Chest Tightness and Dizziness During Exercise: Should You Be Concerned?

Chest tightness and tightness in the neck and jaw during exercise?

Question 1: Recently, during exercise, I occasionally feel chest tightness and discomfort in my throat and jaw, which makes me feel dizzy and experience palpitations when I stop.
However, this does not happen every time I exercise (I usually ride a stationary bike for 50 minutes).
When these symptoms occur, I can barely ride for 10 minutes without feeling very uncomfortable.

Question 2: Last month, I went hiking with friends on a mountain that is 3,400 meters high.
Around 2,000 meters, I started to feel extremely breathless after just a few steps.
After resting for about 40 minutes at the mountain hut, the guide measured my heart rate at 130 beats per minute and my blood oxygen level at 73%.
Is this normal? That night, after resting, I almost fainted when I got up.
Question 3: I also occasionally experience palpitations while at rest, especially when standing up from a seated position.
Question 4: Additionally, every year when the weather turns cooler, I easily develop a dry cough and dry heaving, which lasts for about five minutes until I swallow saliva to feel better.

Should I see a doctor about these symptoms? Could these symptoms indicate a heart problem? Thank you for your response, doctor.

Lu, 30~39 year old female. Ask Date: 2015/10/19

Dr. Li Han reply Cardiology

Hello Lu, the first two questions you have are the most concerning and require serious and careful evaluation.
It is recommended that you consult a cardiologist in person.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2015/10/19

More Info

Experiencing chest tightness, dizziness, and palpitations during exercise can be concerning and warrants careful evaluation. Based on the symptoms you've described, it is essential to consider several factors that could contribute to your discomfort.

Understanding Your Symptoms
1. Chest Tightness and Palpitations: These symptoms can arise from various causes, including anxiety, cardiovascular issues, or respiratory problems. Given that you experience these symptoms intermittently during exercise, it is crucial to monitor their frequency and severity. If they occur consistently, especially with exertion, it may indicate an underlying condition that requires medical attention.

2. Dizziness and Shortness of Breath: Feeling dizzy and short of breath, particularly at high altitudes (like during your mountain hike), can be attributed to several factors. At higher elevations, the oxygen levels decrease, which can lead to hypoxia (low oxygen levels in the body). Your reported blood oxygen level of 73% is significantly low, as normal levels should be between 95% and 100%. This could explain your symptoms of dizziness and fatigue during the hike.

3. Heart Rate and Blood Oxygen Levels: A heart rate of 130 beats per minute at rest, especially when combined with low oxygen saturation, is concerning. It suggests that your heart is working harder to compensate for the lack of oxygen. This could be a sign of an underlying cardiovascular issue or a response to the altitude.

4. Postural Symptoms: The palpitations you experience when standing up from a seated position could indicate orthostatic hypotension, where blood pressure drops upon standing, leading to dizziness and palpitations. This can occur due to dehydration, certain medications, or autonomic nervous system dysfunction.

5. Seasonal Coughing: The dry cough you experience with changing weather could be related to environmental factors, such as allergens or cold air, which can irritate the airways. However, if it is persistent or accompanied by other respiratory symptoms, it may require further evaluation.

Recommendations
Given the complexity of your symptoms, it is advisable to consult a healthcare professional for a thorough evaluation. Here are some steps you can take:
- Medical Evaluation: Schedule an appointment with a cardiologist or a primary care physician. They may recommend tests such as an electrocardiogram (ECG), echocardiogram, or stress testing to assess your heart's function and rule out any cardiovascular conditions.

- Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their duration, and any associated activities. This information can be invaluable for your healthcare provider in diagnosing the issue.

- Hydration and Nutrition: Ensure you are well-hydrated, especially before engaging in physical activities. Dehydration can exacerbate symptoms of dizziness and palpitations.

- Gradual Exercise: If you experience symptoms during exercise, consider reducing the intensity and duration of your workouts. Gradually increase your activity level as tolerated, and listen to your body.

- Altitude Awareness: When engaging in activities at high altitudes, be aware of the signs of altitude sickness, such as headache, nausea, and extreme fatigue. Ascend slowly and take breaks as needed.

- Anxiety Management: If anxiety is contributing to your symptoms, consider speaking with a mental health professional. Techniques such as cognitive-behavioral therapy (CBT) or mindfulness can help manage anxiety and its physical manifestations.

Conclusion
Your symptoms of chest tightness, dizziness, and palpitations during exercise should not be ignored. While they may be related to anxiety or environmental factors, they could also indicate a more serious underlying condition. A comprehensive evaluation by a healthcare professional is essential to determine the cause and appropriate treatment. Remember, it is always better to err on the side of caution when it comes to your health.

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