Heart Palpitations, Chest Pain, and Dizziness Symptoms

Palpitations, chest tightness, shortness of breath, dizziness?

Hello Doctor, for the past three weeks, I have been experiencing frequent chest tightness, difficulty breathing, and palpitations.
There was a moment when I almost fainted.
My legs feel unsteady, and I have dizziness and lightheadedness.
The palpitations are very frequent and intense, making me feel like my heart is about to jump out of my chest.
I often have no appetite due to the rapid and irregular heartbeat.
I don't know what to do.
The doctor suggested I go to a major hospital because of the arrhythmia, but tests have not revealed anything specific; it’s either too fast or too slow, which is also arrhythmia.
Additionally, I have been diagnosed with arrhythmia and thalassemia.
Do I need to serve in the military? Thank you, Doctor, for your response.

T, 10~19 year old female. Ask Date: 2015/11/01

Dr. He Dongjin reply Cardiology

Hello, the symptoms you described are very similar to autonomic nervous system dysfunction, arrhythmia, and thalassemia.
Whether you need to serve in the military cannot be answered unless there is concrete evidence to justify an exemption.
Based solely on the symptoms mentioned, you may still be required to serve.
Changhua Hospital cares about your well-being.

Reply Date: 2015/11/01

More Info

It sounds like you are experiencing a combination of symptoms that can be quite distressing, including heart palpitations, chest tightness, shortness of breath, dizziness, and a general feeling of unease. These symptoms can be indicative of various underlying conditions, and it's important to approach them with a comprehensive understanding.

Understanding Your Symptoms
1. Heart Palpitations: This sensation of feeling your heart beating rapidly or irregularly can be caused by a variety of factors, including anxiety, stress, caffeine intake, or underlying heart conditions. In your case, the palpitations seem to be accompanied by other symptoms, which may suggest a more complex issue.

2. Chest Tightness and Shortness of Breath: These symptoms can be related to both cardiac and non-cardiac issues. Cardiac causes might include ischemic heart disease, where the heart muscle does not receive enough blood, or arrhythmias, which are irregular heartbeats. Non-cardiac causes could include anxiety, respiratory issues, or gastrointestinal problems.

3. Dizziness and Unsteadiness: Feeling dizzy or lightheaded can occur due to several reasons, including low blood pressure, dehydration, or even anxiety. When combined with palpitations, it could indicate that your heart is not pumping effectively, which can happen in certain arrhythmias or during episodes of panic.

4. Loss of Appetite: This can be a result of anxiety or stress, especially if you are feeling unwell. It can also be a response to physical discomfort or pain.

Next Steps
Given the complexity of your symptoms, it is crucial to follow your doctor's advice and seek further evaluation at a larger medical facility. Here are some potential steps that may be taken:
- Comprehensive Cardiac Evaluation: This may include an echocardiogram, stress testing, and possibly Holter monitoring to assess your heart's rhythm over a longer period. These tests can help identify any underlying arrhythmias or structural heart issues.

- Blood Tests: Given your mention of Mediterranean anemia (thalassemia), it's important to evaluate your blood counts and iron levels, as anemia can contribute to fatigue, dizziness, and palpitations.

- Lifestyle Modifications: While awaiting further evaluation, consider reducing caffeine intake, managing stress through relaxation techniques, and ensuring you are well-hydrated. Regular, moderate exercise can also help improve cardiovascular health, but it should be approached cautiously if you are experiencing significant symptoms.

Regarding Military Service
As for your question about military service with a history of arrhythmias and thalassemia, this will depend on the specific requirements and health standards of the military in your country. Generally, significant heart conditions or anemia may disqualify an individual from service, but this is best discussed with a military medical officer who can provide guidance based on your specific health status.

Conclusion
In summary, your symptoms warrant a thorough investigation to rule out any serious underlying conditions. It is essential to communicate openly with your healthcare providers about your symptoms and concerns. They can help guide you through the necessary tests and treatments. Remember, taking care of your mental health is just as important as your physical health, so consider seeking support if you are feeling overwhelmed.

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