Breathing Difficulties and Heart Pain: When to Seek Medical Advice?

Breathing requires a lot of effort, and sometimes there is chest pain?

Hello doctor, I have not been in good health since childhood and have frequently taken medication and visited doctors and hospitals.
After my first year of high school, I started experiencing health issues, and now I am in my fourth year of college and about to graduate.
During the first semester of my junior year, I noticed red spots and pain in my calves, and after examination, I was diagnosed with erythema nodosum.
It flared up for a long time, and I worked with my doctor on various medications, but I still needed to use corticosteroids to manage it (though it has flared up less frequently recently).
I also have a family history of migraines; my mother mentioned that I have bronchial issues, allergies, and also developed irritable bowel syndrome.

Around the age of 18, I began experiencing intermittent chest pain and difficulty breathing, but it does not occur often.
I do not have a regular exercise routine, but previously I had no issues climbing stairs.
However, recently, when climbing from the first to the second floor, I experience difficulty breathing and chest pain.
Is this normal, or should I see a doctor? If so, which specialty would be most appropriate?
Additionally, I have another question that may or may not be related to erythema nodosum or changes in weather: recently, whenever I climb stairs (from the first to the second floor), my knees feel weak, and in severe cases, my legs become weak or I experience pain from my knees to my calves, making it difficult to move.
I remember a doctor mentioning during my junior year that I should keep my legs warm during weather changes, but I have been wearing two pairs of thick fleece-lined pants every day (not leggings or tights).
I apologize for having so many questions.
My family takes me to see doctors they trust and is reluctant to try a different doctor or hospital.
I would appreciate any advice or assistance you can provide.
Thank you.
QAQ

Xinxin, 20~29 year old female. Ask Date: 2016/02/25

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your inquiries, let's discuss them in several parts:
1.
Difficulty in breathing and chest pain: It is advisable to consult a cardiologist to assess for any abnormalities in heart function.
If there are no specific restrictions, starting a regular cardiovascular exercise program is essential to maintain optimal physiological function.
2.
Issues with lower limb mobility: It is recommended to consult a rheumatologist to evaluate both the erythema nodosum and joint problems.
Our hospital has specialists in these fields to provide medical services.
Changhua Hospital cares about you.

Reply Date: 2016/02/25

More Info

When experiencing persistent heart pain and breathing difficulties, it is crucial to understand the potential underlying causes and when to seek medical attention. Based on your description, it seems you have a complex medical history that includes conditions such as nodular erythema, migraines, bronchial issues, allergies, and irritable bowel syndrome. These conditions can contribute to your overall health and may influence your current symptoms.

Given that you have been experiencing heart pain and difficulty breathing, especially during physical exertion like climbing stairs, it is essential to take these symptoms seriously. While it may seem normal to experience some discomfort during physical activity, the fact that you are feeling pain and breathlessness, particularly when you previously did not, warrants further investigation.

When to Seek Medical Advice
1. Persistent Symptoms: If you have been experiencing heart pain and breathing difficulties for an extended period, especially if these symptoms are worsening or occurring more frequently, it is time to consult a healthcare professional.
2. Severity of Symptoms: If the pain is severe, or if you experience additional symptoms such as dizziness, fainting, or swelling in your legs, you should seek immediate medical attention. These could be signs of a more serious condition.

3. Changes in Physical Ability: The fact that you are now experiencing difficulty with activities that were previously manageable, such as climbing stairs, is concerning. This change in your physical capabilities could indicate an underlying issue that needs to be addressed.

Recommended Medical Specialties
Given your symptoms and medical history, it would be advisable to consult with the following specialists:
- Cardiologist: A cardiologist can evaluate your heart health through tests such as an electrocardiogram (EKG), echocardiogram, or stress tests to rule out any cardiac issues.

- Pulmonologist: Since you have a history of bronchial problems and allergies, a pulmonologist can assess your lung function and determine if there are any respiratory issues contributing to your symptoms.

- Rheumatologist: Considering your history of nodular erythema and other systemic symptoms, a rheumatologist may help evaluate for any autoimmune conditions that could be affecting your overall health.

Additional Considerations
1. Lifestyle Modifications: Incorporating regular, gentle exercise into your routine, such as walking or swimming, can improve cardiovascular health and overall well-being. However, it is essential to start slowly and consult with a healthcare provider before beginning any new exercise regimen.

2. Stress Management: Given your history of anxiety and the impact of stress on your health, consider engaging in relaxation techniques such as mindfulness, yoga, or meditation. These practices can help manage anxiety and improve your overall quality of life.

3. Diet and Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support your health. Staying hydrated and avoiding excessive caffeine or alcohol may also help alleviate some symptoms.

4. Follow-Up Care: Regular follow-ups with your healthcare providers are crucial, especially given your complex medical history. Keeping an open line of communication with your doctors can help ensure that any changes in your symptoms are promptly addressed.

In conclusion, while it is understandable to feel hesitant about seeking new medical opinions, it is vital to advocate for your health. If your symptoms persist or worsen, do not hesitate to seek medical attention. Your health is paramount, and addressing these concerns early can lead to better outcomes and improved quality of life.

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