Managing Palpitations and Shortness of Breath: A Guide for Patients

Palpitations, chest tightness, and shortness of breath?

Hello, Doctor! First of all, thank you for responding.
I have a history of arrhythmia and thalassemia.
A couple of days ago, I wore a 24-hour Holter monitor, and the physician said that my palpitations are not severe but that I experience episodes of tachycardia.
However, today during a test while studying, I suddenly experienced "palpitations, chest tightness, shortness of breath, trembling in my hands and feet, and dizziness" (I wasn't under any stress at the time).
I thought it might be related to stress, but I waited for almost 10 minutes, feeling like I was about to faint.
I immediately disregarded the teacher and, feeling weak and breathless, rushed out to take my "Sotalol 10 mg" and drank some water, but I was still sent to the health center.
Every time I am at school or home, as soon as I settle down, I suddenly experience palpitations, shortness of breath, weakness, and dizziness.
Doctor, what should I do if my palpitations occur again?

Ke Ke, 10~19 year old female. Ask Date: 2015/01/20

Dr. He Dongjin reply Cardiology

Hello, do the symptoms you experienced over the past 24 hours feel the same as your usual symptoms? If they do, it may just be as your doctor said, simply tachycardia.
If they don't, there could still be other arrhythmias.
Regardless, if you feel like an episode is about to occur, you should take your antiarrhythmic medication immediately; it's important to extinguish the small fire before it becomes a big one and requires emergency intervention.
Additionally, you can try coughing a few times, but be careful not to take deep breaths continuously.
Changhua Hospital cares about you.

Reply Date: 2015/01/20

More Info

Managing palpitations and shortness of breath can be a challenging experience, especially when they occur unexpectedly and lead to feelings of anxiety or panic. Based on your description, it seems that you have a history of arrhythmia and thalassemia, which can complicate your symptoms. Here’s a comprehensive guide to help you manage these episodes effectively.

Understanding Your Symptoms
Palpitations, or the sensation of your heart racing or fluttering, can be triggered by various factors, including stress, anxiety, caffeine, or even certain medications. Shortness of breath can accompany palpitations, particularly if you are feeling anxious or if your heart is working harder than usual. The combination of these symptoms can lead to feelings of dizziness or weakness, as you've experienced.

Immediate Steps to Take During an Episode
1. Stay Calm: When you feel palpitations starting, try to remain as calm as possible. Anxiety can exacerbate your symptoms. Deep breathing exercises can help. Inhale slowly through your nose, hold for a few seconds, and exhale through your mouth. Repeat this several times.

2. Sit or Lie Down: If you feel faint or dizzy, find a safe place to sit or lie down. This can help prevent falls and allow your body to recover.

3. Hydrate: Drinking water can help, especially if you suspect dehydration might be a factor. However, avoid excessive caffeine or sugary drinks, as these can worsen palpitations.

4. Medication: If you have been prescribed medication for your heart condition, such as the "生達心律錠" (which I assume is a beta-blocker or similar), take it as directed. If you find that your symptoms persist despite taking your medication, consult your doctor.

5. Avoid Triggers: Identify and avoid any known triggers that lead to your palpitations. This could include stress, certain foods, or activities that elevate your heart rate.

Long-Term Management Strategies
1. Regular Check-Ups: Since you have a history of heart rhythm issues, regular follow-ups with your healthcare provider are essential. They can monitor your condition and adjust your treatment plan as necessary.

2. Lifestyle Modifications: Incorporate heart-healthy habits into your daily routine. This includes a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Regular physical activity, as tolerated, can also improve your cardiovascular health.

3. Stress Management: Techniques such as yoga, meditation, or mindfulness can help manage stress and reduce the frequency of palpitations. Consider engaging in activities that promote relaxation.

4. Education: Understanding your condition can empower you to manage it better. Ask your healthcare provider for resources or support groups that can provide additional information and community support.

5. Emergency Plan: Have a plan in place for when you experience severe symptoms. This could include knowing when to seek emergency medical attention, especially if you experience chest pain, severe shortness of breath, or fainting.

When to Seek Medical Attention
If your palpitations are accompanied by severe symptoms such as chest pain, fainting, or persistent shortness of breath, seek immediate medical attention. These could be signs of a more serious condition that requires prompt evaluation.

Conclusion
Managing palpitations and shortness of breath involves a combination of immediate coping strategies and long-term lifestyle changes. By staying informed about your condition, maintaining regular communication with your healthcare provider, and implementing stress-reduction techniques, you can significantly improve your quality of life. Remember, you are not alone in this journey, and support is available to help you navigate these challenges.

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