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Forum Name: Cardiology Symptoms

Question: Tightness soreness in left side back chest


 findingbliss - Wed Sep 10, 2008 1:45 am

Ok I feel like a dork posting this but here goes. I'll be as brief as I can

30 years old male non smoker very very light drinker I do have a weight problem I was as heavy as 380 but now down to 318. I walk twice a day total of 1.5 to 1.8 miles a day I climb stairs I bowl I swim and I am beginning to do some lifting.

FOr the last few months I will sometimes get tightness that seems to start in my back right around the left shoulder blade and it will wrap around and I'll feel the tightness in the left side of my chest. SOmetimes also I'll feel an achey burning in my back between the shoulder blades and it will sometimes wrap around the ribs and I'll feel a slight pressing on my chest. Every now and again I'll notice a spasm in the left chest not painful just feels jumpy for a split second and then gone. Seems muscle related tightness in the pectoral and back muscles? I would liken it to someone pressing a hand on the chest nothing terrible but enough to notice. Seems benign enough but these symptoms drive me insane. I have seen my Dr bout this stuff and we did a workup. BP is moderate it runs high during anxiety attacks but when I am clam it's not bad it's like 120/82 last time I had it checked it was 123/78. Total Cholesterol is fine it's like 170 Blood Sugar is like 93 my BP has been getting better and better as I have been excircizing when I started I'd get reading like 143/89 so I am really proud of myself. My Dr says it's really pretty silly for me to worry about my heart since I am doing well at taking good care of it and with the acitivty I do he says even if I had minor cardiovascular disease I'd be terribly fatigued. Yet the symptoms and my anxiety about them presist. My dad is 61 has BP that is under control by meds and my mom is in top shape and she is 56. My maternal grandfather died of a heart attack at 45 but he had malaria in the war and was a chain smoker and drinker my mothers brother also died of a heart attack at 58 but he had type 1 diabetes.

Could my anxiety be causing all of this? I do get the ocasional panic attack I had one a few night ago at bout 2am got up out of bed and it freaked me out good ole heart racing my shoulder were tight but no tightness or pain in chest. and of course it all went away like panic attacks do.

30 is way too young to be worrying about something like angina isn't it? Especually with the tests I've had done and the excircize I do? I guess mostly I am looking for some peace of mind here I am sorry if I am a bother. EKG's have been done once even during a panic attack and they've come back strong and good. MY Dr always comments when he listens to my heart "man you got a strong heart it sounds good" How do I stop worrying bout all this stuff so I can just enjoy life?

Thanks for your time
M
 John Kenyon, CNA - Sat Sep 13, 2008 8:38 pm

User avatar Hello -

First, you shouldn't feel like a "dork" for bringing this up. The prospect of heart disease at any age is quite frightening and can produce a lot of anxiety. What offsets the obesity issue (which could cause early coronary artery disease in some people) is the fact that a) you tolerate significant exercise very well and b) you've had EKGs which show no indication of heart disease. These are very promising findings. The thing your doctor could (and probably should) do, both for your peace of mind and to be relatively certain his assessment of your cardiovascular health is correct would be to subject you to a stress test, preferably with nuclear scan. The latter may not be practical, given your current weight, but even a plain stress test without the nuc scan should help verify the soundness of your heart.

I would congratulate you on your excellent weight loss progress and urge you to keep on working hard on that, and to also say Good job on the excellent exercise program. As for the symptoms, while they are atypical for heart disease, that alone isn't going to make your concern go away. You apparently suffer from panic disorder (or at least occasional panic attacks) and this always complicates the issue. The discomfort you're feeling is very likely due to a combination of tension due to chronic anxiety which occasionally crescendos in a panic attack, and you have also undertaken a lot of physical challenges which would involve the upper body's musculature, so the odds are that these are the reasons for the back and chest discomfort. Awareness of these sensations is always heightened in the anxious patient anyway, which leads to a vicious cycle of concern, anxiety, and eventually panic.

I certainly hope this has been helpful. Keep on doing your terrific job of taking care of your body. You're highly motivated and on your way to really excellent health. Best of luck to you and please stay in touch with us here.
It sounds like you're doing everything right, but if you really want to proceed with an easy mind, I think a negative stress test should really help put your mind at ease. Other than that, learning to quiet one's self, practicing meditation, relaxation techniques, etc., are often quite helpful in breaking the anxiety-panic cycle. Just bear in mind that wanting to not think about worrisome symptoms means not thinking about not thinking about them! That's quite a trick, but it can be learned.
 findingbliss - Sat Oct 18, 2008 4:23 pm

Hello I thought I would check back in. I'm down to about 315 losing weight very slowly partially because of changes at work I went through a department change and went through changing and the schedule didn't allow me to walk like I wanted to for the last few weeks but am getting back into it now. Can walk a mile or more at one time with no shortness of breth and no chest type pains. Most of the aches and pains I feel(as discribed in privious post) occur when seated perhaps to bad posture leaning forward abdoment pressing against chest a bit. A Chiropractor I am seeing thinks I coud have Hiatal Hernia which from my own study could explain pretty much every symptom that I have except tightness in left shoulder and back ache below shoulders. The pain is never ever enough that it stops me from moving around but it is noticble enoughto make me go "hmmmm what's going on" the symptoms never worsen but they presist. The Chiropractor used AK muscle testing tocome up with her hiatial hernia theory and where I don't know if I completly trust in the use of muscle testing for diagnosis her understanding of the symptoms makes me think she could be onto something. I have not asked about stress test I am a tad bit nervous about the invasive nature of nuc test. Are there risks involved? Also would a non evasive CT Scan checking cacium images around heart be a good route to go or is that a no go I've heard some folks sware by the test and some say it's hogwash.
Oveall I feel better occassional acheyness in the chest which again always seems to resonate from somewhere else which I can usually dismiss as skelital muscular issue and it passes fairly quickly. I have ben checking my resting heart rate when I first wake up and it's usually around a 63.
Your thoughts? ANd thanks for your time as always
 John Kenyon, CNA - Sun Oct 19, 2008 7:30 pm

User avatar Regarding weight loss, you're still doing well, and slow and steady is the way to go with a deliberate, large weight reduction anyway. Just keep up the good work.

It also sounds as though you are doing well with the pain problem in general, and your hiatal hernia theory could certainly be correct, even including the symptoms you seem to feel don't "fit" that scenario. The pain can be diffuse at times. It's something worth looking into.

As for the stress test vs. CT cardioscan, the stress test yields more information about the functioning of the heart, and there is also a chemical type that can be done without the treadmill (adenosine or some similar drug is injected via IV to increase the heart rate and workload, then shut off -- it eliminates very rapidly -- when the goal is reached). This could be a third-way measure for you, although stress tests are generally safe, though by nature not utterly risk-free. Then again, living with undiagnosed heart disease is pretty risky too. Stress tests in essentially healthy populuations have awfully small risks attached. Any of the three tests would probably be better than none of them, with one of the stress-types preferable, since if the CT shows anything you're going to need to do one or another of the stress tests anyway, for the previously mentioned reason that they can yield information the CT cannot. Ultimatel, however, it's your decision.

Hope this is all helpful. Please do stay in touch.

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