Is difficulty breathing after a workout sign of heart disease?

Q. I feel hard to breathe after workout. Is this a sign of heart disease?

Answered by
Dr. Muhammad Majid Hanif
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Sep 16, 2016 and last reviewed on: Jun 01, 2023

Hi doctor,

A few months ago, I have been having left side pain from my shoulder blade down to my arm till the tip of the last finger. I have had ECGs, blood work, chest x-rays and finally a CT angiogram. All were normal. I am tempted to go to the ER every time this happens, because I think this might actually be a heart attack. I am so frustrated. I have been feeling normal and I am back to my regular daily workouts, which are fine. But, my back always feels very tight after my workout and it takes me a while to catch my breath. From today morning, I have been feeling dizzy at times and my left pinky and back feel tight again the way they had in the past. I feel like I am breathing harder than usual. I have had tests done both in the ER and by a very good cardiologist, including a CT angiogram, ECG and blood work. I have had panic attacks and I fear that this is a real heart issue. Should I go to the ER? I am very concerned that my workout seems to make my upper back feel worse. Is this a sign of heart disease?



Welcome to

I appreciate you and have thoroughly worked through your case. I can well realize the sensitivity of the issues you are feeling right now. My discussion today will mostly comprise of reassurance and explaining the things in the best possible way for easy understanding. The issues you have described never warrants an emergency room visit for the suspicion of a heart attack. Rather, these fit more in the setting of anxiety and panic disorders. This is not due to the heart attack that you feel tightness in back after a workout. Many of my patients with the same issue got better once they started workout under the proper guidance of a gym instructor. The same is my suggestion for you. You will feel better in almost no time. You need to make sure that your diet is full of nutrients and plenty of fluids as this is a big issue in gym workouts when our muscles get less than required nutrients and fluids, they get stiffer. Muscles can work optimally if remain bathed in a healthy pool of nutrients, fluids and electrolytes. Your cardiologist has done a good job and the tests needed are all carried out previously. I am happy for you to know there was nothing. You are a lucky one to have a healthy heart muscles and blood vessels. You need to consult a psychiatrist to overcome the obsessions of getting fear of heart disease. This is manageable and psychiatrist is the trained personnel to treat such issues with success. You are not alone who has these kind of symptoms. A lot of females in this age group get the issues like this and is managed with success once we overcome the anxiety and panic of getting something wrong with our heart. You need to take care of your caffeine intake and cut it short with the passage of time. No junk and fried foods, caffeinated drinks and beverages with carbonated water, energy drinks, etc. Keep a balanced lifestyle with proper and hygienic sleep. If you need to get comments on the laboratory reports of your previous visits, you may upload them in a query to me. I will be happy to review and see what is going on in there. Will be happy to assist you. If not done previously, then I am interested in getting some of your laboratory tests done such as serum glucose and HbA1c levels, fasting serum lipid profile, thyroid profile and serum electrolytes. It is necessary to rule out the possibilities of some disorders that may contribute to symptoms and may cause heart issues in future. Revert back with the reports to a cardiologist online.

Thank you doctor,

I have read many warnings about left side arm and shoulder pain representing heart attacks in women. Is that a false statement? Your opinion is should I ignore the pain when it comes? Is the coronary CT angiogram pretty definitive to rule out heart issues? If I have a valve or rhythm problem, could it be the cause of my symptoms?



Welcome back to

Heart attack is more a disease of males. Females get it less often. In the scenario, as per your symptoms, this type of pain is not typical of a heart attack. They have evaluated you well recently in emergency room visits. If there had been any abnormality in the heart's blood vessels or musculature, it had obviously been on reports. Please try to overcome the anxiety related to your heart health. This will help you a lot in the process of getting you to a healthy lifestyle. Yes, coronary CT angiography is sensitive and specific enough to rule out abnormality. So, you may rest assured and leave the rest to our treating doctors. Do not panic much and enjoy the daily life routines. Valve or rhythm issues are ruled out on physical examination, EKG and many other evaluations of the heart that are definitely carried out on ER visit. So, I have no doubt in saying that you may not be having any valvular heart disease or the rhythm issues.

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