Should You See a Cardiologist for Palpitations and Shortness of Breath?

Do I need to see a cardiologist for further evaluation?

Hello Doctor: Five days ago, I experienced mild chest discomfort and palpitations (heart rate around 100).
Resting while lying down helped alleviate the symptoms.
The next day, the palpitations were accompanied by shortness of breath; however, lying down continued to provide relief.
As soon as I stood up or sat down, I felt my heart racing and experienced shortness of breath.
I first visited a clinic where an electrocardiogram was performed, and the doctor diagnosed me with "sinus tachycardia" and referred me to the emergency department.
Upon arrival at the emergency room, I underwent an electrocardiogram, X-ray, blood tests, and a CT scan.
The emergency physician indicated that there were no significant issues.
While lying in the emergency room bed and receiving oxygen, I felt some relief, but as soon as I got up to walk a little, I became extremely short of breath and felt like I was going to faint.
Returning to the bed and continuing to receive oxygen helped me gradually stabilize.
After spending more than a day in the emergency room, I felt improvement and wanted to go home to rest.
However, getting out of bed to walk caused my heart rate to spike and I became very breathless.
The doctor concluded that my palpitations and shortness of breath were due to autonomic nervous system dysfunction and prescribed anti-anxiety medication.
Since returning home, I have not dared to go back to work and have tried to rest well.
While lying at home, I feel fine, and I take one anti-anxiety pill in the morning and one at night.
I fall asleep quickly and feel okay, but as soon as I get out of bed to walk, I start experiencing palpitations and shortness of breath again, even when sitting down to eat! I would like to ask if I should see a cardiologist for a more detailed examination?

Jingjing, 30~39 year old female. Ask Date: 2022/05/06

Dr. He Dongjin reply Cardiology

Hello, please come for a cardiology check-up at Changhua Hospital.
We care about your health.

Reply Date: 2022/05/06

More Info

Based on the symptoms you have described, including palpitations, shortness of breath, and feelings of anxiety, it is indeed advisable to consult a cardiologist for a thorough evaluation. Your recent experiences of increased heart rate (tachycardia) and difficulty breathing, especially when transitioning from lying down to sitting or standing, warrant further investigation to rule out any underlying cardiac issues.

Understanding Your Symptoms
1. Palpitations: These can be caused by a variety of factors, including anxiety, stress, caffeine intake, or underlying heart conditions. The fact that your heart rate spikes to around 100 beats per minute during episodes of anxiety or physical activity suggests that your heart is responding to stressors, which may or may not be indicative of a more serious condition.

2. Shortness of Breath: This symptom can be multifactorial. It may stem from anxiety or panic attacks, especially if you notice it worsening with physical activity or when you change positions. However, it can also be a sign of cardiac or pulmonary issues, which need to be evaluated.

3. Anxiety and Autonomic Nervous System: Your doctors have mentioned that your symptoms could be related to autonomic nervous system dysregulation. Anxiety can indeed exacerbate palpitations and shortness of breath, creating a cycle where anxiety leads to physical symptoms, which in turn increases anxiety.

Why See a Cardiologist?
1. Rule Out Cardiac Issues: While your emergency room evaluations (ECG, chest X-ray, blood tests, and CT scan) did not reveal any acute problems, a cardiologist can perform more specialized tests, such as echocardiograms or Holter monitoring, to assess your heart's structure and function over a longer period. This is crucial in identifying any arrhythmias or structural heart issues that may not have been evident during your initial evaluations.

2. Comprehensive Assessment: A cardiologist can provide a comprehensive assessment of your cardiovascular health, including risk factors such as family history, lifestyle, and any other symptoms you may not have mentioned. They can also evaluate your heart rate variability and response to stress.

3. Management of Symptoms: If your symptoms are indeed linked to anxiety, a cardiologist can work in conjunction with a mental health professional to develop a holistic treatment plan. This may include medication management, lifestyle modifications, and strategies to cope with anxiety.

Additional Considerations
- Lifestyle Factors: Consider evaluating your lifestyle for factors that may contribute to your symptoms, such as caffeine consumption, sleep quality, and stress management techniques. Regular physical activity, even in moderation, can help improve cardiovascular health and reduce anxiety.

- Medication Review: If you are currently on anti-anxiety medications, it’s essential to discuss their effects with your healthcare provider. Some medications can have side effects that may influence heart rate or respiratory function.

- Follow-Up: If your symptoms persist or worsen, or if you experience new symptoms such as chest pain, dizziness, or fainting, seek immediate medical attention.

In conclusion, given your symptoms of palpitations and shortness of breath, it is prudent to see a cardiologist for a detailed evaluation. This will help ensure that any potential cardiac issues are identified and addressed, while also considering the role of anxiety in your overall health. Your well-being is paramount, and taking proactive steps towards understanding and managing your symptoms is essential.

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