Breathing Difficulties and Chest Discomfort: When to Seek Medical Help

Q: Breathing Difficulties and Chest Discomfort: When to Seek Medical Help

Hello： It is recommended that you see a pulmonologist and a cardiologist for evaluation.

Shortness of breath, chest tightness/pain?

Hello Dr.
Lu: On May 9th, I suddenly woke up in the middle of the night feeling short of breath.
After waking up, my breathing was very rapid.
I got up and walked around the living room, and after sitting down to rest for a bit, I felt slightly better.
The next day, I felt a bit improved, but I still had a sensation of tightness in my chest and difficulty breathing.
Since I felt that some of my symptoms resembled gastroesophageal reflux disease (GERD), I first went to see a gastroenterologist.
(I have had issues with GERD approximately once a year.) I have been taking medication for GERD for about three weeks now, but the feelings of difficulty and discomfort in breathing have not significantly improved.
It feels somewhat like there is something pressing on my chest, and I experience slight tenderness when pressing on the xiphoid process, but I do not have any cough or phlegm symptoms.
Additionally, compared to before, I do not feel more short of breath when jogging or walking.
I would like to ask if I need to see a pulmonologist for an examination? However, due to the recent pandemic, the hospitals near my home have basically suspended non-urgent examinations.
If I cannot undergo relevant tests, is there still a need to seek medical attention? Thank you.

CD, 30~39 year old female. Ask Date: 2021/05/31

Dr. Lu Mingzhi reply Pulmonology

Hello: It is recommended that you see a pulmonologist and a cardiologist for evaluation.

Reply Date: 2021/05/31

More Info

Breathing difficulties and chest discomfort can be concerning symptoms that warrant careful evaluation. Based on your description, it seems that you experienced an acute episode of shortness of breath during the night, which improved somewhat with movement but left you with a lingering sensation of chest tightness and discomfort. You also mentioned a history of gastroesophageal reflux disease (GERD), which can sometimes mimic or contribute to respiratory symptoms.

When to Seek Medical Help
1. Acute Symptoms: If you experience sudden onset of shortness of breath, especially if it is severe or accompanied by chest pain, sweating, or dizziness, it is crucial to seek immediate medical attention. These could be signs of serious conditions such as a heart attack or pulmonary embolism.

2. Persistent Symptoms: Since you have ongoing symptoms of chest discomfort and breathing difficulties that have not improved with GERD treatment, it is advisable to consult a healthcare provider. Persistent symptoms can indicate that the underlying cause has not been adequately addressed.

3. Worsening Condition: If your symptoms worsen or if you develop new symptoms such as coughing, wheezing, or significant changes in your ability to perform daily activities, you should seek medical care promptly.

Possible Causes of Your Symptoms
1. Gastroesophageal Reflux Disease (GERD): GERD can cause chest discomfort and may lead to respiratory symptoms due to acid irritating the airways. However, if you are on medication for GERD and not experiencing relief, it may be time to reassess your treatment plan.

2. Anxiety and Stress: Anxiety can manifest as shortness of breath and chest tightness. Given the current global situation with the pandemic, stress and anxiety levels may be heightened, contributing to your symptoms.

3. Respiratory Conditions: Conditions such as asthma, chronic obstructive pulmonary disease (COPD), or even allergies can lead to breathing difficulties. Given your history of asthma, it may be worthwhile to evaluate whether your symptoms are related to this condition.

4. Cardiac Issues: While your symptoms may be related to GERD or anxiety, it is essential to rule out any cardiac issues, especially since you mentioned chest discomfort. Conditions like angina or other heart-related issues can present with similar symptoms.

Recommendations
1. Consult a Specialist: If possible, consider scheduling an appointment with a pulmonologist or a cardiologist. They can perform necessary tests, such as pulmonary function tests or an echocardiogram, to evaluate your lung and heart function.

2. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be valuable for your healthcare provider.

3. Lifestyle Modifications: While waiting for an appointment, consider lifestyle changes that may alleviate symptoms. These can include avoiding large meals before bedtime, elevating the head of your bed, and practicing relaxation techniques to manage stress and anxiety.

4. Telemedicine Options: Given the current pandemic situation, many healthcare providers offer telemedicine consultations. This could be a convenient way to discuss your symptoms with a doctor without needing to visit a clinic in person.

5. Emergency Care: If you experience severe symptoms or feel that your condition is worsening, do not hesitate to seek emergency care. It is always better to err on the side of caution when it comes to breathing difficulties.

In summary, while your symptoms may be related to GERD or anxiety, it is essential to rule out other potential causes, especially given your history of respiratory issues. Seeking medical advice and possibly undergoing further evaluation will help ensure that you receive appropriate care and management for your symptoms.

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