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Chest tightness and shortness of breath are caused by both organic and functional reasons:

Chest tightness caused by organic reasons: First, cardiogenic chest tightness-manifested as chest tightness after fatigue, dyspnea, or paroxysmal dyspnea at night, patients can hold back during sleep, which can be seen in patients with heart disease with pulmonary congestion and cardiac insufficiency. When lying down, pulmonary congestion is aggravated, resulting in chest tightness and dyspnea, which improves after sitting up. In addition, chest tightness can also be a manifestation of myocardial ischemia in coronary heart disease.

Pulmonary chest distress-seen in bronchial asthma, pleural effusion, pulmonary fibrosis, etc.

Chest tightness caused by functional reasons is most common in cardiovascular dysfunction. Patients feel chest tightness, shortness of breath, subjective lack of air, poor breathing, often sigh-like breathing, and feel comfortable after breathing; Sometimes it is often accompanied by palpitations, tingling in the precordial area, and neurological symptoms such as fatigue, dizziness, confusion, panic, anxiety, sweating and insomnia. Most of the patients are young women with obvious symptoms, but no organic lesions were found in ECG, B-ultrasound and chest X-ray examination.

The difference between organic chest tightness and functional chest tightness is that organic chest tightness mostly occurs after exercise or fatigue, while functional chest tightness mostly occurs at rest; Organic chest tightness can be obviously improved after sitting up, while functional chest tightness often does not change because of body position change.

Speaking will cause chest tightness and shortness of breath. If it is pathological or chest tightness caused by organic heart disease, it means that heart and lung failure is serious, because speaking is generally effortless if you don't speak loudly for a long time. If there are no symptoms of chest tightness and shortness of breath during activities, it will cause chest tightness and shortness of breath as soon as you speak, which is not in line with the chest tightness and shortness of breath after heart disease fatigue. Even if there is myocardial ischemia with coronary heart disease, it will not cause ischemic symptoms because of speaking. Therefore, this situation suggests that it is a functional chest tightness symptom caused by mental reasons.

The mechanism of chest distress caused by cardiovascular dysfunction is autonomic nerve dysfunction and increased sympathetic nerve tension, which causes a series of functional symptoms and manifestations of cardiovascular system.

When you have symptoms of chest tightness and shortness of breath, you can do chest X-ray, electrocardiogram, echocardiography and other examinations. If no abnormalities are found in the examination, most of them are neurological symptoms, so don't worry too much. After mental conditioning, physical enhancement, or necessary rest and drug treatment, they will gradually improve and cure.