Chest Tightness, Dizziness, and Heart Discomfort: When to Seek Help? - Cardiology

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Chest tightness, dizziness, and discomfort in the heart?


Hello Doctor, since the beginning of the year 111, I have been experiencing chest tightness.
I have a long history of gastroesophageal reflux disease (GERD) and have undergone an upper gastrointestinal examination and endoscopy, where the doctor indicated that everything was fine.
That year, I also visited a cardiologist for an electrocardiogram (ECG), blood tests, echocardiogram, and X-rays, and the doctor also said everything was normal.
However, with the recent changes in weather, I have started to experience anxiety, nervousness, and chest tightness again.
I returned to the hospital for a follow-up, but the doctor mentioned that since I just had a check-up a little over a year ago, there shouldn't be any major issues.
Nonetheless, they performed X-rays and an ECG (but no echocardiogram), and the results were also normal.
I still feel uncomfortable and would like to ask if I should see a cardiologist again, or could this be caused by anxiety and overthinking?

Chieh, 30~39 year old female. Ask Date: 2024/01/26

Dr. Wu Xueming reply Cardiology


Due to your young age and the absence of chronic diseases, your risk of developing heart disease is low.
Many factors in daily life can contribute to this situation, such as emotions, stress, irregular sleep patterns, or excessive consumption of caffeinated beverages.
It is advisable to adjust your lifestyle and engage in regular exercise.
However, if symptoms persist, it is still recommended to visit a hospital for further evaluation.

Reply Date: 2024/01/26

More Info


When experiencing symptoms such as chest tightness, dizziness, and heart discomfort, it is essential to approach the situation with a comprehensive understanding of both physical and psychological factors. Based on your description, it appears that you have a history of gastroesophageal reflux disease (GERD) and have undergone various cardiac evaluations, including electrocardiograms (ECGs), echocardiograms, and X-rays, all of which returned normal results. This is reassuring, but it does not entirely eliminate the possibility of ongoing discomfort.

Firstly, it is important to recognize that anxiety and stress can significantly contribute to physical symptoms, including chest tightness and palpitations. The mind-body connection is well-documented in medical literature, and anxiety can manifest as somatic symptoms, leading individuals to feel physical discomfort without any underlying organic disease. In your case, the recent changes in weather and increased anxiety levels may be exacerbating your symptoms, leading to a cycle of worry and discomfort.

Given your history of GERD, it is also plausible that your chest discomfort could be related to acid reflux, which can cause sensations of tightness in the chest and mimic cardiac symptoms. GERD can lead to esophageal spasms, which may feel similar to heart-related pain. It is crucial to manage your GERD effectively, as untreated reflux can lead to chronic discomfort and anxiety about your health.

Since you have recently undergone evaluations that did not reveal any significant cardiac issues, it may be beneficial to consider the following steps:
1. Consult a Gastroenterologist: If you suspect that your symptoms may be related to GERD, it might be worthwhile to revisit a gastroenterologist. They can assess your current treatment plan and determine if adjustments are needed, such as medication changes or lifestyle modifications.

2. Mental Health Support: Given the role of anxiety in your symptoms, seeking support from a mental health professional could be beneficial. Cognitive-behavioral therapy (CBT) is particularly effective for managing anxiety and can help you develop coping strategies for dealing with your symptoms.

3. Regular Follow-ups: If your symptoms persist or worsen, it is advisable to follow up with a cardiologist. While your previous tests were normal, ongoing symptoms warrant further evaluation to rule out any potential issues that may have developed since your last assessment.

4. Lifestyle Modifications: Incorporating stress-reducing techniques such as mindfulness, yoga, or regular exercise can help alleviate anxiety and improve overall well-being. Additionally, dietary changes to manage GERD, such as avoiding trigger foods and eating smaller meals, can also be beneficial.

5. Monitor Symptoms: Keep a detailed log of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in determining the best course of action.

In summary, while your previous cardiac evaluations were reassuring, the persistence of your symptoms suggests a multifaceted issue that may involve both gastrointestinal and psychological components. Engaging with both a gastroenterologist and a mental health professional can provide a holistic approach to managing your symptoms and improving your quality of life. Remember, it is always better to err on the side of caution when it comes to your health, so do not hesitate to seek further medical advice if you feel it is necessary.

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