the throat. This occurs when stomach acid flows back into the esophagus, causing irritation and inflammation. The symptoms you describe, such as feeling chest tightness after eating and experiencing a burning sensation, are classic signs of GERD. Additionally, the fact that you feel better when sitting up or in an upright position further supports this diagnosis, as lying down can exacerbate reflux symptoms.

Your experience of sudden chest tightness and difficulty breathing after eating could also be related to esophageal spasms, which can occur in individuals with GERD. These spasms can create a sensation of tightness in the chest and may mimic cardiac-related symptoms, leading to anxiety and further exacerbating your breathing difficulties. It’s also worth noting that anxiety itself can contribute to feelings of chest tightness and shortness of breath, creating a cycle of discomfort.

The acute gastroenteritis you mentioned could also play a role in your symptoms. Inflammation of the stomach lining can lead to nausea, vomiting, and abdominal pain, which can further complicate your situation. If you are experiencing gastrointestinal distress, it may lead to changes in your eating habits, which can affect your overall health and exacerbate GERD symptoms. Eating smaller, more frequent meals and avoiding trigger foods (such as spicy or acidic foods) can help manage both gastritis and GERD symptoms.

Regarding your concerns about the medications you are taking, it’s essential to follow your healthcare provider’s recommendations closely. If you feel that the medications are not providing adequate relief, or if your symptoms persist or worsen, it’s crucial to communicate this to your doctor. They may consider adjusting your treatment plan or exploring other diagnostic options, such as an upper endoscopy, to assess the condition of your esophagus and stomach more thoroughly.

In terms of lifestyle modifications, consider the following strategies to help alleviate your symptoms:
1. Dietary Changes: Avoid large meals and try to eat smaller portions throughout the day. Steer clear of spicy, fatty, or acidic foods that can trigger reflux. Also, limit caffeine and alcohol intake, as these can exacerbate symptoms.

2. Posture: After eating, remain upright for at least two to three hours to prevent reflux. If you need to lie down, consider elevating your head and upper body to reduce the likelihood of acid reflux.

3. Weight Management: If applicable, losing weight can significantly reduce the pressure on your stomach and lower esophageal sphincter, helping to alleviate GERD symptoms.

4. Stress Management: Since anxiety can contribute to your symptoms, consider incorporating relaxation techniques such as deep breathing exercises, meditation, or yoga into your routine.

5. Regular Follow-ups: Keep in touch with your healthcare provider to monitor your symptoms and adjust your treatment as necessary.

In summary, your symptoms of chest tightness and breathing difficulties are likely interconnected with your gastrointestinal issues, particularly GERD and possibly gastritis. It’s essential to work closely with your healthcare team to manage these conditions effectively and to ensure that any underlying issues are addressed. If your symptoms continue or worsen, further evaluation may be necessary to rule out other potential causes.

Similar Q&A

Understanding Chest Tightness and Breathing Issues: A Cardiovascular Perspective

Hello, Doctor. I would like to inquire about an incident that occurred in March this year. While exercising, I suddenly felt unable to breathe, as if my airways were blocked. After resting for a while, my condition improved. I went to a health center where an electrocardiogram sh...

Dr. Huang Yinghe reply Cardiology
Hello: Based on the symptoms you described, multiple hospital examinations have shown no cardiovascular or pulmonary issues. The purpose of these tests was to rule out any life-threatening conditions or significant organ abnormalities. Other less dangerous conditions that may cau...

Understanding Chest Tightness and Breathing Difficulties: Causes and Concerns

In recent days, I've suddenly felt a tightness in my chest and difficulty breathing, and my stomach hasn't been feeling well lately. However, I don't have any other symptoms besides the stomach issues. Could you please advise what this might indicate? Is it a psych...

Dr. Lu Mingzhi reply Pulmonology
Hello: Symptoms such as chest tightness and difficulty breathing should raise concerns about heart and lung issues. Gastroesophageal reflux disease (GERD) and gastrointestinal problems, as well as anxiety disorders, may also present similar symptoms. It is recommended to visit an...

Understanding Chest Discomfort: Causes and Solutions for Breathing Issues

There is a feeling of tightness in the chest, as if there is a blockage, and it requires significant effort to breathe in air.

Dr. Jian Shuntian reply Pulmonology
Hello, there are many factors to consider in this situation, which could include pulmonary heart issues, psychological stress, or problems such as gastroesophageal reflux. Please visit a pulmonology clinic first to confirm the underlying cause. Thank you. Sincerely, Dr. Jian Shun...

Understanding Chest Tightness and Gastrointestinal Discomfort

Hello, in the past week, I've been experiencing a frequent urge to take deep breaths, along with a feeling of tightness in the area from my chest to my stomach. However, I can't quite distinguish whether it's a tightness in my chest or my stomach. When I'm bus...

Dr. Liao Yaopan reply Family Medicine
Hello, regarding your concerns, it is recommended that you first consult your family physician for an evaluation. If necessary, they may refer you to other subspecialties for assistance. It is essential to maintain a regular routine, a balanced diet, and exercise habits, as well ...