[20M] Experiencing anxiety and chest discomfort

Patient Description

A 20-year-old male started experiencing symptoms on Wednesday, including a fast heart rate, chest discomfort, shortness of breath, body heat, and severe anxiety. These symptoms seem to come on when he is resting or lying down and improve when he is active. He is taking 15 credit hours at university and working at a winery, which could be contributing to his stress levels. The chest discomfort feels like a slight pinching sensation inside his chest, and he can feel his heart beating. His shortness of breath is moderate, and he has experienced palpitations. He also had some nausea when the symptoms first started, along with sweating and clamminess. He had neck pain for a short period, but it went away. He hasn't noticed any swelling in his legs or feet. He smokes daily but has recently cut back, and he used weed slightly after his first symptom on Wednesday, although he hadn't smoked for a week before that. He hasn't experienced similar symptoms in the past, and he hasn't been diagnosed with any mental health or heart conditions. He usually has a bit of anxiety, which is normal for him, but he has not been diagnosed with any anxiety or depression. He is not taking any medications and considers himself a healthy person overall.

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Arora's Assessment

What might be happening

Based on the information you have provided, a possible unifying diagnosis is:

  • Panic Attack or Anxiety Attack: These can cause symptoms such as a fast heart rate, chest discomfort, shortness of breath, body heat, and severe anxiety. They can be triggered by stress, such as your increased workload at university and work. The fact that your symptoms improve when you are active and worsen when you are resting or lying down is also consistent with anxiety.

    • Treatment: Treatment for anxiety or panic attacks often includes lifestyle changes, therapy, and sometimes medication. Techniques such as deep breathing exercises, mindfulness, and cognitive-behavioral therapy (CBT) can be very effective. In some cases, medications like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may be prescribed by a healthcare provider.
  • Substance-Induced Anxiety: Your recent use of weed could also be contributing to your symptoms. Cannabis can sometimes trigger anxiety or panic attacks, especially if you are not a regular user or if you have recently increased your usage.

    • Treatment: Avoiding substances that trigger your symptoms is crucial. If you suspect that weed is contributing to your anxiety, it would be best to avoid using it and see if your symptoms improve.
  • Other Considerations: While less likely given your age and overall health, it's important to rule out any potential heart conditions, especially since you mentioned chest discomfort and palpitations. Conditions like arrhythmias or other heart issues can sometimes present with similar symptoms.

    • Treatment: If your symptoms persist or worsen, it would be important to see a healthcare provider for a thorough evaluation, which may include an electrocardiogram (ECG) or other heart-related tests.

What you can do

  1. Practice Relaxation Techniques: Try deep breathing exercises, meditation, or progressive muscle relaxation to help manage your anxiety.
  2. Stay Active: Since you mentioned that being active helps alleviate your symptoms, try to incorporate regular physical activity into your routine.
  3. Avoid Triggers: If you suspect that smoking or weed use is contributing to your symptoms, try to avoid these substances.
  4. Maintain a Healthy Lifestyle: Ensure you are getting enough sleep, eating a balanced diet, and staying hydrated.
  5. Seek Support: Talk to a trusted friend, family member, or counselor about your feelings and experiences.
  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Reasons to see a doctor more urgently:

  • If you notice any new or worsening symptoms, such as severe chest pain, difficulty breathing, or fainting.
  • If your anxiety becomes unmanageable or starts to interfere significantly with your daily life.
  • If you experience any other concerning symptoms, such as swelling in your legs or feet, or if you have any doubts about your health.

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

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3 mo ago


People Also Ask


What are the common symptoms of a panic attack?

Common symptoms of a panic attack include a fast heart rate, chest discomfort, shortness of breath, sweating, nausea, dizziness, and a feeling of losing control or impending doom. These symptoms can be intense and often occur suddenly.


Can smoking or using cannabis trigger anxiety or panic attacks?

Yes, smoking and cannabis use can trigger anxiety or panic attacks, especially in individuals who are not regular users or have recently increased their usage. These substances can affect the nervous system and exacerbate anxiety symptoms.


How can I differentiate between anxiety symptoms and a heart condition?

Anxiety symptoms and heart conditions can sometimes overlap, but anxiety often improves with activity and worsens at rest, while heart conditions may not follow this pattern. If you experience severe chest pain, fainting, or persistent symptoms, it's important to seek medical evaluation to rule out heart issues.


What lifestyle changes can help manage anxiety symptoms?

Lifestyle changes that can help manage anxiety include practicing relaxation techniques like deep breathing and meditation, staying physically active, avoiding known triggers such as certain substances, maintaining a healthy diet, ensuring adequate sleep, and seeking support from friends, family, or mental health professionals.

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