[31F] Experiencing chest tightness and difficulty breathing after gastrointestinal symptoms

Patient Description

A 31-year-old female initially experienced lightheadedness and frequent diarrhea every hour for about 14 hours, accompanied by more lightheadedness. The diarrhea has since stopped, but she is now experiencing tightness in her chest and difficulty breathing. These symptoms occur randomly, often when walking or talking, and tend to relax when she lies down. The chest tightness feels like a squeezing sensation and varies in severity, sometimes mild and other times more severe, especially when more active. Each episode of chest pain lasts until she lies down, with the worst episode lasting about 20 minutes before it dulled and about 2 hours before the tightness completely subsided. She rates her shortness of breath as a 5 out of 10 at its worst. She has not experienced any swelling in her legs or ankles, palpitations, irregular heartbeats, vomiting, sweating, clamminess, coughing, wheezing, or pain radiating to her arm, neck, jaw, or back. She mentioned some nausea but no regurgitation or burning sensation in her chest or upper abdomen. She occasionally drinks alcohol but hasn't recently. She has a family history of heart disease and high blood pressure and is up to date with her vaccinations, including the flu shot and COVID-19 vaccine. She recently moved from the USA to Indonesia and is working with wildlife in a completely new environment with new foods. She does not have any pre-existing medical conditions or chronic illnesses and is not taking any medications.

Arora's Assessment

What might be happening

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

Gastroenteritis: The initial lightheadedness and frequent diarrhea could be due to a gastrointestinal infection, commonly known as gastroenteritis. This can be caused by bacteria, viruses, or parasites, especially in a new environment with different foods and water sources. Dehydration from diarrhea can also cause lightheadedness.
Heart-related issues: The chest tightness and difficulty breathing, especially with a squeezing sensation, could be related to heart issues such as angina or even a mild heart attack. Given your family history of heart disease and high blood pressure, this is a serious consideration. Angina is chest pain caused by reduced blood flow to the heart muscles and can be triggered by physical activity or stress.
Anxiety or Panic Attacks: The random occurrence of chest tightness and difficulty breathing could also be related to anxiety or panic attacks, especially if you are in a new and potentially stressful environment.
Respiratory Issues: Exposure to new allergens or environmental factors in Indonesia could be causing respiratory issues, leading to chest tightness and difficulty breathing.

What you can do

For Gastroenteritis and Dehydration:

Hydrate: Drink plenty of fluids, such as water, oral rehydration solutions, or clear broths, to prevent dehydration.
Rest: Give your body time to recover by resting as much as possible.
Diet: Eat bland foods like bananas, rice, applesauce, and toast (the BRAT diet) until your stomach feels better.

For Chest Tightness and Difficulty Breathing:

Seek Immediate Medical Attention: Given the potential for heart-related issues, it's crucial to see a doctor as soon as possible. If the chest tightness and difficulty breathing worsen or become more frequent, go to the emergency department immediately.
Rest: Avoid strenuous activities and rest as much as possible.
Monitor Symptoms: Keep track of when the chest tightness and difficulty breathing occur, what you were doing at the time, and how long the symptoms last. Use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

For Anxiety or Panic Attacks:

Relaxation Techniques: Practice deep breathing exercises, meditation, or yoga to help manage anxiety.
Seek Support: Talk to a mental health professional if you suspect anxiety or panic attacks.

For Respiratory Issues:

Avoid Triggers: Identify and avoid potential allergens or environmental factors that may be causing respiratory issues.
Consult a Doctor: See a healthcare provider to rule out any respiratory conditions and get appropriate treatment.

What you should look out for

Given the severity of your symptoms and the possibility of life-threatening causes, you should seek medical care as soon as you can. Reasons to seek care even more urgently include:

Severe or worsening chest pain
Shortness of breath that doesn't improve with rest
Fainting or severe lightheadedness
New or worsening symptoms

Remember, while I can provide information and suggestions, I am not a doctor. It's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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1 yr ago

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