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Forum Name: Chest symptoms

Question: Chest pain due to anxiety?


 vanilth - Sun Nov 09, 2008 3:42 pm

Hi,

I am suffering from anxiety and have a pressure on my chest in the middle where my ribcage joins together. I also have a burning/buzzing feeling on my left chest muscle.

Since I started having panic attacks 2 months ago I have been in the A&E three times thinking I'm having a heart attack and had my ECG checked everytime, nothing wrong with my heart.
I have also been to my doctors which have done bloodtest and urin and everything is fine. He prescribed me Citalopram to take but after 3 weeks the side effects was just too bad so had to stop.

After 3 weeks without Citalopram my body is getting back to normal accept from my stomach. I have a really sensitive stomach and that was one of the main reasons why I stopped with the anti depressants.

I had a really bad panic attack 3 weeks ago and it made my chest really sore on my left breast and I also had a stitch 3 cm below. Since then I have had this sore feeling in my left breast muscle and it feels like it's vibrating or buzzing. This feeling comes and goes but the last couple of days it's got worse again.

I am wondering if this burning/buzzing feeling in my chest is caused by acid reflux, inflammation in muscle or just nerves playing up? I am a bit scared that it could affect my heart in some way.
I havent been diagnosed with acid reflux but the last couple of days I've had a really bad pressure where my ribs join on the chest and it feels like it's fizzy inside and my stomach is making a lot of noises. don't get proper heartburn but have a feeling of something in my throat and alot of flem. I also have an ulcer on the side of my tongue far back that has been there for about 2 weeks.

I would be very grateful for any help.

Many thanks
 John Kenyon, CNA - Mon Nov 24, 2008 8:44 pm

User avatar Hello -

Well you've started out well by addressing the panic disorder (PD) problem. It's too bad the medication wasn't well tolerated, but there are others you could (and probably should) try. Meanwhile, we'll try to evaluated and explain the chest discomfort, etc.

People who have anxiety disorders also have, for any number of possible reasons, gastroesophageal reflux disease (GERD), as well as other stress-related GI problems (IBS, gastritis, etc.), so this may be at least part of the problem causing the disturbing sensations in your chest. However, there is something else to consider with that, and that is that anxious people tend to breathe in faulty ways as well, which can often cause chest discomfort, because it not only strains the accessory muscles (those between the ribs and at the top of the ribcage, between the shoulders and the neck), but also can irritate the cartilage between the ribs. Either of these things (or both together) can cause localized chest pain and tenderness as well as "stitches", which are usually little painful muscle spasms in the chest wall.

The buzzing sensation is something often reported also by anxious people, and while I have never yet heard anyone advance a convincing theory as to why it happens, it is clear it's benign as well.

If you'd like to try and determine if you're having some anxiety-related GI problems you might attempt a trial of one of the over the counter medications for that purpose (such as Pepcid AC, or its generic equivalent, Prilosec OTC, etc.). If the stomach symptoms are reduced or go away, all to the good. If not, after a week or two, then you can safely discontinue the trial of whatever medication you decide on.

As for the chest discomfort, there are two things you can try yourself also. One is to take an over-the-counter non-steroidal anti-inflammatory such as Advil or Aleve, but bear in mind these can irritate the stomach, which may work at cross-purposes to the other medication. Another thing, not involving medications, would be to try and take note of your breathing: whether you sigh a lot at rest, or if you feel you can't draw a full, satisfying breath. If so, you may be breathing in a faulty way, which is, again, very common in the setting of anxiety. If you find you may be doing this, try consciously breathing through your nose (or at least take note if you're sighing a lot -- you can't sigh very easily through the nose).

Most of all, though, I'd try and find another prescription medication you can tolerate, to use to control the anxiety and panic disorder. There are any number of not only antidepressants, but also benzodiazepines such as Klonopin (generic: clonazepam).

I hope this is all helpful to you. Please follow up with us as needed. Best of luck to you.
 vanilth - Thu Nov 27, 2008 5:47 pm

Thank you for taking your time to reply.

Since my posting I've been to see my doctor a couple of times. First visit I told him about my concern about acid reflux and I was prescribed som tablets to take for it. After 2 weeks of taking them I still had a bad chest discomfort. I went back to see my doctor again and he said it's all to do with the anxiety and that I should go councelling.

For weeks now I have been experiencing more or less a constant tingeling in my chest, mostly on the left side right on my breast. It feels worse if I touch and also radiates down my left arm. When the tingling is worse and I press my chest muscles it feels like they will cramp up underneath my chest. Sometimes I get a tingle inside my chest close to my lungs.I am really struggeling to understand that anxiety can cause these symptoms as it feels really awful.
Something that hit me was when you mentioned the breathing in your reply. Normally when breathing is mentioned in panic attacks/anxiety it is hyperventilation, I never thought I had that problem as I am not breathing fast. But thinking about I probably don't breath as I should. Alot of the time, probably more often than I am aware of I stop breathing as I am scared of the pain in my chest. So from now on I am going to practice more on my breathing and hopefully that will help me with my chest pain.

Another thing I wanted to mention is that this feeling of muscle cramps on my chest has more or less been with me since my panic attacks started. I used to go to the gym 2 times a week and often lift weights to to build up my chest and arms. Could this be something muscular or even a trapped nerve?
There is also a muscle in my neck on the right side that has been sore for 3-4 months that wont go away. But I do work in an office and sit in front of a computer all day so my neck doesn't get that much rest.
I noticed a week ago that there must be trapped nerve in my tailbone as when I pull to the right it hurts.
don't really know where to turn now as I have had 3 doctors telling me it is anxiety but to me it feels like as soon as I mention anxiety they settle with that explanation and don't want to do any further investigation.

I would be grateful for any help.

Vanilth
 John Kenyon, CNA - Thu Nov 27, 2008 8:47 pm

User avatar Hi Vanith -

I think you've pinned down the two possible causes of your chest discomfort in this followup post. While it definitely can be caused by anxiety-related faulty breathing, what you describe also could be due to a secondary (or even unrelated) problem with a nerve being impinged upon (anxiety could have caused this through the mechanics of breathing or it's possible it could be a coincidental repetitive movement/postural injury, likely due to your work).

It is very true -- strangely so -- that anxious patients are often unable to recognize when they are breathing in a faulty manner, which is why hyperventilation can sneak up on one so stealthily. Strange, but true. So it's good you're willing to look at that possibility.

If you can elicit pain or tingling or other discomfort via manual pressure on your chest, then you have either a pinched nerve or inflammation in one or more of the costochondral spaces (between the ribs, where they connect to the sternum). While in no case is this related to the heart, it may well be an actual physical issue, whether it is the result of faulty breathing, posture in front of the computer (a common cause) or just a random case of inflammation. It may well respond to non-steroidal anti-inflammatory medication such as ibuprofin or naproxin, in which case you would notice relief and your attention would then cease to be drawn to it. Even if this doesn't work (nerve impingement often doesn't), you can know it is something relatively simple and benign, even though it is odd and annoying.

It sounds as though you are on a good path toward improving this aspect of your anxiety. Best of luck to you with that, thanks for the followup, and please do stay in touch.
 vanilth - Tue Dec 09, 2008 3:55 am

Thanks again for following up on my problem.

I have tried to focus more on my breathing and it is making me much more calm.
I've had some really good days in the behinning of last week when I almost felt normal again but after 2 days back at work it got worse again.

I have now discovered a lump about 2-3cm in diameter in my lower back that hurts when I push on it and can be moved around. Only discovered it because I was in pain after sitting down and still am. The pain in my tailbone is still with me too. Not sure what is going on there but will see my doctor about it tonight.

I am trying to relax more now as I know I have been tensing all my chest for a long period. But everytime I relax my chest I get a really bad pressure especially in the solar plexus area. This is getting me down alot at the moment as I want to relax to get rid of all this. Is this to do with the muscles as I have been tense for so long?
I also get the feeling of something pushing on organs or tissue inside my chest. I guess this must be my mind tricking me or could this happen?

I went out with a friend over the weekend and we had a bottle of white wine to drink. Had a great night but feel rubbish after and its not a hangover. Since that night it feels like a more or less constant flutter in my throat when I breath. I have checked my pulse and it is normal 80. I also have a hard time eating and feel out of breath if I do eat something. I am scared I now have got irregular heart beat or something.

Thank you again for taking your time to explain and ease my mind.

Vanilth
 bignasi13 - Sat Jan 03, 2009 10:47 am

Hey V, I HAVE YOUR CURE MUST READ!!

I had a very similer problem.. im 24, 6'4 190 I am very athletic and in immaculate shape as told by doctors lol.. so I had this breathing problem and it started causeing these same EXACT chest pains you describe i went through all the ***** you did misdiagonisis ect... I mean 1 of the doctors took an x-ray of my chest and came back to me and told me i had pneomonia, which can easily be seen in an x-ray well the next time i had a panic attack was becaseu i thought i was dying from pneomonia lol so i rushed back to the ER they watned to x ray blah blah i told them check the old X-ray im not paying for ***** more.. This was a diffrent doctor and he looked at the old x-ray taken of me an told me my lungs looked beautiful ( Mind me i smoke Marijuana every day for about 4 years now) he said there was no pneomonia so this really pissed me off becasue the other doctor blatently lied to me. don't TRUST Docs. except the one of this site he seems on point every time good job.

Ok so i have conquered my pains and breathing let me tell you as far as i know its ANXIETY 100% ok because after that 3nd visit when they finally diagnosed that it was Anxiety I have not had an attack since then maybe small eruptions but i come to terms with myself that its all in my head... it takes mental strengh, Im very strong mentally ok the reason I had my early relapses was becasue they had diagnosed me wrong and when your told you have pneomonia and you start reading about it and then Bernie Mack dies of pneomonia symptoms you start to get very scared an worried so I had my anxiety attack... so I was able to understand that my conditions were caused by my erratic thoughts.. I bet you are a very very consi0ounce thinker every little detail matters, as does every detail on your body and you begin to have fearful thoughts about all minor things like finding the small bump im sure its nothing but in your mind you might think tumor immediately and rampant thoughts of cancer death run through your mind these thoughts bring much fear and that's when you start feeling uncomfortable and the pain slowly creeps back and will intensify as long as you stay in that form of fear that something really bad is going on with your body, but if you can somehow releave yourself of the fear and be at peace with your diagnosis, that is the most important for anxiety you need to be in peace with that fact that you have anxiety and that all those odd pains are YES caused by (your mental state-thinking about bad things.. think happy think its nothing its only stress nothing is wrong with me i am strong my mental state may not be strong but that is the reason why my pains occur )..this is your cure when you have done this you will know that when you begin to feel some discomfort that it is simply all in your mind from maybe some form of stress if you can come to terms with yourself on this then your worrying an fear should go away and the result of that is no more attacks. Also its not only thoughts of cancer death blah blah it can be thoughts of any high worrying occasions that cause stress like a deadline on a paper or worrying about your kids.. it can be as simple as did i lock the front door and you can become enthralled by many thoughts of what might happen if i didn't lock the door... well V, the names Dan...... good luck
 John Kenyon, CNA - Sat Jan 03, 2009 9:23 pm

User avatar Hello Vanith -

I don't know why I didn't get the notification of your follow up post, but now that I have, I'm inclined to agree with bignasi13, at least about the likelihood that this is mostly anxiety-mediated. While the pain could still have been something minor but physical, what you've demonstrated in your most recent post is your being extremely tuned in to your body's behavior,which is classic for people with chronic anxiety. For instance, you felt that fluttering sensation in your throat (something that can happen sometimes, and can even be due to premature atrial heartbeats sometime, which, if it were that, would still be inconsequential), but then you checked your pulse and it was 80 and regular, but you're still concerned about having an irregular heartbeat.

This is part of the price one pays for living with chronic anxiety, due to the fact that it is very difficult to be subjectively aware that's what's happening. It's very impressive that bignasi13 has been able to not only recognize but manage this on his own, but he also seems to possess a "strong" personality. It's really rather unusual for a person to be able to do what he's done. The support and insights should be helpful to you (and are appreciated here), but don't hold yourself to that standard, as you could try and have difficulty with it, and then blame yourself for being "weak", and that is not the case. Most people do have a great deal of difficulty in getting the upper hand of this without outside help. There is plenty to be had, too. Not only are there excellent medications if needed, but also cognitive behavioral therapy (CBT) and relaxation techniques that can be learned, etc.

Hopefully this, along with bignasi13's excellent advice and insights, will be of help to you. Just remember there are also dedicated resources. Don't hesitate to take advantage of them.

Best of luck to you, thanks for following up, and my apologies for being so long in getting back to you. I had no idea you'd posted again.

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