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Forum Name: Valvular Heart Diseases

Question: chest pain, arm weakness,palpitations


 BLAQUEBERRY1978 - Mon Mar 03, 2008 9:39 am

i am 30 years old and in the last 5 mths i have been seen in the ER for chest pain, palpitations (PSVT) ( ia was psvt free for 3-4years) (then all of a sudden after suffering from sciatica and bad pain i went into tach @ 150bpm and since then had been scared), stress, anxiety attacks, and sob and PVC's. i have had numerous labs done, cardiac enzymes. I have had a cardiac enzyme done on 02/19/08 that had a Troponin-I of 0.11 (this is the only one where it was high), but the next day it went back to 0.0. they told me damage to muscles other than the heart can cause this. i do have a trace as my cardiologist put it of pulmonary regurgitation. ( i have had every test done known to mankind) i have had an hiv test, stress test, echo, ekgs(over 10 all normal, except for the tachycardia) all of these came out normal. i even had a nuclear scan of my heart done the day of the stress test which my cardiologist said was normal. i have had a ct scan of the chest with contrast to rule out clots due to a positive d-dimer) it. came out negative. a ct scan of my head which was normal. i have had a ugi and ba swallow which was normal, but i still have some burning and pin prick pains in both sides of my chest nd experience arm weakness. i am a 50dd/ddd and i am due for breast reduction. but i need to know where you think this burning in my chest area (upper) is from and the mucsle weakness and fatigue. do you think it is muscle inflammation? i have not lifted any thing heavy or could it just be from haveing large breast. i say no because i have them up in a bra all day long. my cardiologists stated that my psvt and panic attacks were all stress related due to me being worried after all these tests that something is still wrong. also i had high levels of cholesterol, triglycerides, hga1c, ldls. i have gotten them back in great range and i have lost from 225lbs down to 180lbs. please help??????
 Dr. A. Madia - Wed Mar 12, 2008 8:30 am

User avatar Hi,

You have undergone some extensive investigational work up! All that I can find positive from this is the PSVT. Sometimes it can be precipitated by anxiety, a basic organic conduction abnormality is always there and if the PSVTs are too frequent and not preventable by oral medications, its certainly worth considering an ablation therapy.

The burning and pin prick sensations (paraesthesia in medical parlance) are usually a classic sign of either some nerve irritation or some deficiency of Vit B12. Paraesthesia in chest area is sometimes due to nerve root irritation or compression in the neck vertebrae. If your doctor agrees you may get an X ray of the cervical spine done.

However I think anxiety on your part is playing a major role in your predicament, and you must try and calm down as majority of youe tests have come out normal.

Apurva
 BLAQUEBERRY1978 - Mon Mar 17, 2008 1:53 pm

IS IT NORMAL ALSO FOR METOPROLOL TO MAKE YOU FEEL DIZZY IF TAKEN ON AN EMPTY STOMACHE.
 Dr. A. Madia - Tue Mar 18, 2008 9:14 am

User avatar No, it does not cause dizziness on either empty or full stomach unless the dose is not right and one has some low blood pressure because of it.

Apurva
 tahan - Thu Sep 18, 2008 12:49 pm

I did get very depressed i was waiting for something to happen in my life and i was thinking about my relation, so i got depressed stressed and i started getting thoughts negative etc..happens, but with that i had weakness in left arm pain under the left shoulder plate,
upper left chest, and some kind of piercing pain NOT pressure or heart attack but pain specially when i get stressed, but other wise ecg was normal, xrays showed normal, i can run a lot, and physically i am strong!!! i wonder what is the cause of pain specially it comes with my back pain from the left side and it happens when i am sad..before my left hand was weak..now i am normal..yeahh one thing my BP was 130..now normal..i don't exercise much i stay mostly at home..and i seldom smoke..also living in a polluted area the last month had dry cough and short breath for a whole month, weather keeps on changing..Doctor i would like to ask you..how common is heart diseases among youth, and what triggers it? and would it heal if a person does the right treatment?
 John Kenyon, CNA - Thu Sep 18, 2008 8:41 pm

User avatar Hello -

It seems you have a great deal of insight into the link between depression and somatic feelings of illness or discomfort. Depression, whether situational or clinical, can cause physical stress which can, in turn, cause symptoms that can mimic other diseases. Your symptoms could, of course, possibly be heart-related, especially if there is a strong family history of it, and those symptoms should be evaluated by a healthcare provider, but it is relatively rare for heart disease to show up, even in people with a family history, before the age of 50 (although there is a small subset of families in which it begins to show up in the 30s). In short, the odds are great that your symptoms are not caused by heart disease (and your good tolerance for exercise really argues that it's something else). You also recognize your own depression and the fact that these symptoms tend to show up mostly when you're feeling down. The connection is probably solid.

I would bring the whole matter, the physical symptoms and the emotional ones, to a doctor, who can evaluate the physical ones and likely refer you to a psychologist who can help you deal with the emotional ones -- which are very likely causing the physical ones. Even if the depression isn't causing them, which it probably is, depression is as serious as any illness, and is very manageable in the right hands.

I hope you'll pursue both problems medically. I strongly suspect one is causing the other, but even if it's two separate things they deserve to be treated, and you deserve to be enjoying life a lot more than you can when you're depressed and hurting.

Best of luck to you. Please follow up with us as needed.

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