Suggest treatment for light headedness and shortness of breath

Posted on Thu, 12 Feb 2015 in Hypertension and Heart Disease
Question: Hi my name is XXXXXXX I'm 21. My overall physical condition is good, I work out (or at least I used to) 5 times a week for 1-2 hours a day. Knowing that, here is the concern that i have. In the past year or so I've been experiencing chest pain; on the left side about half way across my collar bone (medial to lateral) and about 3 inches down. In the past months it has been sporadic and would not be very painful. But in this last month and a half everything has changed I am having frequent intense chest pain and also in this past month when ever my chest would hurt I would also get a deep surging pain in my bicep and forearm underarm. These episodes would last anywhere from 5 minutes to 30 minutes. What I have notice in the beginning of December that cause these symptoms would be any strenuous activity but recently the symptoms have been getting worse and worse by the day and anything such as walking up a few flights of stairs would cause these symptoms; 1 light headed 2 shortness of breath 3 chest pain scale of a 1-10 I would rate I between a 6 and an 8 depending on the day.
My family does not have a history of heart problems in the only one.

What are your thoughts on what may be going on?
What precautions should I take?
How soon should I see a doctor?
Please give your feedback i would really appreciate it
Thank you for your time.
Sincerely, XXXX
Answered by Dr. Devendra Kumar Tripathi 3 hours later
Brief Answer:
Need complete cardiac evaluation

Detailed Answer:
Dear XXXX,
I can understand your concern .
You have given a very detail and relevant history .
I would like to inform you that on the basis of information that you have given to me it is very suggestive of angina that is actually ischemic pain originating from heart because of decreased oxygen supply to heart muscles .
The chest discomfort or pain that is mainly on left side or retrosternal , with radiation to left upper limb and get aggrevated by exertion ,relieved on taking rest and is associated with lightheadedness and breathlessness is very suggestive of angina.
One thing that is not common with this diagnosis is your age of 21 years but now a days we are getting patients in the age group of 25 to 35 having diagnosis of angina.most of then are smoker.
I would like to inform you that there are certain risk factors that are helping in making diagnosis of ischemic heart disease , such as
1.Male sex
3. Diabetes
4. hypertension
5. Dyslipidemia
6 . obesity that is BMI more than 25.
7. physical inactivity history
9. Age of more than 40 years but now common in younger age groups as well.etc.
you can check whether you have any of these or not.
At this time I would like to suggest you that the diagnosis of ischemic heart disease is clinical that is only on the basis od history and examination . ECG, echocardiography and some more advanced diagnostic modalities may come absolutely normal.
So in my opinion you look for life style modifications such as
stop smoking if any, salt and saturated fat restricted diet ,diet rich in fruits and vegetables is good for heart , regular exercise that is 30 minutes brisk walk that I think you are doing . Maintain your BMI less than 25 etc.
Plan to consult your cardiologist as soon as possible because your problems are increasing day by day .This means disease process is increasing .
Hope this will help you . If you have any other concerns please feel free to message me . Thanks for contacting HCM .

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
Answered by
Dr. Devendra Kumar Tripathi

Internal Medicine Specialist

Practicing since :2008

Answered : 275 Questions


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