Heart Pain and Breathing Issues: When to Seek Help

Q: Heart Pain and Breathing Issues: When to Seek Help

Hello： Based on your description, your symptoms are non-specific manifestations, and there are currently no test results available for assessment. <br>It is difficult to determine the underlying cause at this time. <br>If your symptoms persist, I recommend visiting a trusted hosp

Chest pain and rapid shock?

Hello, recently whenever I exercise or eat very hot food, I start to experience an increased heart rate, low-grade fever (rarely exceeding 38.3°C), jugular vein distension, and I can feel my neck pulsating.
My blood pressure spikes to 160 (it was 120 before eating).
My head feels very hot, almost like it's going to explode, and I have severe shortness of breath, feeling like I can hardly breathe.
My heart beats very strongly, and the heart rate monitor shows sinus rhythm with a resting heart rate reaching 120.
Sometimes my blood oxygen levels drop, and I experience chest tightness.
I consulted a cardiologist, but they said they couldn't help me.
Could this be a pulmonary vascular disease like pulmonary embolism? I have visited many hospitals and have seen hundreds of doctors without finding a cause, but I truly feel like I can't breathe (this happens whenever I eat very hot food, so it can’t be attributed to autonomic nervous system dysfunction, although doctors often dismiss me with that diagnosis).

What tests should I undergo, and which specialist should I see? Should I get a cardiac CT scan or a pulmonary CT scan? Also, I cannot hold my breath for long without feeling weak, and it often feels like I'm breathing in stale air and unable to breathe properly.

nv vivian, 50~59 year old female. Ask Date: 2022/12/25

Dr. Wang Lanfeng reply Pulmonology

Hello: Based on your description, your symptoms are non-specific manifestations, and there are currently no test results available for assessment.
It is difficult to determine the underlying cause at this time.
If your symptoms persist, I recommend visiting a trusted hospital and consulting with a pulmonologist for a thorough evaluation.
Thank you.

Reply Date: 2022/12/25

More Info

It sounds like you are experiencing a complex set of symptoms that can be quite distressing. Your description includes rapid heart rate, elevated blood pressure, feelings of breathlessness, and discomfort in your chest, particularly after eating hot foods or exercising. These symptoms can be indicative of several underlying conditions, and it is crucial to approach this systematically to identify the root cause.

First, it is essential to understand that symptoms like rapid heart rate (tachycardia), elevated blood pressure, and shortness of breath can arise from various sources, including cardiovascular issues, respiratory problems, or even anxiety and panic disorders. Given your symptoms, it is wise to consider both cardiac and pulmonary evaluations.

Potential Causes of Your Symptoms
1. Cardiovascular Issues: Conditions such as arrhythmias (irregular heartbeats), valvular heart disease, or even heart failure can lead to symptoms like those you describe. The fact that your heart rate can reach 120 beats per minute while at rest is concerning and warrants further investigation.

2. Pulmonary Conditions: You mentioned the possibility of pulmonary embolism (a blockage in the lung arteries). This is a serious condition that can cause sudden shortness of breath, chest pain, and rapid heart rate. A CT scan of the chest (CT pulmonary angiography) is typically the gold standard for diagnosing pulmonary embolism.

3. Gastroesophageal Reflux Disease (GERD): Eating hot foods can exacerbate GERD, leading to symptoms that mimic cardiac issues, such as chest discomfort and difficulty breathing.
4. Anxiety and Panic Disorders: These can also manifest with physical symptoms that mimic heart and lung issues, including rapid heart rate, shortness of breath, and feelings of impending doom.

Recommended Steps
1. Consult a Cardiologist: Since you have already seen a cardiologist, it may be beneficial to seek a second opinion or consult a different specialist who can perform a comprehensive evaluation, including an echocardiogram, stress test, and possibly a Holter monitor to assess your heart rhythm over a 24-hour period.

2. Pulmonary Evaluation: A pulmonologist can evaluate your lung function and perform tests such as a chest X-ray, CT scan, or pulmonary function tests to rule out conditions like asthma, chronic obstructive pulmonary disease (COPD), or pulmonary embolism.

3. Gastroenterology Consultation: If GERD is suspected, a gastroenterologist can perform an endoscopy or recommend treatments to manage acid reflux.

4. Mental Health Evaluation: Given the potential for anxiety to exacerbate physical symptoms, it may be helpful to consult a mental health professional. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can be beneficial in managing anxiety-related symptoms.

Diagnostic Tests to Consider
- Electrocardiogram (EKG): To assess your heart's electrical activity.

- Echocardiogram: To visualize the heart's structure and function.

- Chest CT Scan: To check for pulmonary embolism or other lung issues.

- Holter Monitor: To track your heart rhythm over an extended period.

- Pulmonary Function Tests: To evaluate lung capacity and function.

Conclusion
Your symptoms are complex and could stem from multiple sources. It is crucial to work closely with healthcare professionals to conduct a thorough evaluation. Keep a detailed record of your symptoms, including when they occur and any potential triggers, as this information can be invaluable in diagnosing your condition. Remember, it is essential to advocate for your health and seek further evaluations if you feel your concerns are not being adequately addressed.

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