what resp problems may cause palpitations?

[boochew]

I am a 34 yr old male, 60 lbs overweight..Although I do workout 30 mins per day (i guess i just eat too much).

But for at least 7 months now I've had symptoms all start coming on together and getting slowly worse.

I have alot of persistant nausea, breathless feelings (at rest), heavy and tight chest discomfort in the center and upper part of my chest,  feel very lightheaded most of the time too.   I have also have occasional heart palps (skipped beats) that I feel in the exact same area as the chest tightness/heaviness I described.

I passed a cardiolite stress test (well, sort of...I could only go 7 minutes).  Normal echo, normal chest xray, mild polycythemia however.  That's the only thing abnormal found.  
I had a normal ABG with 96.9% oxygen, HOwever, I have an expensive, reliable pulse oximeter, and when at rest I have noticed often my o2 drops to 93-94, though during exercise it is never below 96-97..and even at rest it's typically 95-97, but it's just the occasional dip-off.    I suspect at night it gets much lower...I slept with it on once and woke up and saw my o2 was 90, then I took a deep breath and it shot back up.     I will be having a sleep study as soon as I can manage to (long waiting list).      

I have mentioned all the tests I've had---cardiolite stress, echo, brain MRI, chest xray, ABG.  Only abnormal finding mild polycythemia (very mild).  

I was wondering,  I just have the feeling it's very unlikely ALL this can be connected to a sleep disorder.  Could this be a non-apnea related lung disease?     The tight squeezing feeling in my chest doesn't get worse with exercise, it's just there.    One other thing I should definately mention is that going back 3 years, I've had chronic daily headache with lots of red inflammation in my nasal passages with a chronically blocked nose (not in the typical sinusitis, runny nose way...it's inflammed and dry...just very red).   I was thinking this may be connected somehow?  

Thanks Very mu

[National Jewish Health]

You have provided a lot of information in a very succinct manner.  It is important to avoid underestimating the wide range of symptoms or sensations that can arise due to a sleep disturbance and/or the potential for a sleep disturbance to worsen a pre-existing condition, for example hypertension, headaches, abnormal heart rhythms, or emotional disturbances such as anxiety or depression.  While the majority of sleep disorders involve airway obstruction, there are some that do not, such as central hypoventilation disorders that involve diminished breathing.  In either event, we would deem it very important that you proceed with a full sleep study, performed in an accredited sleep laboratory.

A number of your symptoms are commonly experienced in the setting of chronic anxiety with panic disorder.  These symptoms are on an emotional basis, but are all too real to the person who suffers from them, in many instances indistinguishable from symptoms due to organic/physical disease.  In this regard, the normal test results you describe are very encouraging.  However despite the normal chest x-ray, you would need pulmonary function tests (PFTs) to rule out other pulmonary disease and ambulatory cardiac monitoring might be useful to rule out serious abnormal heart rhythms, as a cause of palpitation.

If the sleep study is abnormal, do your best to comply with any and all recommended therapy.  If your symptoms are not relieved by this therapy, you might want to consult with a behavioral health professional to address the question of possible chronic anxiety with panic disorder.

Good luck.

[boochew]

PS-- My SED rate has been measure 3 times in 3 years, it is Always 0