Breathing Difficulties and Chest Discomfort: When to Seek Medical Help

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

Dear Lingling： You can visit the Department of Thoracic Medicine and the Department of Gastroenterology at Changhua Hospital for your concerns.

Difficulty breathing, chest tightness, and a sensation of something stuck while swallowing?

Recently, when I wake up, I feel like I can't breathe properly and can't get enough air.
My esophagus feels like it's blocked when swallowing saliva, and I have a sensation of breathlessness that makes me feel nauseous.
My hands and feet start to feel cold, and I need to go outside to walk around and take deep breaths of fresh air or smell something fragrant.
Sometimes I even have to pinch my nose to feel like I'm getting air.
These symptoms have occurred two to three times over the past two weeks.
The inability to breathe properly makes me feel scared and anxious.
When I apply slight pressure to my chest, I feel a mild pain, and I have some phlegm.
I am currently taking gastrointestinal medication because I feel like my esophagus is blocked when swallowing, and I experience frequent burping.
I don't particularly enjoy exercising, I have a sedentary job, and my diet is not well-controlled, as I sometimes eat too much.
Which medical specialty should I consult for these issues?

Ling Ling, 30~39 year old female. Ask Date: 2022/10/03

Dr. Huang Yiwen reply Pulmonology

Dear Lingling: You can visit the Department of Thoracic Medicine and the Department of Gastroenterology at Changhua Hospital for your concerns.

Reply Date: 2022/10/03

More Info

Breathing difficulties and chest discomfort can be alarming symptoms, especially when they occur frequently and are accompanied by feelings of anxiety or panic. Based on your description, it seems that you are experiencing episodes of breathlessness, a sensation of tightness in the chest, and discomfort while swallowing. These symptoms can be indicative of several underlying conditions, and it is essential to approach them with caution.

Given the symptoms you've described, it would be prudent to consult with a healthcare professional who specializes in respiratory issues, such as a pulmonologist. They can conduct a thorough evaluation, which may include pulmonary function tests, imaging studies like a chest X-ray or CT scan, and possibly allergy testing if there is a suspicion of asthma or other allergic reactions contributing to your symptoms.

Additionally, your mention of gastrointestinal symptoms, such as difficulty swallowing and excessive belching, suggests that you might also benefit from seeing a gastroenterologist. Conditions like gastroesophageal reflux disease (GERD) can cause symptoms that mimic respiratory issues, including a sensation of tightness in the chest and difficulty swallowing. The esophagus and the respiratory system are closely linked, and issues in one can often affect the other.

It is also important to consider the psychological aspect of your symptoms. Anxiety can manifest physically, leading to hyperventilation, chest tightness, and a feeling of not being able to breathe. If you find that your symptoms are exacerbated by stress or anxiety, it may be beneficial to speak with a mental health professional. Cognitive-behavioral therapy (CBT) and relaxation techniques can be effective in managing anxiety-related symptoms.

In terms of lifestyle factors, your sedentary work environment and dietary habits may also be contributing to your symptoms. Regular physical activity can improve lung function and overall well-being. Even simple activities like walking can help alleviate feelings of breathlessness. Additionally, maintaining a balanced diet and managing portion sizes can help prevent gastrointestinal discomfort, which may be exacerbating your breathing issues.

If you experience any of the following symptoms, you should seek immediate medical attention:
1. Severe shortness of breath: If you feel like you cannot catch your breath, or if your breathing becomes rapid and shallow.

2. Chest pain: Especially if it radiates to your arm, jaw, or back, or if it is accompanied by sweating, nausea, or lightheadedness.

3. Cyanosis: A bluish tint to your lips or face, indicating a lack of oxygen.

4. Persistent cough with blood: This could indicate a serious condition that requires urgent evaluation.

In summary, your symptoms warrant a comprehensive evaluation by both a pulmonologist and a gastroenterologist. Addressing any underlying respiratory or gastrointestinal issues, along with considering the psychological components of your symptoms, will be crucial in managing your condition effectively. Remember, it is always better to err on the side of caution when it comes to your health, so do not hesitate to seek medical help if your symptoms persist or worsen.

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