Sudden Heart Pain: Should You See a Cardiologist?

Sudden sharp pain in the heart?

Hello, doctor.
Last night, I followed an online tutorial and sat on my bed to practice deep breathing, slowly exhaling afterward.
After doing two sets (five times each) and resting for a while, I didn't feel anything unusual.
However, later before bed, while lying down and practicing deep breathing and exhaling, I suddenly felt a sharp pain in my heart.
I was a bit startled afterward and felt a slight numbness in my upper body and head for a moment.
Should I see a cardiologist for this? Previously, I had a one-minute ECG and a 24-hour Holter monitor, which detected three premature beats, but I haven't done an exercise stress test.
Should I consult a doctor for an exercise stress test? (The cardiologist previously suspected I might have panic disorder and prescribed a sedative for me to take if necessary.
That afternoon, I walked by the river with my family, but after about an hour and a half, I felt tired, a bit dizzy, and short of breath while talking, and I started to feel a little panicky.
I rested for a bit and slowed down my pace, which helped a little.) Sorry for the lengthy message, and thank you.

abc, 20~29 year old female. Ask Date: 2015/08/03

Dr. He Dongjin reply Cardiology

Hello, if you experience a sudden sharp pain in your heart, it could be a symptom of premature contractions or nerve pain, which is not typical of angina.
You likely do not need to undergo an exercise stress test.
Please avoid excessive breathing exercises, as they may lead to hyperventilation.
Changhua Hospital is concerned about your well-being.

Reply Date: 2015/08/03

More Info

Based on your description, it seems you are experiencing episodes of sudden heart pain, accompanied by sensations of numbness and dizziness. Given your previous history of early heartbeats (premature beats) noted in your 24-hour ECG, and the fact that you have been prescribed anxiolytics for suspected panic disorder, it is understandable that you are concerned about your heart health.

First and foremost, it is essential to recognize that sudden heart pain can arise from various causes, some of which may be benign while others could indicate a more serious condition. The fact that you have experienced this pain after deep breathing exercises and while lying down may suggest a few possibilities. Stress and anxiety can lead to hyperventilation, which can cause temporary changes in heart rhythm and sensations of chest pain or discomfort. This is often linked to panic attacks, where the body reacts to perceived threats with a fight-or-flight response, leading to physical symptoms such as heart palpitations, chest pain, and feelings of dizziness or numbness.

However, it is crucial to rule out any underlying cardiac issues, especially since you have a history of premature beats. While these are often benign, they can sometimes be associated with other heart conditions. The fact that you felt a sudden sharp pain and experienced numbness in your upper body warrants further investigation.
You mentioned that you have not undergone an exercise stress test (also known as a treadmill test), which can be a valuable tool in assessing how your heart responds to physical exertion. This test can help determine if there are any underlying issues that may not be apparent during rest. Given your symptoms, it would be prudent to discuss the possibility of undergoing this test with your cardiologist.

In addition to the exercise stress test, it may also be beneficial to have a thorough evaluation of your anxiety symptoms. Since anxiety can manifest physically and mimic cardiac symptoms, addressing this aspect of your health could provide significant relief. If you have not already, consider discussing your anxiety management strategies with your healthcare provider, as they may recommend therapy or adjustments to your medication.

In summary, while your symptoms could be related to anxiety and hyperventilation, it is essential to consult with a cardiologist to rule out any serious heart conditions. An exercise stress test, along with a comprehensive evaluation of your anxiety, would be appropriate next steps. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention. Your health and peace of mind are paramount, and it is always better to err on the side of caution when it comes to heart-related symptoms.

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