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Forum Name: Cardiology Symptoms

Question: Chest pain, slow heart raite, sob


 Ellie1216 - Wed Apr 01, 2009 9:52 pm

I'm 26 years old and have been having chest pains for several years now. My heart rate will suddenly drop and my chest feels 'tight' I can't breath and I don't know what to do. I've been to a doctor and he told me it was anxiety and sent me home without running any tests. I was hoping you would be able to help me understand. I am 5'6" and 98 pounds. I have always been thin and struggled to maintain a healthy weight. Nothing seems to trigger the pain, it happens at any time, even when I am sitting on a couch. There was one time that my husband said my lips were turning blue and he actually had to breath for me and that seems to ease the pain somewhat. These attacks last anywhere from 20-40 minutes but the dull pain continues for about an hour.Thank you for any information you may be able to provide
 John Kenyon, CNA - Fri Apr 10, 2009 9:05 pm

User avatar Hello --

First you need to be seen by a doctor who's interested in taking care of you. Blowing this off as anxiety without any testing or a comprehensive exam is a very bad idea. While it's possible this is anxiety based, the chances are even if it is, it's having a fairly strong effect on you at the time it happens. It doesn't sound like any of the classic anxiety-based cardiac syndromes.

You may be having episodes of ventricular bigemeny, which would seem to cut your regular heart rate roughly in half (although a monitor would pick up all the beats, but would show the beats to be closely coupled every other beat -- a benign but somtimes painful event). This could also account for the shortness of breath, since if bigemeny is timed (through luck or some odd factor) so that the premature beats fall when the pulmonary valve is closed, it makes the effectively slowed heart rate feel like the beat is very strong and also takes one's breath away. This doesn't happen every time, but in some people, depending upon the trigger, it can be a common occurrence. The beats then make the chest feel tight and almost painful, and in someone as slim as you are, this is all the more noticeable.

This is but one possibility, and while it is essentially benign, if it's even temporarily disabling it needs medical management. If it's something else (and I'm not sure what it might be, because your doctor didn't do even the simplest tests) then it needs to be identified via 12-lead EKG, possibly echoardiogram, and some blood work. All this should have been done upon your first visit. If this doctor won't take the time to make certain what's going on then you'll need to find another one who will, preferably a cardiologist, who would have a proprietary interest in solving the mystery and getting you feeling normal again. Two years of this is way too long to have to worry about what it might be.

I hope this is helpful to you. Good luck, and please follow up with us as needed.

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