[22M] With chronic shortness of breath and heart palpitations post-smoking cessation

Patient Description

A 22-year-old male reports experiencing chronic shortness of breath and heart palpitations following the cessation of smoking cigarettes and THC dabs approximately 9 months ago. The patient describes the sensation of unsatisfying breaths, as if the air isn't being absorbed properly, and notes that these symptoms are exacerbated by anxiety and hyperfixation on breathing. The symptoms are not present during sleep or upon waking. The patient rates the severity of shortness of breath between 4 to 7 out of 10 and finds that breathing exercises sometimes provide relief. Medical evaluations, including pulmonary function tests (PFTs) and a chest X-ray, have returned normal results, and oxygen saturation levels consistently range between 95 and 98%. The patient also experiences heart palpitations, described as skipped beats, which began around the same time as the breathing issues. These palpitations were more frequent upon waking while on Buspar, but have since become random after discontinuation of the medication. The patient has a history of increased stress and anxiety over the past year, which may be contributing to the symptoms. Exercise does not seem to exacerbate the symptoms, as the patient can engage in moderate cardio for an hour without significant shortness of breath. Occasional alcohol use is reported, with no chronic cough or wheezing present.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities for what might be happening:

Anxiety and Stress-Related Symptoms: Your history of Generalized Anxiety Disorder (GAD) and recent stress could be contributing to your shortness of breath and heart palpitations. Anxiety can cause hyperventilation and a sensation of not getting enough air, which might explain your symptoms.
Residual Effects from Smoking: Although your tests came back normal, your lungs might still be recovering from the effects of smoking cigarettes and THC. This could contribute to the sensation of unsatisfying breaths.
Hyperventilation Syndrome: This occurs when you breathe too quickly or deeply, often due to anxiety, leading to a feeling of shortness of breath and palpitations. It can be a cycle where anxiety causes hyperventilation, which then increases anxiety.
Post-acute Withdrawal Syndrome (PAWS): After quitting substances like nicotine and THC, some people experience lingering withdrawal symptoms, including anxiety and palpitations, which can last for months.

It's important to continue monitoring your symptoms and consult with a healthcare professional for further evaluation if needed.

What you can do

Here are some steps you can take to help manage your symptoms:

Practice Breathing Exercises: Techniques like diaphragmatic breathing or paced breathing can help manage anxiety and improve your sense of breath control.
Engage in Regular Physical Activity: Exercise can help reduce anxiety and improve lung function. Start with moderate activities like walking or cycling.
Manage Stress: Incorporate stress-reducing activities into your routine, such as meditation, yoga, or mindfulness practices.
Track Your Symptoms: Use MDandMe to journal your symptoms, track progress, and gain insights. This information can be valuable for your healthcare provider.
Seek Support: Consider talking to a mental health professional to help manage anxiety and stress.

What you should look out for

Be aware of the following signs that may require more urgent medical attention:

If your shortness of breath worsens or becomes more frequent
If you experience chest pain or discomfort
If you notice any new or unusual symptoms
If your heart palpitations become more severe or frequent

Remember, it's always best to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to ask!

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1 mo ago

Top picked over-the-counter products for POTS: Heart Rhythm Society Treatment Consensus

[22M] With chronic shortness of breath and heart palpitations post-smoking cessation

What might be happening

What you can do

What you should look out for

Experiencing symptoms?