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Forum Name: Cardiology Symptoms

Question: PVC's, Anxiety, and Chest Pain


 ChloeO - Sat Sep 13, 2008 10:44 pm

First, I am an extremely anxious person. By nature, I am a worrier. I was diagnosed with an anxiety disorder in 2005, and I'm also a hypochondriac. I'm 21 years old. I currently take Pexeva for anxiety. I also smoked for two years, but I quit a year ago. I'm overweight, but recently adopted a more healthy lifestyle. I exercise, and eat better, and I've lost 15lbs so far.

My question is I'm prone to PVC's (I assume they are PVC's because my mom gets them), I'm not very concerned about the "skipped beats" especially because since I cut caffeine out of my diet, they happen much less frequently. What I'm concerned about is a dull ache I get in my left chest above my breast. One doctor I talked with told me it was most likely muscle cramps between my ribs, or at the worse, benign chest wall pain that is brought on by stress. I get this dull ache almost daily. It is not brought on by exertion, and exercise seems to help with the ache. I have been extremely stressed recently. I have a lot of family problems, and I've noticed if I think about it, the pain gets worse. Half of me thinks it's something to do with my heart, and the other part of me thinks it's cancer or something like that. I've had a small lump on my neck for years that I've been told is harmless, it hasn't grown in size, but it is hard. Sometimes I think that it's cancer that's spread to my chest. Wow, do I sound crazy or what? I don't have insurance, or a family doctor, so going to the doctor is a little difficult.

My question is, do you think this sound cardiac in nature, or even something I should address? Or would you chalk it up to stress like most of the other people have? As I said, I'm a hypochondriac, so I sometimes make things a lot worse than they really are. Any input would be appreciated. Thank you!
 John Kenyon, CNA - Fri Oct 03, 2008 11:06 pm

User avatar Hi there -

Have you been diagnosed with hypochondria or has a medical person actually called you a hypochondriac? The reason I ask is that this is a separate condition from somatically-based anxiety, and often makes it difficult for a person to get proper care because eventually everything becomes "all in the head." Your feelings, your sensations, are real. Whether or not they are significant is what needs to be determined, and all of us have to deal with that from time to time. If you are a very anxious person at least you recognize it, and how it can cloud the picture. This still by no means should allow anyone to dismiss your symptoms out of hand.

There. I feel better about that now, as it is a sore subject with me and I hope the "hypochondriac" tag has been self-applied, because you then can probably discard that. It's enough to deal with anxiety. But let's get to your immediate concern: Your pain is a very legitimate concern, although it does sound non-cardiac in nature, based on certain things you've told us about it, as well as its location and character. Part of that involves recent stress you mention and the fact that you experience the pain when you think about "it" (either the stress or the pain -- I'm not certain which you meant, but it doesn't really matter). It could definitely be an inflammation of chest wall muscle or of the connective tissue between the upper ribs near where they connect with the breastbone. Pressing firmly on the affected area may well produce some tenderness, which almost certifies that it is inflammatory (this connective tissue inflammation is known as costochondritis or Tietz' syndrome and is harmless; it responds to over-the-counter anti-inflammatories such as Advil or Aleve). You also say the pain is not brought on by exertion, which cardiac pain would be. In fact, you say it tends to go away with exercise, which pretty much rules out any cardiac cause.

As for cancer, something no one wants and is a scary subject for many of us, keep in mind that most cancers are quite advanced before they begin to cause pain, so chronic pain with no other symptoms preceding it rarely signals a cancer problem. The knot in your neck has already been diagnosed as innocent, so I think you can safely let the cancer concern go.

You don't sound crazy, though, no. Anyone who has these symptoms and doesn't feel some concern would sound closer to crazy, unless they had a medical background. The question is a perfectly legitmate one. I'm happy to be able to tell you that with the information you've provided you've given me enough to feel very safe in telling you I don't believe you have either a heart problem or cancer (based on the current symptoms). I'm not so sure you're a hypchondriac, either. Anxious maybe, but there's a lot of that going around.

I hope this is helfpul. Please follow up with us as necessary and thanks for bringing your questions to this site.
 ChloeO - Sat Oct 04, 2008 1:56 am

Thank you for the response. It really made me feel better about all the symptoms I've been experiencing.

To clarify, though, the hypochondria term is not self applied. I was diagnosed with it when I was really young. Third grade to be exact, after years of thinking I had cancer or AIDS. It was my third grade teacher that convinced my parents to take me to the doctor. I've been in therapy for it before, but it's something I've been learning to manage myself, and of course, the Pexeva takes the edge off a bit. I was diagnosed with a panic disorder when I was 18, which the doctor said goes hand in hand with the hypochondria, which I can see, but am not sure that's the case. Anyway, off subject, I know. I tend to not want to tell doctors about my diagnosis, because instead of treating me how they would treat a "normal" patient, I feel they overlook things because they think it's "all in my head". And when I go back because I feel I was treated inadequately, it presents an even bigger problem. I've stopped going to doctors before because of this. I do admit I'm a bit annoying, as sometimes I really don't believe a doctor's diagnosis, and will look up every symptom until I find the illness that's going to for sure kill me, and then I return to the doctor. I can't help it.

But I really do appreciate the response. Thank you so much!
 John Kenyon, CNA - Sat Oct 04, 2008 2:51 pm

User avatar You're very welcome, and I'm glad my response was helpful.

Third grade (about 8 years old?) is awfully young to be tagged with a diagnosis of hypochondria, and you're wise to not mention it during most medical encounters, as it's bound to throw off the generally good detective work doctors do. I won't argue the fine points of the disorder, I'm just glad you've managed to come to terms with it.

I haven't found you annoying as yet, by the way. :)

Again, you're very welcome, I'm glad I could help, and don't hesitate to come to us with other questions you mave have.

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