[18F] Experiencing worsening shortness of breath and fast heart rate

Patient Description

An 18-year-old female has been experiencing worsening shortness of breath for about a month, which is particularly exacerbated during work. The shortness of breath is described as moderate and has not been alleviated by any measures. Alongside this, she has noticed a fast heart rate, which started around the same time as her breathing issues. These symptoms occur frequently throughout the day and typically last about a day or two. She sometimes experiences wheezing when breathing deeply and felt chest tightness during the initial days of symptom onset. Additionally, she reports dizziness and lightheadedness. She used to vape for about 7-8 months but stopped two weeks before her breathing problems began. She works with cleaning chemicals and has observed that her symptoms sometimes worsen after using specific chemicals. She has no known chronic illnesses or pre-existing conditions and is currently taking Pantoprazole 40 mg once a day. Occasionally, she takes ibuprofen (1-2 times a month). She has no known allergies to medications and is not using any topical medications or creams.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Asthma or Reactive Airway Disease:

    • Rationale: Your symptoms of shortness of breath, wheezing, and chest tightness, especially when exposed to cleaning chemicals, could indicate asthma or a similar condition. Asthma can be triggered by irritants like chemicals and can cause the airways to narrow, leading to difficulty breathing.
    • Typical Treatments/Testing: Diagnosis often involves lung function tests, such as spirometry. Treatment may include inhalers (bronchodilators and corticosteroids) to reduce inflammation and open the airways.
  2. Anxiety or Panic Disorder:

    • Rationale: Rapid heart rate, shortness of breath, and chest tightness can also be symptoms of anxiety or panic attacks. These conditions can cause physical symptoms that mimic respiratory or cardiac issues.
    • Typical Treatments/Testing: Diagnosis is usually clinical, based on your history and symptoms. Treatment may include therapy (such as cognitive-behavioral therapy) and medications (such as SSRIs or benzodiazepines).
  3. Chemical Irritant-Induced Respiratory Issues:

    • Rationale: Exposure to cleaning chemicals can cause respiratory symptoms, including shortness of breath and wheezing. This could be due to irritation or an allergic reaction to the chemicals.
    • Typical Treatments/Testing: Avoidance of the irritant is key. Treatment may include bronchodilators or antihistamines. A healthcare provider might recommend allergy testing or a referral to a pulmonologist.

What you can do

Shortness of Breath and Wheezing:

  • See a doctor: It's important to consult a healthcare provider to determine the exact cause of your symptoms. They may perform lung function tests or other diagnostic tests.
  • Avoid triggers: Try to minimize exposure to cleaning chemicals and other potential irritants. Use protective equipment like masks if you must handle these substances.
  • Monitor symptoms: Keep track of when your symptoms occur and any potential triggers. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

Fast Heart Rate:

  • Consult a healthcare provider: A fast heart rate, especially when accompanied by shortness of breath, should be evaluated by a doctor. They may perform an ECG or other cardiac tests.
  • Relaxation techniques: Practice deep breathing exercises, meditation, or other relaxation techniques to help manage anxiety and reduce heart rate.

Dizziness and Lightheadedness:

  • Stay hydrated: Ensure you are drinking enough water throughout the day.
  • Avoid sudden movements: Stand up slowly from sitting or lying positions to prevent dizziness.
  • Consult a doctor: Persistent dizziness and lightheadedness should be evaluated by a healthcare provider to rule out underlying conditions.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Severe shortness of breath: If you find it extremely difficult to breathe or if your symptoms worsen suddenly.
  • Chest pain: If you experience severe or persistent chest pain.
  • Fainting or severe dizziness: If you faint or feel like you might faint.
  • Swelling in legs or ankles: If you notice swelling, which could indicate a cardiac issue.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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4 mo ago

People Also Ask


Can exposure to cleaning chemicals cause respiratory issues like shortness of breath and wheezing?

Yes, exposure to cleaning chemicals can cause respiratory issues such as shortness of breath and wheezing. These symptoms can result from irritation or an allergic reaction to the chemicals. Avoiding exposure and using protective equipment can help manage these symptoms.


What are the common symptoms of asthma, and how is it diagnosed?

Common symptoms of asthma include shortness of breath, wheezing, chest tightness, and coughing. Asthma is often diagnosed through lung function tests like spirometry, which measure how well the lungs are working. Treatment typically involves inhalers to reduce inflammation and open the airways.


How can anxiety or panic attacks mimic respiratory or cardiac issues?

Anxiety or panic attacks can cause physical symptoms such as rapid heart rate, shortness of breath, and chest tightness, which can mimic respiratory or cardiac issues. These symptoms occur due to the body's 'fight or flight' response. Diagnosis is usually clinical, and treatment may include therapy and medications.


What steps can be taken to manage a fast heart rate and dizziness?

To manage a fast heart rate and dizziness, it's important to stay hydrated, avoid sudden movements, and practice relaxation techniques like deep breathing or meditation. Consulting a healthcare provider is crucial to rule out any underlying conditions and receive appropriate treatment.


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