Shortness of Breath: When to Seek Medical Attention

Q: Shortness of Breath: When to Seek Medical Attention

Hello： Regarding your discomfort in the chest and difficulty breathing, if both the electrocardiogram and chest X-ray show no significant abnormalities, it is less likely to be a serious heart or lung condition. <br>Given your mother's history of thyroid-related issues and your s

Shortness of breath?

Last Wednesday, I went to see a doctor due to chest pain.
An electrocardiogram (ECG) was performed, and the doctor said there were no significant issues, just that my heart rate was a bit elevated, so he prescribed me New Kangle.
However, I went back to see the doctor again on Friday because I was experiencing chest tightness and difficulty breathing, whether I was walking or sitting.
I often needed to take deep breaths.
I asked the doctor if it could be asthma, but he said it didn't sound like it.
I recall having similar symptoms in the past, but not as uncomfortable as this time.
This time, I had a chest X-ray, and the doctor also said there were no abnormalities.
He suggested that I might be overly anxious and prescribed Xanax to take before bedtime.
On Friday, I had blood tests done because there might be a thyroid issue; my mother seems to have this problem, so the doctor said to return this Friday to review the results.
Recently, my appetite has been a bit poor, and sometimes I feel dizzy.
I feel sleepy, but the difficulty in breathing persists.
I would like to know what could be causing this and if I should return for an earlier consultation.

yu, 20~29 year old female. Ask Date: 2023/04/24

Dr. Lin Zhebin reply Family Medicine

Hello: Regarding your discomfort in the chest and difficulty breathing, if both the electrocardiogram and chest X-ray show no significant abnormalities, it is less likely to be a serious heart or lung condition.
Given your mother's history of thyroid-related issues and your symptoms of tachycardia, it may be worth considering hyperthyroidism.
Additionally, other conditions to consider include respiratory infections and asthma, among others.
If your chest discomfort and breathing difficulties remain similar to before, it is advisable to return for a follow-up appointment this Friday.
However, if you feel that your discomfort has worsened, it is recommended to seek an earlier appointment or even consider going to the emergency department.

Reply Date: 2023/04/24

More Info

Understanding shortness of breath can be quite complex, especially when it is accompanied by other symptoms such as chest pain, palpitations, and fatigue. Based on your description, it seems you have been experiencing a range of symptoms that could be indicative of various underlying conditions.
Firstly, it’s important to recognize that shortness of breath (dyspnea) can arise from multiple causes, including respiratory issues, cardiovascular problems, anxiety, and even metabolic disorders. Given that you have already undergone several tests, including an electrocardiogram (ECG) and chest X-ray, and that these tests did not reveal any significant abnormalities, it is crucial to consider other potential factors contributing to your symptoms.

1. Anxiety and Stress: Your doctor mentioned that your symptoms might be related to anxiety. Anxiety can manifest physically, leading to symptoms such as chest tightness, shortness of breath, and palpitations. When a person is anxious, they may hyperventilate, which can exacerbate feelings of breathlessness. If you find that your symptoms worsen during stressful situations, this could be a significant factor.

2. Thyroid Issues: Since your family history includes thyroid problems, and your doctor has ordered blood tests to check your thyroid function, it’s wise to consider this as a potential cause. Hyperthyroidism, for instance, can lead to symptoms like increased heart rate, anxiety, and shortness of breath. If your thyroid levels are abnormal, treating the underlying thyroid condition may alleviate your respiratory symptoms.

3. Cardiovascular Factors: Although your ECG was normal, it’s essential to keep in mind that some heart conditions can present with subtle symptoms. Conditions such as arrhythmias or even early heart failure can sometimes cause shortness of breath and fatigue. If you continue to experience these symptoms, further cardiovascular evaluation may be warranted.

4. Pulmonary Issues: While your chest X-ray did not show any abnormalities, it’s still possible to have conditions such as asthma or chronic obstructive pulmonary disease (COPD) that may not be evident on an X-ray. If you have a history of respiratory issues or if your symptoms include wheezing or a cough, discussing this with your doctor could be beneficial.

5. Other Considerations: Your symptoms of decreased appetite and dizziness could suggest a more systemic issue, such as anemia or other metabolic disorders. These conditions can lead to fatigue and shortness of breath, particularly during exertion.

Given the persistence of your symptoms and the fact that they are affecting your daily life, it would be prudent to follow up with your healthcare provider sooner rather than later. It’s essential to communicate all your symptoms clearly, including any changes in appetite, energy levels, and emotional state. Your doctor may consider additional tests, such as pulmonary function tests, thyroid function tests, or even a referral to a specialist, depending on your clinical picture.

In summary, while it’s reassuring that initial tests have not indicated any severe issues, the combination of your symptoms warrants further investigation. Don’t hesitate to seek medical attention if you feel your condition is worsening or if you have new symptoms. Your health and well-being are paramount, and addressing these concerns early can lead to better outcomes.

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