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Date of last update: 10/20/2017.

Forum Name: Cardiology Symptoms

Question: chest tightness and tingling

 kln - Fri Sep 26, 2008 3:23 pm

I am a 17 year old girl with no history of any heart problems.
last week on tuesday I had my mom call 911 because I felt shortness of breath and my heart started beating very fast.
So I went to the emergency room and they did all kinds of tests such as an ekg, they tested my thyroid, a brain scan, and tested alot of my blood for clots or anything else that could be wrong and all of it came back fine with no signs of any problems. Also my blood pressure was 120/80, my pulse was fine, and breathing was really good they said.
They told me that I had a very severe anxiety attack and I have had a history of anxiety for almost 3 years untreated.
I have been under alot of stress lately due to my mom just having surgery and us in the process of moving.
And ever since i went to the emergency room ive been feeling like chest tightness and tingling and it runs into my left arm along with alittle pressure it feels on my throat.
I went to have a follow up a couple days ago and the doctor said my left shoulder was very tense and she said its my back shoulder muscle that is giving me the trouble and she put me on 500mg naproxin. I asked her if she thought it had anything to do with my heart and she said it didnt because it would have came up on my ekg and she said im too young.
I am over weight but every check up i have im very healthy.
ive just been extremely on edge lately thinking something is going to happen to me or they missed something or im dyeing because of the tightness.
i don't know how to relax and i was wondering if you think it is anxiety or if its something more serious.
I just need all the opinions i can get to calm down.
 John Kenyon, CNA - Wed Oct 01, 2008 9:50 pm

User avatar Hi there -

It's strange but true that often the last person to recognize an anxiety problem is the patient suffering from it. Since so many aspects of anxiety both affect and are affected by behaviors of the heart, this usually winds up being the center of attention during acute, unrecognized anxiety and panic disorder.

Having had an extensive workup which has ruled out every scary thing that could have otherwise accounted for your symptoms (which were classic for acute anxiety or even a panic attack), I think you can rest easy in the knowlege that your heart and other vital systems are fine.

It can be really hard to let go of the object of anxiety once we've been caused to feel as though something is wrong internally, and even really extensive and competent medical testing sometimes is insufficient to reassure the anxious patient. You're also at an age when this problem first expresses itself this way.

A panic attack commonly begins with a complete unawareness of stress or anxiety, and often the patient had been very quiet and seemingly relaxed just prior to the onset. What sometimes happens is that, subconsciously anxious, the patient has been sighing deeply (from worry, stress, etc.) and this throws off the PH balance of the body, by exhaling too much carbon dioxide, the component of air which gives the brain the message that its owner needs to breathe. What happens then, is that there is no apparent impulse to breathe, so the subject feels stifled and tries to breathe even more, which throws off yet more CO2, with the eventual result of what's called hyperventilation. During this situation the patient may feel he or she cannot get any air in at all (actually the brain is just getting the message it doesn't need any), and a full-blown panic ensues, the heart rate shoots up as adrenaline is released, tense muscles in the upper body begin to hurt or even go into spasm, causing chest pains, and hyperventilation has the odd effect of causing tingling and numbness in the face and hands, often with numbness around the mouth and in the hands and spasm in the hands. The collection of bizarre symptoms convinces the patient something horrendous is happening (heart attack, stroke, loss of mind, ect.) and, well, you know the rest.

Once this has happened there is often a tendency to allow it to happen again. Hopefully reassurance will help you to recognize this when it's starting to happen again, so that you can abort an attack on your own. Try, if this happens again, to consciously relax, breathe slowly, through your nose, and consciously release your voluntary muscles, one group at a time. Often this practice can help avoid having to resort to medication to abort or prevent the attacks. The sooner the problem is recognized, the better the chances of making this go away or at least become manageable.

It can be really tough. It's a virtual certainty you're suffering from generalized anxiety and possibly panic disorder as well. Knowing this early on can often keep it from becoming a huge disruption.

Learning to deal with life's stresses, such as your mom's surgery and especially the upcoming move (this can be a huge stressor!) is a challenge, but if one is aware of them, it becomes easier.

I hope this is helpful and that you will follow up here with us as needed. You're going to be fine, but if you can't enjoy being fine it's not much fun. Please stay in touch with us here.
 kln - Thu Oct 02, 2008 4:12 pm

thank you for responding
this made me feel so much better

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