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Forum Name: Cardiology Symptoms

Question: Anxiety or something else?

senagod - Mon Apr 30, 2007 9:07 pm

Hello. I'm a 34 year old female, pack a day smoker. Two months ago I had a burning pain in the right side of my chest, above the breast, towards the armpit with a Rapid heart rate and a hot feeling that goes to the back of my neck. Went to the ER, had stress test, chest X-ray, CT scan, Echocardiogram, EKG, and bloodwork. All came back negative. Went to the family doctor, who said costochondritis and gave me Ibuprofen. Went back to the ER two weeks later with similar symptoms. My pulse was 120. They tested blood for thyroid and came back negative. Went to the cardiologist who saw me in the ER. He said it could be a sign of perimenopause, told me to stop taking The Pill and put me on 25mg of Atenolol. I will have a string of good days and then I'll have a day where I have pain on either side of my chest, never lasting longer than a couple of seconds, and a Rapid heart rate. It's making me tired. My appetite is gone. I only manage to eat one meal a day and I've lost over 20 pounds, from 148 to 127. My family doctor sent me for more bloodwork and all they found was slighly high Cholesterol. 221 total, 132 bad Cholesterol. I saw a second cardiologist today. The nurse did an EKG and pulse was 105. When the cardiologist checked my pulse, it was 80. He said it's not my heart and that it's either an autoimmune disease or it's Anxiety/depression. I don't feel depressed or anxious about anything. Life is going good except for this health problem. Please help. I don't want to go on Anxiety medication, especially if it's unwarranted. Thank you.

shaz29 - Mon Apr 30, 2007 10:49 pm

Hi Senagod I have been going through similar symptoms for the past 9 months, I used to be in and out of A&E at the beginning, they could never find anything wrong with me, I was told its costochondritis and was told alot of the pain I was decribing was brought on by Anxiety/panic... my heart rate used to shoot up too, I take Beta blockers now so it keeps it at a steady rate.. anway I've recently had an Echo and also a treadmill test, both came back fine, since august last year I must have been to A&E 20 times... the way I look at it is, if it was my heart then something would have happened by now, and 20 plus doctors can't be wrong.. anyway my cardiologist said that its probably just chest wall pain, could be nerve deep inside thats causing the pain. I have been off from work for the past 9 months because of this but I am returning to work tomorrow. Hope this advice helps

senagod - Tue May 01, 2007 1:59 am

Thanks Shaz29, It's nice to know I'm not alone. I think for right now, I'm going to go back to my family doctor and we're going to start over and see if it's something other than the heart. I've had this for two months now, and you're right, if this was the heart something would've happened by now.

John Kenyon, CNA - Thu May 03, 2007 6:13 pm

Hello senigod - I will reluctantly skip the sermon about smoking. You already know this will cause you problems that may eventually become life-threatening and will worsen any existing problems, no matter what they are. Nope, that wasn't the sermon. That was just the obligatory response to your having listed being a pack-day-smoker. Nothing good will come from that. Only you can eliminate that health risk. That being said, the pain you describe doesn't really sound heart-related, for two reasons: one, it is very brief and fleeting, and two, its location is so far from the center (and can be on one side or the other at different times). This makes a cardiac cause fairly unlikely. The reason for the rapid heartrate following these episodes is most likely a startle reflex caused by the sudden onset of the pains. That just leaves us to figure out what's causing them. Since these pains seem to be located in an area where the upper bronchial tree can refer pain, and also sounds somewhat pleuritic in nature, it may be that you're suffering from an irritation of the pleura, the protective membrane that surrounds the lungs. This pain is usually triggered by a deep breath, however. The possibilities suggested by doctors all seem reasonable except for perimenopause, as 34 seems awfully early for that. The chostocondritis idea has possibilities but can easily be ruled in or out by pressing on the area in question. If you can provoke pain by moderate finger pressure in the general area of the pains then that's the likely cause. Also twisting of the upper body might have the same effect. Any pain that can be elicited by pressure or changing position is not cardiac related. I can't help thinking that smoking may have something to do with this, though, if only secondarily. There's still the Anxiety angle, too. Although you deny stress and Anxiety other than that generated by the symptoms, you also state your appetite is "gone" (and eating once a day I'd say that's an accurate assessment). Anxiety and/or Panic attacks can actually kill one's appetite, cause non-specific Chest pains, increase the heart rate and otherwise wreak havoc. In most such cases the patient denies a problem in precisely the area where it lies. It sounds strange but it's true. Work on the smoking, as that will, as I've already said, make anything worse and ultimately cause you real, serious problems. Also open yourself up to the possibility of an Anxiety-related problem. There are some really innocuous medications now available that can help a lot. And of course that's only one possibility. I'm really doubting the perimenopause theory. It seems you've ruled out any serious physical problems, so it might be worthwhile to take a closer look at Anxiety as a cause. This is one of the sneakiest things we can encounter and the person so-affected is usually the last one to know. Good luck to you and please stay in touch.

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