Heart Sounds and Symptoms: When to Seek Medical Advice - Pulmonology

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Lying down to rest, I can hear sounds from my heart?


Recently, my sleep duration has decreased (averaging 4-5 hours).
Current condition: I feel short of breath and nauseous after standing for a long time.
When I lie down to rest, I can hear a rhythmic sound from my heart when I exhale (similar to a thumping sound).
This lasts for about 30 beats before the sound disappears.
Previously, I experienced sudden sharp pain in my heart while sleeping and felt like I couldn't breathe, which led me to visit the emergency room.
I underwent an electrocardiogram (ECG) and X-rays, and the doctor assessed that there were no issues.
A few months later, I noticed a loud thumping sound from my heart when lying down, with an irregular rhythm.
I decided to see a doctor again, but after evaluation, I was told that my heart rate might be slightly elevated and that there was no significant problem.
I would like to ask the doctor if I should have regular follow-ups for monitoring (since different doctors have diagnosed me with no issues), or if there might be a specific reason for my symptoms (as this has never happened before, and the incidents occurred suddenly without warning, and it has been a long time since).

Yi, 20~29 year old female. Ask Date: 2022/07/09

Dr. Wang Zhengde reply Pulmonology


Dear Miss Yi,
Based on your description, your condition may be indicative of paroxysmal arrhythmia, and insufficient sleep could be a contributing factor.
However, online consultations cannot replace actual clinical evaluations.
I recommend that you seek a professional clinical assessment from a cardiologist or pulmonologist in your area.
Thank you for your inquiry! Wishing you good health.
Dr.
Wang Cheng-Te
Attending Physician, Department of Pulmonary Medicine
Ministry of Health and Welfare, Hsin-Ying Hospital

Reply Date: 2022/07/09

More Info


When it comes to understanding heart sounds and symptoms, especially in the context of your recent experiences, it's essential to approach the situation with a comprehensive understanding of cardiovascular health. Your symptoms, including shortness of breath, nausea, and unusual heart sounds, warrant careful consideration and monitoring.

Firstly, the fact that you have experienced a decrease in sleep duration to an average of 4-5 hours can significantly impact your overall health, including cardiovascular function. Sleep deprivation is known to contribute to increased stress levels, anxiety, and can exacerbate existing heart conditions. It can also lead to increased heart rate and blood pressure, which may explain some of the sensations you are experiencing.

The symptoms you describe—feeling breathless after standing for a long time and experiencing a rhythmic sound from your heart—could be indicative of several underlying issues. The rhythmic sound you hear, akin to bowel sounds, might be related to your heart's activity, particularly if you are experiencing palpitations or irregular heartbeats. This could be a result of anxiety or stress, which can manifest physically in various ways, including heart palpitations.

Your previous evaluations, including an electrocardiogram (ECG) and chest X-ray, did not reveal any significant issues, which is reassuring. However, the fact that you continue to experience these symptoms suggests that further monitoring may be beneficial. Regular follow-ups with your healthcare provider are essential, especially if your symptoms persist or worsen. It might be helpful to keep a symptom diary, noting when these episodes occur, their duration, and any associated activities or stressors. This information can be invaluable for your healthcare provider in determining the next steps.

In terms of potential causes for your symptoms, several factors could be at play. Anxiety and stress are common culprits that can lead to physical symptoms such as palpitations, shortness of breath, and even gastrointestinal discomfort. Additionally, dehydration, electrolyte imbalances, or even dietary factors (such as caffeine intake) could contribute to these sensations. It’s also worth considering your posture and activity levels; standing for prolonged periods can lead to orthostatic hypotension, where blood pressure drops upon standing, causing dizziness and nausea.

Given your history of sudden heart pain and the subsequent evaluations that found no significant issues, it is crucial to remain vigilant. If you notice any new symptoms, such as chest pain, severe shortness of breath, or fainting, seek immediate medical attention.
In conclusion, while your previous evaluations have not indicated any serious issues, your ongoing symptoms suggest that regular monitoring and possibly further evaluation may be warranted. Discuss your concerns with your healthcare provider, who may recommend additional tests or a referral to a cardiologist for specialized assessment. Lifestyle modifications, such as improving sleep hygiene, managing stress, and staying hydrated, can also play a significant role in your overall heart health. Always prioritize open communication with your healthcare team to ensure that your concerns are addressed and that you receive appropriate care.

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