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    What causes shortness of breath and rapid heart beats?

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Posted on Fri, 10 Oct 2014 in General Health
Question: I'm 52 years old very healthy but lately, about 2 months, I've had shortness of breath and rapid heartbeat that I can hear in my ears. I've alway been a runner but lately can't run because I get so dizzy and out of breath. Just climbing the stairs in my house cause my heart to beat fast and I can't catch my breath. I've been under a lot of stress lately, could this be the problem? I've tried getting an appointment for a physical with my primary care doctor, but he can't see me for 4 months. I'm so fatigued all the time all I want to do is sleep...but the pounding in my head from my heartbeat keeps me awake. Can you give me a clue?
doctor
Answered by Dr. Muhammad Sareer Khalil 1 hour later
Brief Answer:
Requires workup

Detailed Answer:
Hello and Welcome

I appreciate your concern.

The shortness of breath and associated palpitations ( rapid heart beat ) which you have described requires work up to find the exact cause.
The causes include cardiac, pulmonary, mixed , and non cardiac or non pulmonary. Most cases of dyspnea are due to cardiac or pulmonary disease.

Usually in heart disease exertional dyspnea ( shortness of breath upon exertion) occurs first and then progressively , it can occur at rest or lying down, the patient can also feel palpitations and chest pains.In Lung disease , the dyspnea is accompanied by coughing and / or wheezing and sputum.

Chest X ray, electrocardiography and screening spirometry should be done , which can provide valuable info for the cause precipitating the shortness of breath and palpitations.These initial tests are inexpensive and safe . They can help confirm or exclude many common diagnoses.

If the test results are inconclusive , complete pulmonary function testing, arterial blood gas measurement, echocardiography and standard exercise treadmill testing or complete cardiopulmonary exercise testing can be done

Anemia and hyperthyroidism can also be a cause of your symptoms and workup should be done for them , too. A finger-stick hemoglobin determination or a complete blood count can quantify the severity of suspected anemia. Thyroid abnormalities if present with dyspnea can be assessed by measurement of the serum thyroid-stimulating hormone level.

You inquired if stress could be the cause, stress , anxiety and panic attacks can cause hyperventilation and rapid heartbeat but your history of these symptoms is of two months and the nature of the dyspnea indicates a cardiac cause rather than
stress or anxiety.

Cardiac and pulmonary causes should be ruled out first , if ruled out then a XXXXXXX mental state exam can be performed via a psychiatrist to ascertain depression and or anxiety, Medication can be adjusted afterwards in addition to cognitive behavioral therapy.

Let me know what medications you are currently using and what is your average blood pressure ( if monitored at home ).

Keep in touch

Let me know if you have any query

wishing you best of health

Thanks


Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Muhammad Sareer Khalil 2 hours later
I do not take any medications. I only take a multivitamin, potasium, and calcium daily. My bloodpressue is 120 over 80 and has always been normal.
doctor
Answered by Dr. Muhammad Sareer Khalil 8 hours later
Brief Answer:
Explained

Detailed Answer:
Hello ,

The blood pressure is in normal range though a cardiac cause can not be neglected simply because the B.P is in normal range. I would still strongly recommend the workup which i mentioned in my previous reply.

Multi vitamins and supplements especially Potasium and calcium use , without proven and documented deficiency , can do more harm rather than being beneficial. So i would not recommend empiric use without any evidence of deficiency.

You stated earlier that your primary care physician would not be able to see you for the next four months. If the Shortness of breath worsens or you develop confusion, chest pain and hypotension (low B.P), then these are alarm symptoms and you should go to the E.R ( Emergency Room) instead of your primary care physician.

You may give me feedback about your workup and the treatment prescribed afterwards. I would be more than happy to guide you along the way.

Hope I have answered your query. If you have any further questions I will be glad to address them. If you do not have any clarifications then you may close the discussion and rate the answer.

Wish you good health.
Thanks








Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Muhammad Sareer Khalil 16 hours later
Also I have noticed that i am bruising very easily. Could this be related?
doctor
Answered by Dr. Muhammad Sareer Khalil 9 hours later
Brief Answer:
Yes, could be related, lab evaluation needed

Detailed Answer:
Hello,

hope you are feeling better,

Yes , it could be related.

As I mentioned in my previous answer, anemia could be a possible cause for your symptoms ( shortness of breath and palpitations ) , the bruising you stated is most likely due to platelet dysfunction or deficiency. Platelet abnormalities can lead to anemia with increased blood loss.


Initial laboratory evaluations should include a complete blood count with platelet count, peripheral blood smear, prothrombin time, and partial thromboplastin time.
Workup for platelet function disorders, quantitative platelet disorders, factor deficiencies, and factor inhibitors should follow subsequently.

Please Let me know if you have any other queries
I will be more than glad to address them.

Thanks



Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2919 Questions

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