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What causes shortness of breath and fast heart beat?

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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

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Posted on Mon, 4 Aug 2014 in Hypertension and Heart Disease
Question: This past Wednesday, after eating lunch around 4:30pm, I noticed that I was experiencing a series of short breathing. I thought that it may have been because of the fact that I had just finished eating. I sat down on the couch and proceeded to watch television. During that time, I noticed that my body felt the need to yawn often, XXXXXXX and take in deep breaths. That evening, I was laying in bed using my laptop. I began to freak out because it had gotten to the point that I found myself having to catch my breath every few words I spoke. The next morning, I went to a doctor and described to him all of the above. He checked my pulse and all of that good stuff and said that everything was just fine. He also asked me to lay on the bed to see if I had any difficulties breathing while laying on my back because if I did, then it'd be a big issue. He ordered blood work to be done. The day after, i went back to follow up with the results from the blood work that showed that I am perfectly healthy and don't have any deficiencies. The doctor concluded that the shortness of breath and fast heartbeat may be linked to anxiety, stress, or even the lack or quality of sleep. Later that day, I went to work and was slightly miserable because I had trouble speaking due to the shortness of breath I was experiencing. As my shift progressed, I noticed myself feeling better. I felt a hundred times better that evening. The next day, I woke up feeling good as new. However, when I would lay down, I felt some minor chest pains if I turned my body a certain way, but the pains never occurred when I would breathe in and out. I went to sleep with high hopes of feeling better by today. Today, I woke up and went to church. On the car ride to and from church, I noticed my breathing and heartbeat acting up again, which i think was caused by how hot the car was inside as the AC was blowing air my way. It was a struggle to sit through church because of my issue. When I got home, I became aware that I was back to square one feeling the same way I felt when I first noticed I had this issue. I know for a fact that there is something wrong with me, but I just don't know what it is and no one else seems to know. If it matters, I currently take birth control pills (Microgestin 1/20) When this incident occurred, I was on the placebo portion of the pack- last two placebo pills, actually. Earlier this month when I had first began my pills, I had a UTI and was prescribed Cipro. Also, earlier in the week before I contracted this issue, I had taken Pepto Bismol to deal with diarrhea. And a week before, I took a single pain killer to combat some bad cramping. What could possibly be wrong with me?
Could it be possible that this is all in my head? My heart beat per minute is normal. When I breathe, I feel as though I don't have enough oxygen in my body for my comfort.
doctor
Answered by Dr. Anantharamakrishnan 5 hours later
Brief Answer:
Need more investigations...

Detailed Answer:
Dear friend,
Welcome to Health Care Magic

You are too young to have Coronary Artery Disease (CAD) / a bit old to start Congenital her Disease…
CAD is uncommon in women of reproductive age...
Pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on.

Your description is highly suggestive of Anxiety and/or Depression.. and your thoughts are appropriate.
Like physical problem, psychological problem could also be diagnosed by their symptoms and signs…
Still, as a safety measure and with a view to prevent future episodes, all attempts are made to exclude organic diseases, before attributing to anxiety.

EKG / HOLTER (24 to 48 hour ambulatory monitoring) / ECHOcardiogram / TMT (Treadmill exercise ECG) / LABORATORY work-up – may all be done for further assessment and assistance.
The treating doctor may suggest them depending on need, based on his assessment of the situation.
Be in touch with your doctor - it is a question of time and you will be well.
Medicine is well advanced nowadays – management is possible for almost all situations...

See a Cardiologist - rather to rule out rather than to rule in...
Also have an endoscopy to rule out problems of stomach and oesophagus...
Then see a Psychiatrist - for further assessment and assistance
The prognosis is generally excellent in such situations...

Take care
Good luck

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Anantharamakrishnan 25 minutes later
Would you suggest that my birth control pill may have something to do with this happening even though this occurred during the placebo week of the pill pack?
doctor
Answered by Dr. Anantharamakrishnan 27 minutes later
Brief Answer:
Most unlikely

Detailed Answer:
Hi

The pills can have certain side effects, but not like this

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Anantharamakrishnan 16 minutes later
It's just odd how the potential cause of this situation may very well linked to anxiety and depression because I have never in my life have had this happen to me. Even during the most stressful or depressing times in my life, such as college or heartbreak, never has this occurred. Like I said, I consulted a physician earlier last week and he said nothing was wrong and that heart beat and pulse were okay. It's the that the palpitations that I have been experiencing and minor chest pains have been rather worrisome.
doctor
Answered by Dr. Anantharamakrishnan 24 minutes later
Brief Answer:
Follow up and/or second opinion & tests

Detailed Answer:
Welcome back

     Clinically, absence of proof is no proof of absence… Hence, investigations are done – specific to the situation. Only a Psychiatrist is entitled to make a direct diagnosis of Anxiety; we, physicians need tests to exclude organic diseases – because no curable condition should be missed.
     Reaction to any illness is – Denial / depression / Realistic adaptation. And it changes with time, situation and experience and exposure. Past performance does not predict future performance perfectly… it is an useful clue, at the most
     The most common causes of palpitation are – Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much tea, coffee, cola) / Fever / Infection / Pain / Stress / Thyroid / electrolytes / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on. Rarely, abnormal nerve paths in the heart (bypass tracts) or disease of the conduction system may be responsible!
     HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not document it.
     Many cases of palpitation are benign, especially when associated with normal ECHO and may not require treatment. Only if you also have symptoms like blurred vision, dizziness, loss of consciousness and so on along with this, you need urgent evaluation

A second opinion and investigations are often helpful in some cases…

Regards
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Anantharamakrishnan 13 hours later
I also have been experiencing some minor pain on my forearm. Also, is it normal to have back pain because of this? I have decided to stop taking Microgestin.
How can I make or the heart palpitations go away? Or how can I reduce them?
doctor
Answered by Dr. Anantharamakrishnan 7 hours later
Brief Answer:
management discussed

Detailed Answer:
Hi

The pain in the back / forearm are likely to be muscular – spasm from posture. Not from this. Over The Counter Non-Steroidal Anti Inflammatory Drugs like Ibuprofen or naproxen often with muscle relaxants / anxiolytics / hot packs / rest to the part will be useful.      X-ray of the spine may be useful, if it is severe or not responding

The pills can be stopped safely ... If in need, your Gynaecologist can suggest alternatives for the same indication.

Learn to ignore the palpitations, if everything else is normal. Learn to enjoy life – rapport with friends & family, park, beach, walking and so on help to relax and divert. Concentration in work takes away the focus from heart …
     If bothering still, small dose of beta blockers (like Metoprolol) are generally given first – they have multiple effects and help anxiety, pressure, palpitation and so on.
If there are no clues and if the problem is bothering to the extent of interfering with life style, there are advanced techniques of investigations – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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