Chest Discomfort: When to Seek Heart Health Evaluation

Cardiac issues

Hello Dr.
He: This past week, I have been experiencing a slight tingling sensation on the outer side of my left chest, along with a feeling of pressure and pain in my left chest and left armpit.
I often feel my heartbeat, but my self-measured pulse seems to be normal.
I wonder if my anxiety is causing this, as I frequently feel short of breath and experience a sensation similar to anemia when standing for more than 10 minutes.
This has been ongoing for a while.
I do not have a family history of heart disease, and I do not smoke or drink alcohol.
I do not exercise much.
Is this just a psychological issue, or could there be a problem with my heart? Should I go to the hospital for an examination?

Peipei, 20~29 year old female. Ask Date: 2012/06/28

Dr. He Dongjin reply Cardiology

Hello, feeling your heart beating, known as palpitations, is not a disease.
Your symptoms seem to be caused by increased anxiety leading to autonomic nervous system dysregulation.
If you're concerned, you can visit a hospital for an examination and also bring some medications to help soothe your autonomic nervous system.
Changhua Hospital cares about you.

Reply Date: 2012/06/28

More Info

When it comes to chest discomfort, especially when accompanied by symptoms such as tingling, pain, or a sensation of pressure in the chest or left arm, it is crucial to take these signs seriously. While your self-measured pulse appears normal and you have no family history of heart disease, the symptoms you describe warrant a thorough evaluation by a healthcare professional.

Understanding Your Symptoms
1. Chest Discomfort: The tingling and pain you feel in your left chest and underarm can be indicative of various conditions. While it may be anxiety-related, it is essential to rule out any cardiac issues. Symptoms like these can sometimes be associated with angina, which is chest pain caused by reduced blood flow to the heart muscle.

2. Palpitations: Feeling your heart beating strongly or irregularly can be a common experience, especially during periods of stress or anxiety. However, if these palpitations are frequent or accompanied by other symptoms like dizziness or shortness of breath, they should be evaluated.

3. Shortness of Breath: Experiencing breathlessness, especially when standing for extended periods, can be concerning. It may be related to anxiety, but it can also indicate underlying cardiovascular or respiratory issues.

4. Anxiety: Given that you mention feeling anxious, it is possible that your symptoms could be exacerbated by stress or anxiety. However, anxiety can also manifest physically, mimicking heart-related symptoms.

When to Seek Medical Evaluation
You should consider seeking medical evaluation if:
- Your symptoms persist or worsen.

- You experience additional symptoms such as nausea, sweating, or severe dizziness.

- You have a family history of heart disease or other risk factors that may predispose you to cardiac issues, even if you currently do not have any known risk factors.

- You feel uncertain or anxious about your symptoms, as peace of mind is also an important aspect of health.

Recommended Evaluations
1. Electrocardiogram (EKG): This test can help identify any irregularities in your heart's rhythm and electrical activity.

2. Echocardiogram: An ultrasound of the heart can provide information about the heart's structure and function, helping to identify any abnormalities.

3. Stress Testing: If indicated, a stress test can evaluate how your heart performs under physical stress, which can help detect coronary artery disease.

4. Blood Tests: These can check for markers of heart disease, such as cholesterol levels and other risk factors.

Conclusion
While it is possible that your symptoms are related to anxiety or other non-cardiac issues, it is always better to err on the side of caution when it comes to heart health. Given your symptoms of chest discomfort, tingling, and shortness of breath, I recommend scheduling an appointment with a healthcare provider for a comprehensive evaluation. They can provide a more accurate diagnosis and appropriate treatment options based on your specific situation. Remember, early detection and intervention are key to managing any potential heart issues effectively.

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