Chest Pain and Breathing Issues: A Cardiovascular Perspective

Chest pain?

Since last year, I have experienced shortness of breath whenever I walk more than a kilometer.
This year, I have been feeling persistent chest pain, cold sweats, and a constant tightness in my chest.
I often cannot feel my pulse, and my heartbeat has become very heavy.
My heart races irregularly, and sometimes I can feel it pounding in my neck as if it might leap out.
I frequently feel like I can't catch my breath.
My smartwatch occasionally shows my blood oxygen levels dropping to 70, and my heart rate at 45.
I am particularly sensitive to heat; whenever I sweat, my heart feels weak, and my heart rate often exceeds 100 beats per minute.

It seems similar to thyroid issues, but after an ultrasound, the cardiologist was reluctant to examine me further and kept suggesting a referral.
I saw a pulmonologist who diagnosed me with asthma (this was six months ago, and I haven't had a follow-up recently).
During my expiratory flow measurements, I often struggle to hold my breath and feel like I'm about to pass out; I used to be able to hold my breath for twenty seconds, but now I can only manage five seconds before feeling faint.

What could be causing these symptoms? Ever since I started taking benzodiazepines, my condition has worsened.
I've heard that individuals with poor lung function should avoid taking sedatives.
After taking them for a month, my situation has deteriorated, yet the cardiologist continues to encourage me to take them, which has led to my current state of breathlessness.

He Tong, 40~49 year old female. Ask Date: 2022/12/21

Dr. Wu Xueming reply Cardiology

Many factors in daily life can contribute to this condition, such as emotions, stress, irregular sleep patterns, or excessive intake of caffeinated beverages.
It is advisable to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is recommended to seek further evaluation at a hospital.

Reply Date: 2022/12/21

More Info

Understanding chest pain and breathing issues from a cardiovascular perspective is crucial for identifying potential underlying health problems. Your symptoms, which include shortness of breath after walking a short distance, persistent chest pain, cold sweats, and irregular heartbeats, warrant a thorough evaluation by a healthcare professional.

Chest Pain and Its Implications
Chest pain can arise from various causes, including musculoskeletal issues, gastrointestinal problems, and, importantly, cardiovascular conditions. Given your description of chest pain that feels like pressure and is accompanied by sweating and irregular heartbeats, it is essential to consider the possibility of angina or even a myocardial infarction (heart attack). Angina typically occurs when the heart muscle does not receive enough blood, often due to narrowed coronary arteries. This can lead to symptoms like chest discomfort, shortness of breath, and fatigue.

Breathing Difficulties
Breathing issues, particularly when they occur during physical exertion or in hot conditions, can be indicative of several conditions, including asthma, chronic obstructive pulmonary disease (COPD), or even heart failure. Your report of oxygen saturation dropping to 70% is concerning, as normal levels should be above 90%. Such low levels can lead to significant health risks, including hypoxia, which can affect organ function.

Potential Causes of Your Symptoms
1. Cardiovascular Issues: Given your history of chest pain and irregular heartbeats, it is vital to rule out any significant cardiovascular conditions. The sensation of your heart racing or feeling heavy, along with cold sweats, could indicate a serious issue that requires immediate attention.

2. Pulmonary Conditions: Your mention of asthma and difficulty with breath-holding suggests that lung function may be compromised. If you have a history of asthma, it is essential to manage it effectively, as poorly controlled asthma can lead to significant breathing difficulties.

3. Medication Effects: You noted that your symptoms worsened after starting benzodiazepines (BZD). These medications can cause respiratory depression, especially in individuals with pre-existing lung conditions. If you feel that your medication is exacerbating your symptoms, it is crucial to discuss this with your prescribing physician.

4. Anxiety and Panic Disorders: Anxiety can manifest physically, leading to symptoms such as palpitations, shortness of breath, and a feeling of impending doom. If you are experiencing significant anxiety, it may be contributing to your physical symptoms.

Recommendations
1. Seek Immediate Medical Attention: Given the severity of your symptoms, including chest pain and low oxygen saturation, it is imperative to seek immediate medical evaluation. A healthcare provider may recommend tests such as an electrocardiogram (ECG), echocardiogram, or stress testing to assess your heart's function.

2. Pulmonary Function Testing: A comprehensive evaluation of your lung function can help determine if there are underlying respiratory issues contributing to your symptoms.

3. Medication Review: Discuss your current medications with your healthcare provider to assess their appropriateness and potential side effects. If benzodiazepines are contributing to your breathing difficulties, alternative treatments may be necessary.

4. Lifestyle Modifications: Engaging in light physical activity, managing stress, and avoiding triggers that exacerbate your symptoms can be beneficial. If you have asthma, ensure you have an action plan in place.

5. Follow-Up Care: Regular follow-ups with both your cardiologist and pulmonologist can help monitor your symptoms and adjust treatment plans as necessary.

In conclusion, your symptoms are complex and multifactorial, necessitating a comprehensive approach to diagnosis and management. It is essential to advocate for your health and ensure that you receive the appropriate evaluations and treatments to address your concerns effectively.

Similar Q&A

Understanding Chest Pain and Breathing Issues: A Cardiovascular Perspective

I experience tightness and pain in my chest, along with difficulty breathing and occasional dizziness. These symptoms occur briefly during work or exercise. When they happen, resting and taking a few deep breaths (3 to 4 times) helps me feel more comfortable, and my breathing bec...

Dr. Wu Xueming reply Cardiology
Chest pain associated with breathing is not a typical symptom of cardiovascular disease. It is recommended to follow up with a cardiologist to review the echocardiogram and exercise electrocardiogram reports to determine if there are any abnormalities.

Understanding Chest Discomfort: Heart Pain and Breathing Difficulties Explained

If there are occasional feelings of chest tightness, sharp pain in the heart, and difficulty breathing, what could this indicate?

Dr. Zhu Nianfeng reply Cardiology
Hello: Chest tightness and chest pain are complex conditions that can be attributed to both cardiac and non-cardiac diseases. The evaluation should consider the patient's age, gender, presence of other cardiovascular risk factors, and relevant medical history, such as cough ...

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...

Should You See a Cardiologist for Chest Pain and Breathing Issues?

Hello. For the past six months, I have been experiencing a sensation in the left side of my chest where it feels like blood is not flowing properly while I am breathing. It is accompanied by a sharp pain that lasts for about five to six minutes, sometimes longer. I also feel shor...

Dr. Li Han reply Cardiology
Hello, Sister Juan. Based on your description, many of the symptoms are not typical manifestations of angina; however, this does not rule out the possibility or risk of coronary artery disease. If these symptoms continue to trouble you, it may be worthwhile to consult with your t...