[24F] Experiencing shortness of breath, chest tightness, and palpitations

Patient Description

A 24-year-old female has been experiencing shortness of breath, chest tightness, and palpitations for the past 2 days. The shortness of breath is mild to moderate, worsens with walking, and improves with distraction and calming anxiety. The patient describes the palpitations as a fluttering sensation, which becomes more noticeable when sitting still and during panic attacks. The chest tightness is described as a 3 out of 10 in severity and is associated with bloating and a burning sensation that extends to the throat. The patient has a history of acid reflux, which is currently being treated with Omeprazole (40mg daily), and there is a family history of severe acid reflux. No known allergies or other medications reported. The patient's symptoms are exacerbated by inactivity and anxiety but alleviate somewhat with distraction.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following conditions could be possible:

  • Anxiety Disorder or Panic Disorder: Your symptoms of a fast heartbeat, shortness of breath, and chest tightness, particularly during periods of stress or panic, could be indicative of an anxiety disorder or panic disorder. These conditions can cause physical symptoms that mimic those of heart disease or other physical conditions.

    • Treatment typically involves a combination of psychotherapy (talk therapy), cognitive behavioral therapy, and medication.
  • Gastroesophageal Reflux Disease (GERD): Your symptoms of bloating, a burning sensation in the chest, and the sensation of something in your throat could be due to GERD. This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause heartburn.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be necessary.
  • Functional Dyspepsia: This is a chronic disorder of sensation and movement (peristalsis) in the upper digestive tract. It can cause bloating, belching, and discomfort in the upper belly, among other symptoms.

    • Treatment typically involves dietary changes, medication, and addressing any underlying psychological issues, such as anxiety or depression.

What you can do

  1. Seek professional help: If your symptoms persist or worsen, seek medical attention. A healthcare provider can help determine the cause of your symptoms and suggest appropriate treatment.

  2. Manage your anxiety: Techniques such as deep breathing, meditation, and yoga may help manage your anxiety and reduce symptoms. Cognitive behavioral therapy can also be effective.

  3. Monitor your diet: Certain foods can trigger GERD symptoms. Try to identify and avoid foods that cause you discomfort. Common triggers include fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.

  4. Maintain a healthy lifestyle: Regular exercise and a healthy diet can help manage symptoms of both anxiety and GERD.

What you should look out for

  • If your symptoms persist or worsen
  • If you experience severe chest pain or pressure, especially if it's accompanied by pain in the arm, jaw, or back, sweating, or nausea
  • If you have difficulty swallowing
  • If you experience unexplained weight loss
  • If your stool is black or bloody or you vomit blood

Please remember that while I strive to provide accurate information, I am an AI and not a substitute for professional medical advice. Always consult with a healthcare provider for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are common symptoms of an anxiety or panic disorder?

Common symptoms of an anxiety or panic disorder include rapid heartbeat, shortness of breath, chest tightness, dizziness, sweating, trembling, and a feeling of impending doom. These symptoms often occur suddenly and can be very intense.


How can GERD be managed effectively?

GERD can be managed with lifestyle changes such as avoiding trigger foods, eating smaller meals, not lying down immediately after eating, and elevating the head of the bed. Medications like antacids, H2 blockers, and proton pump inhibitors (such as Omeprazole) can also help reduce stomach acid and relieve symptoms.


What lifestyle changes can help reduce symptoms of acid reflux?

To reduce symptoms of acid reflux, avoid foods and drinks that trigger reflux, such as fatty foods, spicy foods, caffeine, alcohol, and chocolate. Eating smaller, more frequent meals, maintaining a healthy weight, and avoiding lying down soon after eating can also help.


When should I seek medical attention for chest tightness and palpitations?

You should seek medical attention if your chest tightness and palpitations are severe, persistent, or accompanied by other symptoms such as pain radiating to the arm, jaw, or back, sweating, nausea, difficulty swallowing, unexplained weight loss, or if you experience black or bloody stools or vomit blood.


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