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Forum Name: Chest symptoms

Question: Chest symptoms


 Hefaistos - Sat Jan 21, 2006 11:52 am

Hi.
Almost a year ago I had an episode of anxiety, shortness of breath and dizziness. Went to the ER and after examination and several EKGs been diagnosed with pretty much nothing (neuro-vegetative disturbances) and prescribed to take calcium and magnesium supplements. Checked with my doc and he ran blood tests which came back normal, except for a mild anemia (low Iron, magnesium and calcium levels, not too low but near-minimum). Doc prescribed iron supplements.
Gradually the sensation of not getting enough air pretty much dissapeared.
During the summer I experienced a mild sinus tachycardia (rate about 90) treated with Propranolol. Now my pulse is around 70 and I do not take any more pills for it (sometimes is rises up to 85-90 bpm, but it doesn't bother me..btw what's the normal pulse for a man of my age?).
However, I still get a permanent feeling of shortness of breath, like my lung doesn't fill normally with air or like I can't yawn right. Also my chest hurts, sometimes in the left area, sometimes in the right, near the sternum or under it. The chest hurts when pressed with my finger. Ribs are painful too. The pain is not intense and goes away for a few days, comes back for a few days in some other area in my chest. Sometimes my ankles hurt a bit and my right hand, the small bones right near my fist. Fingers at my right hand are painful at times. These pains go away quickly when applying ibuprofen or the like(spelled it right I hope) to the area. However they are back after some hours and are quite acute at times.
I have done blood tests 3 times in the last year, went to 3 different cardiologists, had echo of the heart, echo of the abdomen, neurological exam, etc. etc, everything is OK. I went to the cardiologist when I was at peak with my symptoms and nothing was found (the only mention was I have high R waves in leads V5 and V6 caused by thin chest).
I am currently taking mineral supplements and following psychological counselling since I have developped a strong fear that something is deeply wrong with me. When in session and days after I feel ok, no more symptoms.
My syptoms are generally not very intense, I feel like my fear is amplifying them somehow.
I am a 25 year old male, no heart disease or other medical condition, good health, good family health, not overweight, smoker (under 1 pack a day), not in best fittness (sitting job - programmer).
My questions are:
1. If sometimes were wrong with my heart, would it have been diagnosed yet?
2. Need I do more investigations regarding my heart/lungs?
3. Does all this look more like a psychological condition than a physical one?
Thank you for reading this message.
Bogdan
 Dr. Safaa Mahmoud - Fri Jul 07, 2006 4:51 am

User avatar Dear Hefaistos,
The symptoms you have described are more likely to be part of autonomic dysfunction, a condition in which the balance between the sympathetic and the parasympathetic nervous system is disturbed. The condition is named Dysautonomia.
Symptoms of dysautonomia include:
Inappropriate sinus tachycardia (IST) is a condition in the resting heart rate is greater than 100 beats per minute. People with IST experience also tachycardia with minimal effort that is usually accompanied with palpitations and fatigue. ECG is normal in pattern,
Panic attacks, anxiety, shortness of breath which aggravate all the other symptoms,
Fibromyalgia in which muscle pain (myalgia) that is present at rest and increases with movement, tenderness (pain when press on the affected muscles). That involves any muscles in the body and goes away then recurs in another muscle or group of muscles, etc,
Chronic fatigue syndrome (CFS) in which individuals suffer from being constantly tired and easy fatigued,
Vasovagal syncope in which persons get fainting or dizziness attacks for unknown reasons,
Irritable bowel syndrome (IBS,) abdominal pain, distension, alternating constipation and diarrhea are the main complaints,
Postural orthostatic hypotension in which Dizziness and syncope occurs on standing.
The exact underlying cause of Dysautonomias is not known however it is believed to be of hereditary origin and can be triggered by certain factors like viral infections (after cold, flu, etc), toxic exposures, or trauma (head trauma). In Chronic fatigue syndrome, it commonly happens following sore throat due to viral infection, fever, the pain starts and the muscles are felt weak.

There is no accepted general rule for the diagnosis and treatment of these conditions. However, A daily level of activity and physical exercises are very important to improve symptoms of Dysautonmia. Some vitamins and mineral supplements can help as well in some case. Sometimes anti-anxiety drugs and antidepressant or anti-inflammatory drugs are prescribed by some doctors.
I advise you to calm down and to keep on follow up with your consultant and continue on psychological counseling as you mentioned also that it helps.
Best regards,

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