Please help

[jzube]

Hi there, I am a 21 year old male and have recently had some troubles breathing over the past two months or so.  I have seen the doctor several times and was referred to a cardiologist for testing because I have a heart murmur.  Of all the cardiac tests in the world, nothing came up abnormal except that my thyroid was a little bit low.

One night I was watching a movie with my girlfriend.  Once it was over, I got up and felt tight in the chest or kind of bloated. I was also referred to the cardiologist because I usually feel some "fluttering" in my chest.  I have noticed that when the constriction is the worst, there is pressure just below my sternum, in the middle of my chest, and it is slightly painfull when i press on it.  As of yet I have not had symptoms with coughing excessively or anything, but when i get the "flutter" feelings, it often feels as though it is tickling my lungs or throat and causing me to want to cough to releave it. It often seems I have to always be concentrating on my breathing. It is very difficult to describe the whole feeling.  Sometimes it is worse than others, I seem to be fine when I exercise and it often helps when i eat, and is better in the morning before I get going.

The only thing that the doctors have told me is that I need to relax, and they have prescribed me medication for anxiety.  I do not like taking it however, as I truly don't beleive that it helps.  What sort of things, if any related to respiratory illness should I be suggesting to my doctor, as I have a difficult time getting them to understand my symptoms. Thanks, JD

[National Jewish]

You might want to ask your doctor if a 72-hour Holter monitor might be appropriate to check for abnormal heart rhythms.  This could explain the “fluttering” that you feel in your chest.

Also ask your doctor if testing for a problem in your digestive system would be helpful since you feel bloated and it often helps when you eat.

To know for sure if your symptoms are due to a lung problem ask your doctor about spirometry and a chest x-ray, if you did not have one as part of your cardiac testing.  Spirometry is a simple breathing test that measures how your lungs are working.  It will show if there is obstruction in your airways.  This testing should identify if your symptoms are due to a problem in your lungs.

Regardless of the cause of your symptoms, diaphragmatic breathing can help you move more air in and out of your lungs.  This is the most efficient way to breathe and may improve your symptoms.  Learning this technique will help you to breathe slowly, regularly, gently, and smoothly all of the time.  Here are the instructions:
· Breathe in slowly and deeply through your nose.
· While you breathe in, count 1, 2 and push your stomach out.
· Place your hand on your stomach so you can feel your stomach going out.  This promotes the use of your diaphragm and your lower breathing muscles.
· Breathe out slowly and deeply through your mouth.  Imagine that you are breathing out through a straw by “pursing” your lips.
· While you slowly breathe out all the way, count 1, 2, 3, 4 and let your stomach relax.  You can feel your stomach going in with your hand.
You often can get help with this type of breathing by taking an introductory yoga class or checking out a videotape on yoga that focuses on breathing and relaxation.

[AndyRRT]

I don't believe this is related to the respiratory system. This mostlikely involves your heart. Despite your symptoms, I'm shocked your cardiologist hasn't hooked you up to a holter monitor. This is a device about the side of a walkman that latches onto your belt with electrodes that are placed on your chest. Holter monitoring is a continuous, twenty-four hour electrocardiographic (EKG) recording of the heart's rhythm. This test helps your doctor evaluate the type and amount of irregular heart beats you may be having during regular activities, exercise and sleep.

Try keeping a diray when these events happen. What time of day and the activity you JUST did that may have caused it. Document how often and how long the feeling lasted, what you felt, and scale the degree of sensation as well.

A heart murmur is usually a sign of a valve defect inside the heart. There are four different valves in the heart that open and close as the heart muscle pumps blood. The opening and closing of these valves are the actual "Lub-Dub" we hear when we listen to heart sounds. Sometime, a "whoooosh" sound is heart inbetween the lub-dubs. Thats the murmur. It means that one (or more) of the valves isnt operating porperly. Wheater its not opening right, or closing right....some blood that is being pumped "whooooshes" back into the heart. For the most part, it can be benign. More serious cases can be symptomatic with strenuous activity. When the Whooosh increases...less blood is efficiently being pumped. This can cause lowered bloodflow to the lungs.

It can get VERY complicated describing cardiac function. I know enough to steer me through my work day, but I am not qualified to discuss it in great detail in this forum. Speak with your doctor more about this. If you still feel uncomfortable with his explanations, don't hesitate to seek a second opinion. (And keep that diary going too!)

-Andy, RRT, CPFT

[jzube]

Just to clarify what I meant by "of all the cardiac tests in the world", I have had just about every test performed on me, with no signs of a problem.  This includes several EKGs, Stress test, 24 hr Holter monitor, amulatory blood pressure monitor, and echocardiogram (ultrasound).  There are no problems he found, and did not sound to him as though the sysmptoms were cardiac in nature.
JD

[AndyRRT]

hmmmm....this is puzzling. I'm not sure if invasive procedures are needed to rule out things like a bronchoscopy or perhaps endoscopy for espohageal varacies or a hiatal hernia....

I'll keep thinking.

[abdullah]

with regard the murmur it's likely to be an anocent murmur which is common among young age groups without structural abnormality of the heart.
now with regard the tight feeling that your feeling could be related to various things. First, arrythmias (abnormal heart beats), the 24-hour holter moniter is good test but not sensitive enough to exclude arrythmias, in this case more prolonged monitoring will be rquired like loop-event recorder which is a monitoring goes for 2-4 weeks and the patient only needs to press the recording when he start to feel the abnormal flutter, this test will clarify if you have arrythmias or not. one thing to mention here that there was a study that showed up to 20% of patients labeled with anxiety disorder have actually arrythias. Second, the feeling that you have could also be related to what is called eosophegeal spasm in which a spasmodic spasm of eosophegus in response to high acidity, and you need to see gastro-enterologist to assess this by 24-hour pH monitoring of eosophagus or other methods.

if all of these been negative then yes behavioural modifications need to assessed but i think you need to role out structural and pathological diseases.

i hope this will help you in yoyr review, and get well

[blondeviolin1]

I would ask about acid reflux disease...

[ozark]

the fact that your thyroid test was a little off and the fluttering feelings, my thought would be that you may  have paroxysmal atrial fibrillation...this is associated with thyroid problems.....the best way to check this since it is intermittent is thru an event monitor.......have they investigated your thyroid any more?

[jzube]

They have not tested my thyroid any more yet, although I am seeing the doctor this week and hope to suggest that he does.  It also seems as though these fluttering feelings make sort of a "tickle" in my neck, just above my breast bone. I have on occassion noticed that it is slightly difficult or painful to swallow as well, perhaps a sign that my thyroid is slightly enlarged? I hope that the symptoms are associated with something as simple as thyroid problems...my mother has thyroid problems and takes synthroid pills every day.
JD

[ozark]

many people young and old have a fluttering sensation in the middle of their chest or near their throat....these can be premature beats...they can go as quick as they come....it can cause one to feel as if they have a tickle in their throat...does the sensation last long? do you at times feel like your heart is beating fast or thumping? or soing flip flops at the time you have the breathing sensation?

[jzube]

Overall, the tickling sensation is usually quite mild....just enough to annoy me. Whenever I try to feel my heart when I have some sensations, I can never quite tell whether it is my heart, as my heart beat feels normal.  There are some evenings when it seems like my heart is beating "harder" than normal or thumping.  The scary sensation that happens out of the blue and almost once every day, is a kind of thump in my chest that feels like the heart is skipping a beat or something.  It is always only once, so I probably would not be able to catch them on something like an event monitor test.
JD

[ozark]

it does sound like maybe you are having some pvc's which many of us have......describe what you commented on to your dr.....they are benign extra beats that people can notice when they are at rest...during the day your heart beats more and you dont notice them.......when you relax your heart rate slows and then they are more noticible...they can scare you and that can increase them      ask your dr obout the possibility of this and i would also ask about your thyroid in association with an irregular heart beat......you can also post on the heart site and describe your sensations there.....dont worry about this...its good you are checking it out.....my son who at 16 had some heart irregularities out of the blue and he is fine now at age 20.......good luck

[carebear1234]

Here is some things you might suggest to be done when going to your Cardiologist:
1. 48 Hour Holter Monitor
2. Event Monitor
3. Echocardiogram

I think an Echocardiogram would be a good choice, but he may want to start you out with a holter monitor.  Good Luck!

[carebear1234]

Here is some things you might suggest to be done when going to your Cardiologist:
1. 48 Hour Holter Monitor
2. Event Monitor
3. Echocardiogram

I think an Echocardiogram would be a good choice, but he may want to start you out with a holter monitor.  Good Luck!

[Alex G]

I have a similar problem as explained here.  I feel that fluttering in my throat as well.  Lately it seems to be more often.  I also sometimes feel that fluttering in other parts of my body as well such as my neck and arms and legs.  I do alot of running and mtn biking and my heart rate is rather low.  It's about 38 resting.  My blood pressure is around 150/80.  Which I know is high.

I havent been to the doc yet but I got curious and found this post.  I can't tell if this is something serious or not.  I usually pass the flutters in my arms, legs, and neck off as little muscle spasms but after reading this I am a little more concerned.  Do you think I have some sort of a condition that I should have checked out?

[jzube]

To be quite honest, I don't really know much at this point, and am still in the process of determining what is wrong with me!  Sorry I can't help more, but I would definately go see a doctor if it keeps up, especially with high blood pressure. It can't hurt right?
JD

[Purified Air]

I used to always clear my throat and cough...since having an air purifier in my home that covers the whole house; I've totally stopped that and found it to help all my children even in the midst of this WI winter - we've had no colds or flu or other respiratory ills.  Here's some obvious signs in your own home that can indicate a need simply for air purification.
COMMON TRAITS OF INDOOR AIR POLLUTION
Affected Household Members initials: ____ ____ ____ ____ ____
Dust on furniture / Visible in air
House odors
Allergies
Asthma
Sinus problems
Headaches
Sleeplessness / Light sleeper
Snoring
Sore throats / Colds / Flu
Itchy/ Watery eyes
Coughing / Throat clearing
Lack of Concentration
Depression / Irritability
Fatigue / Naps
Mold / Mildew in basement & bathrooms
Pet dander and odors
Smoking
Wood / Coal heater
Static Electricity

As you fill this in and realize how much is affected by your indoor air; maybe you should try an ionizing/ozone air purifier like I have.  It's removed all respiratory ills in our family with 8 children 19 down to two.

[Leo10]

I happened to be surfing the net trying to figure out what is wrong with me when I saw your post. A lot of what you describe is what I have too. I, like you have not been diagnosed either. I have been to so many doctors and no one has figured it out. I get a flutter feeling that pretty much can come at any time out of the blue. Sometimes I think it is my throat, other times I think it is my heart. I have had this since I was around 15 years old and I am now 32. SO, I know I am not going to die from it. It is just very annoying and scary. I have been to many cardiologists who have given me all the tests more than once...echo, EKG, holter monitor, stress test. I have also been to a gastroenterologist who gave me a upper and lower GI test and a colonoscopy. Everything has come back normal. I was told once that I had mitral valve prolapse. My problem is that I can be doing anything, watching TV, playing soccer and I will have this flutter feeling that makes me breathe in and sometimes I cannot breathe out for a few seconds..it is probably more becaue I am so scared. It only lasts a second. A few doctors tell me it is anxiey or panic disorder but how can that be when it only lasts a split second? My last trip to the doctor they found my thyroid was low so they put me on Synthroid..I just started taking it but I will let you know if it relieves my problem. I am sure it wont because I think the doctors are just saying it is this too get me out of the office. ha! But I understand what you are explaining..I have a hard time putting the feeling into words because I feel like i am not making sense.