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- Sun Sep 09, 2007 3:59 am
I am a 45 yr old male with a history of high blood pressure & high cholesterol and a family history of heart disease. Recently whenever I am extremely irritated or angry, I have felt an intense almost cramp like pain in my chest. This stops me in my tracks and when I calm down the pain subsides. However I have a residual soreness/tingling in my chest and left arm for several hours afterwords. I have had 2 such episodes in the past 6 months. I am currently on norvac and zocor. I have had two stress tests in the past 3 years (the treadmill ones) and pass each one with flying colors. I have never had these episodes triggered by exercise only by being very angry or upset. I visited my doctor after the first episode, and he did not think it was heart related but rather digestive related /heartburn sort of thing. I believe he feels I'm a hypochondriac. However the pain I experience is real and not like anything I've ever experienced before. My question is what does this sound like? How concerned should I be? And what is my next step in determining what is going on?
| Debbie Miller, RN
- Thu Oct 04, 2007 6:24 pm
Your doctor may be right - you could have esophogeal reflux because the symptoms you describe could fit this scenario. Stomach acid is VERY strong and if it splashes up into your esophagus, the result can be very painful as well as damaging to the tissues. Intense feelings can also alter stomach acid and trigger such a response.
Of course it could also fit other disorders, such as panic attacks. Given the identifiable trigger is anger, either scenario is possible. Our bodies have their own ways of protecting themselves and when you find yourself in "fight or flight" mode, all kinds of physical symptoms can appear intensely and very suddenly.
When breathing is affected there is also the possibility it could be lung related or involving the chest wall muscle and/or ribs. Pericarditis (inflammation of the outer sac lining of the heart) is also a possibility.
This is not all-inclusive. Other disorders could also cause your symptoms. Stay with your doctor until you get a satisfactory answer or until it gets better on its own.
I would not get overly worried about this unless it gets markedly worse or it feels like a heart attack - pressure, squeezing or dull ache felt in the center of the chest (not actually over the heart) that is usually brought on with exertion and relieved by rest and possibly radiating to neck, back, arm, abdomen. I know you have said exercise does not bring this on but it is something to be alert to.
Meanwhile, follow your doctor's advice in observing for possible causes, treating stomach acid, etc.