Midnight Discomfort: Heart and Vascular Issues - Cardiology

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Feeling unwell in the middle of the night?


Hello Doctor, I have been feeling very cold lately and often wake up in the middle of the night feeling weak and cold.
My heart rate seems to be very slow, and I feel a tightness in my chest, somewhat like a sensation of hypoxia.
My usual blood pressure is 90/60, and my heart rate is around 70.
However, during the night, my heart rate drops to about 58 or 60, and my blood pressure is also lower.
Sometimes I wake up suddenly in the middle of the night with a rapid heartbeat and feel short of breath, which makes me uncomfortable.
I do some exercise before bed, which helps a bit.
If I am in a place with poor air circulation, my face becomes very red.
After sitting or standing for a long time, I feel dizzy, but I feel better after exercising.
I'm not sure what is going on.
Thank you, Doctor.

Miss Lin, 30~39 year old female. Ask Date: 2016/01/16

Dr. Li Han reply Cardiology


Hello Ms.
Lin, based on your statements of weakness, sensitivity to cold, low blood pressure, bradycardia, chest tightness, shortness of breath, dizziness, and facial flushing, these symptoms are generally non-specific and require more details for further differential diagnosis.
Additionally, since your symptoms improve after exercise, the likelihood of cardiopulmonary diseases is relatively low.
Regarding your heart rate, a resting rate of approximately 50-90 beats per minute is generally considered appropriate.
I recommend that you consult with a trusted family physician for further evaluation.
The Changhua Hospital of the Ministry of Health and Welfare is concerned about your well-being.

Reply Date: 2016/01/16

More Info


It sounds like you are experiencing a range of concerning symptoms that could be related to various heart and vascular issues. Your description of feeling cold, weak, and having a sensation of chest tightness, along with a slow heart rate and low blood pressure, is particularly noteworthy. Additionally, the episodes of rapid heart rate upon waking and feelings of shortness of breath could suggest underlying cardiovascular concerns that warrant further investigation.

Firstly, it’s important to understand that symptoms like chest tightness, especially when accompanied by changes in heart rate and blood pressure, should not be taken lightly. These symptoms could potentially indicate issues such as bradycardia (slow heart rate), which you mentioned occurs during the night, or even episodes of tachycardia (rapid heart rate) when you wake up. Both conditions can lead to inadequate blood flow to the heart and other organs, potentially resulting in feelings of weakness or dizziness.

Your blood pressure readings of 90/60 mmHg are on the lower end of the normal range, and this could contribute to feelings of lightheadedness, especially when standing up or after prolonged sitting. Low blood pressure can sometimes be a sign of dehydration, blood loss, or other underlying health issues. It’s also worth noting that if your heart rate drops significantly during sleep, it could be a sign of sleep apnea or other sleep-related disorders, which can affect oxygen levels during the night and lead to feelings of suffocation or discomfort.

The fact that you feel better after exercising suggests that physical activity may help improve your circulation and increase your heart rate, which can alleviate some of the symptoms you are experiencing. However, it is crucial to approach exercise cautiously, especially if you are experiencing these symptoms.
Given your symptoms and the potential for underlying heart or vascular issues, I strongly recommend that you seek medical attention. A healthcare provider can perform a thorough evaluation, which may include an electrocardiogram (EKG) to assess your heart rhythm, blood tests to check for any underlying conditions, and possibly a Holter monitor to track your heart rate over a 24-hour period.
Additionally, it would be beneficial to discuss your lifestyle factors, such as diet, hydration, and stress levels, as these can significantly impact cardiovascular health. Ensuring adequate hydration, managing stress, and maintaining a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can support heart health.
In summary, while some of your symptoms may be related to benign factors such as low blood pressure or anxiety, the combination of symptoms you are experiencing suggests that a thorough medical evaluation is necessary to rule out any serious conditions. Please do not hesitate to reach out to a healthcare professional for a comprehensive assessment and appropriate management of your symptoms. Your health and well-being are paramount, and early intervention can often lead to better outcomes.

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