Chest Tightness and Breathing Issues: When to Seek Help

Q: Chest Tightness and Breathing Issues: When to Seek Help

Hello： Both depression and anxiety can present with the aforementioned discomforts; you may want to consult a psychiatrist for confirmation.

Often feel a tightness in the chest, with a sensation of being unable to catch my breath?

About three years ago, I suddenly felt a tightness in my chest while sleeping, as if I couldn't catch my breath and was about to die.
It took a long time to calm down.
I went to the hospital for an examination, and everything was normal; they suggested it might be caused by work-related stress.
However, the same symptoms recurred the following year, accompanied by a feeling of tightness in my neck, discomfort in my upper back, and frequent sensations of numbness in my head and face.
My left eye often appears congested and red (sometimes I also sense a metallic taste in my mouth and nose, but I don't know where it's coming from).
The frequency of these episodes has been increasing, and now I experience these discomforts almost daily.
Recently, I've also had a feeling of fullness in my left ear and mild headaches on the left side.
My back has started to feel sore as well, and I feel more uncomfortable with a sensation of pressure in my head while sleeping.

I underwent a comprehensive health check-up (except for a brain scan), which revealed only a deviated septum and allergic rhinitis, as well as gastroesophageal reflux disease.
Most other tests were normal (only the stool test showed a positive reaction for occult blood, which is still under re-evaluation).
I have visited various departments at Chang Gung Memorial Hospital in Taoyuan (gastroenterology, cardiology, neurology, otolaryngology, etc.), but none of the symptoms have improved.
I feel that my health is deteriorating and I am becoming increasingly fatigued.
Recently, I consulted a neurologist at Chang Gung who suggested I might have mild depression and prescribed medication, indicating that it would take 1-2 months of consistent use to see results.
I am currently taking the medication as prescribed.

However, I would like to ask the doctor if depression can cause the symptoms I've described.
Additionally, I feel that there hasn't been much improvement since starting the medication, and the frequency of my symptoms seems to be increasing.
What could be wrong with my body, and which specialist should I consult for further evaluation?

Steven, 30~39 year old female. Ask Date: 2007/01/31

Dr. Ye Boshou reply Neurology

Hello: Both depression and anxiety can present with the aforementioned discomforts; you may want to consult a psychiatrist for confirmation.

Reply Date: 2007/01/31

More Info

When experiencing chest tightness and breathing issues, it is crucial to understand the underlying causes and when to seek medical help. Based on your description, it appears that you have been dealing with a complex array of symptoms that have progressively worsened over time. These symptoms include chest tightness, difficulty breathing, neck tightness, back pain, facial numbness, and even ear pressure, along with a history of anxiety and potential depression.

Firstly, it is essential to recognize that chest tightness and breathing difficulties can stem from various sources, including physical, psychological, and environmental factors. Given your history of stress and anxiety, it is possible that these emotional states are contributing to your physical symptoms. Anxiety can manifest in many ways, including hyperventilation, which can lead to feelings of breathlessness and chest discomfort. Additionally, the physical symptoms you describe, such as neck and back pain, may also be exacerbated by stress and anxiety.

However, it is equally important to rule out any serious medical conditions. You mentioned that you have undergone extensive testing, including evaluations from various specialists, and that most results have come back normal, except for a deviated septum and allergic rhinitis. While these findings can contribute to nasal congestion and breathing difficulties, they may not fully explain the chest tightness and other systemic symptoms you are experiencing.

The presence of potential gastrointestinal issues, such as gastroesophageal reflux disease (GERD), could also play a role in your symptoms. GERD can cause chest discomfort and may mimic cardiac symptoms, leading to confusion about the source of your pain. It is advisable to follow up with a gastroenterologist to ensure that your reflux is being managed effectively.

Regarding your concerns about depression, it is well-documented that mental health conditions can manifest with physical symptoms. Depression and anxiety can lead to a range of somatic complaints, including fatigue, pain, and changes in appetite or sleep patterns. The fact that you have been prescribed medication for depression suggests that your healthcare provider believes there is a psychological component to your symptoms. It may take time for these medications to take effect, and it is essential to maintain open communication with your prescribing physician about your progress and any side effects you may experience.

Given the complexity of your symptoms, it may be beneficial to consider a multidisciplinary approach to your care. This could involve working with a psychiatrist for your mental health concerns, a pulmonologist for your breathing issues, and possibly a pain management specialist for your neck and back pain. Additionally, engaging in cognitive-behavioral therapy (CBT) or other forms of psychotherapy may help address the anxiety and stress that could be contributing to your physical symptoms.

In summary, while your symptoms may have a psychological basis, it is crucial to continue monitoring your physical health and seeking appropriate medical evaluations. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention. It is essential to advocate for your health and ensure that all potential causes are thoroughly investigated. Remember, you are not alone in this journey, and there are healthcare professionals available to support you through your recovery.

Similar Q&A

Understanding Chest Tightness and Breathing Difficulties: When to Seek Help

Hello, Doctor: In March of this year, I suddenly experienced chest tightness and difficulty breathing, feeling as if I couldn't get enough air, so I went to the hospital's cardiology department for an examination. After an electrocardiogram and blood tests, myocardial i...

Dr. Chen Pengsheng reply Family Medicine
Dear Johnny, After reading your description, I understand that you have undergone many examinations and learned about hyperventilation syndrome. I want to emphasize that the physicians you have encountered are very dedicated and excellent. The real issue seems to stem from diff...

Sudden Breathing Difficulties: When to Seek Medical Attention

Hello Doctor: I have been experiencing a sudden tightness in my chest (a feeling of constriction) accompanied by difficulty breathing, but it resolves after a few seconds. This used to happen infrequently, but I have noticed an increase in frequency recently. These episodes occur...

Dr. Zhou Ziguang reply Pulmonology
Please visit a pulmonologist or cardiologist for evaluation and treatment by a physician.

Breathing Difficulties: When to Seek Help for Lung or Heart Issues

If you have a smoking habit and have recently experienced shortness of breath, chest tightness, dry mouth, post-nasal drip, muscle stiffness in the shoulders, neck, and back, along with some palpitations, it is important to seek medical attention. Given your symptoms, it would be...

Dr. Yang Wenda reply Pulmonology
Hello: At this age, it is unlikely to have cardiopulmonary issues. It would be better to quit smoking, drink more water, exercise more, and manage stress; these measures can help alleviate symptoms.

Understanding Heart Symptoms: What to Do When You Can't Breathe

If you experience difficulty breathing or a feeling of tightness in your chest, it is important to take the following steps: 1. Stay Calm: Try to remain as calm as possible, as anxiety can worsen the symptoms. 2. Sit Upright: Find a comfortable position, preferably sitti...

Dr. Huang Guosheng reply Cardiology
Hello: The causes of heart palpitations and chest tightness can include angina, heart failure, lung diseases, emotions, and stress. Generally speaking, if the palpitations and chest tightness are heart-related, they tend to worsen with physical activity and improve with rest. Giv...