Medical Specialty >> Cardiology

Doctors Lounge - Cardiology Answers

Back to Cardiology Answers List

If you think you may have a medical emergency, call your doctor or 911 immediately. Doctors Lounge ( does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. 

DISCLAIMER: The information provided on is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her physician. Please read our 'Terms and Conditions of Use' carefully before using this site.

Date of last update: 10/20/2017.

Forum Name: Cardiology Symptoms

Question: 22 Year Old Male/Panic attack or Heart Attact?

 zabzinda - Mon Nov 17, 2008 8:52 pm

I apologize for the length of this post, however there is a heart related question, I just want to state the facts in which I think are important and have led to my "problem":

I am a 22 year old male. I was extremely obese as a teen.. reaching the weight of 277 lbs at 6' 1" at the age of 15/16. As of today I weigh 168 lbs. Although my weight sounds encouraging, it concerns me how the weight was lost.

I'm not sure if I have been malnourished, undiagnosed diabetes, or anorexic as losing weight has been a goal for the past few years. I weighed 207 lbs this April and 7 months later I have lost 40 lbs. I must say I have made a huge change in my food choices (no fast food, rarely eat fried foods, no soda [only water, beer, and coffee], pretty much grilled chicken, salads, slimfasts, and Kashi cereal are my main diet. HOWEVER, 40 lbs lost just from eating properly doesn't sound right to me? I didn't workout at all, although I did make a career change (from sitting at a desk in a call center for 4 years; to serving tables walking at least a couple of miles per shift) which did increase my activity level a lot.

So far, I was very obese (very bad food choices), have lost a dramatic amount of weight in a short period of time (from lack of eating because of my odd schedule; although the food I do eat is of good nature) Now to the heart related question:

My lifestyle includes:
-smoking cigarettes since I was 16 (avg 3/4 a pack a day)
-smoking marijuana since I was 16 (daily, sometimes once, sometimes 10 times daily)
-chewing tobacco randomly throughout the same time
-drinking alcohol regularly, but no abusing it (as of late, about once or twice every two weeks)

About two months ago I was at home and went outside to smoke a blunt of marijuana.. I came inside and about 10 minutes passed, when I noticed (more than ever) my heart rate was incredibly fast and hard. I immediately looked online for what a "normal" heart rate should be. I noticed mine was far beyond what was listed. I immediately fell into a panic attack, thinking I was about to die, that lasted for serveral hours with full blown symptoms, until I finally was able to fall asleep when the sun came up. (I thought it was a heart attack at the time, but after researching online, I am trying to convince myself that it was indeed a panic attack)

The next day, I was weak, tired, seeing stars (which all of these symptoms, come to think of it, have happened irregularly over the past several months). The day after that, I tried to smoke marijuana again, in the morning, just to see if it would happen again, and it did. I had another panic attack. That whole day I felt terrible. Left work, came home, and just laid down all day. I was extremely achy over my entire body, had a fever, and thought I was getting the flu, but those symptoms were no longer the next morning. So it concerned me, because it wasn't the flu?

I have been suffering from depersonalization and anxiety ever since this, (2 months now) and over the same period of time, I have been experiencing random, sharp (not too intense) pains in my chest.

They occur about 2 inches to the left of my left nipple, about an inch down, and under my ribcage. There isn't any particular time that I could say it does happen, except a lot when I try to go to sleep at night, but I believe that's when my anxiety kicks in because I always think I am about to die, thinking that 2 months ago, it was in fact a heart attack. But my anxiety shouldn't trigger a sharp pain in my chest, right?

A lot of the time these pains occur, simultaneously, I feel a sharp pain in either my spleen or liver.. not sure which one, but I've tried to match it up with an organ diagram from the internet. I try to focus on these pains more, because I feel like they are less important than my chest pains (which I believe are heart related) and helps me feel comforted thinking it's something other than my heart.
I experience light-headiness, a feeling that I'm "not all there", and depressed.

Did I indeed have a heart attack, which has weakened my heart? But then, would I have been able to go right back to work like I did, and play basketball like I do? According to research it takes a couple of months to recover.

Do I have clogged arteries because of my previous life style and food choices?

Does it sound like I have diabetes because of my possible liver pains and weight loss?

I've read about Precordial Catch Syndrome (PCS), could it be that?

Could ALL of this be a cause of malnourishment in which I am lacking either some sort of blood cells, or vitamins and minerals?

I know this a very complex situation, so where do I start?

I have not seen any type of doctor, physician, cardiologist, or psychiatrist due to the fact that I have no money, nor does my job offer health insurance.

If I were to see some sort of expert, who should I see first? The last time I went to a doctor of any sort has to have been over 6-7 years ago when I had mono.

 John Kenyon, CNA - Tue Nov 18, 2008 10:33 pm

User avatar Hi there -

The lengthy but intelligent and well-written, thorough explanation of your concerns is greatly appreciated. Hopefully the somewhat shorter answer will help you feel better.

You describe a number of things which deservedly have gotten your attention, but which are, for the most part, quite benign. However, anxiety-related symptoms, in particular, can be lifestyle threatening only, which is bad enough.

First, your weight loss. You are wise and well-informed to understand the importance of rapid weight loss. However, in your case, what you describe is not especially abnormal, but is, rather, something that is easier to achieve at your relatively young age than it would be later on (and so, I must say, good job!). It is odd, but in my experience 40 pounds seems to be a watermark for intentional weight loss over a period of 4-12 months. Not 34, not 43, but 40. The number comes up with remarkable frequency. I have no scientific rationale for this, but it has been my experience that young people who have become obese or at least significantly overweight often do, by diet alone, manage to lose 40 lbs. Over the course of seven months this is, of course, an average of a little more than six per month, and admirable and healthy rate of loss. Take it for what it is and be glad you've done it early when it was still possible.

Now then: there are, as I'm sure you realize, some more lifestyle changes in order, the first of which would be the elimination of tobacco use. This is the single greatest risk factor you carry, and since you've lost the weight it may be the only remaining risk factor, but it is a significant one. I'm sure you know the story on this, so I'm not going to launch into a lecture. Do your best to lose the tobacco dependency. That's all.

The drinking sounds as though it's within reasonable limits. Only you can know this for certain, so be careful, but don't deprive yourself unless you know you have a problem. No one can be certain of this but you, so cultivating an awareness about the way you consume alcohol, as well as the reasons, will help guide your use of this substance.

The marijuana experiements have shown you that marijuana, while essentially benign (when used on occasion and not daily nor hourly) can sometimes trigger panic attacks. I'm not entirely certain why this happens, but since the THC does alter one's consciousness, I suppose "playing with the brain" can result in unwanted and unpleasant reactions as well as pleasant ones. If it doesn't agree with you, and/or if the episodes begin to happen without marijuana use, you'll have to weigh the pleasure against the pain. Panic disorder, once it becomes established, can be a real challenge to manage, and it can definitely put a huge drag on one's enjoyment of life and ability to function socially and professionally. So another thing for you to consider.

As for the pains in your chest, what you describe do not sound, in any way, like what cardiac pains feel like. On the other hand, this sort of pain, in the location you describe, is classic for anxiety and panic disorder. While "precordial catch" is an attractive term, it has no essential meaning except to describe the sort of pains you describe. Its cause is unclear, but is related most often to anxiety. It is, therefore, verbal baggage unless used to describe innocent, benign left-sided chest pain.

Depersonalization, which some people don't seem to mind, can be a very disturbing phenomenon, and again, is classic for chronic anxiety and is often a prodromal sign of a coming panic attack (or, as I personally believe may actually serve as a trigger, since many people have this phenomenon without panic, and actually seem to enjoy it, though I cannot for the life of me see anything fun about it myself).

In short, it sounds as though you are a healthy young man who has had some unhealthy habits early on, and are making excellent headway against them, but are also inclined toward anxiety and panic disorder, which may need to be addressed by a qualified professional if they begin to interfere with your normal life. Otherwise, the biggest challenge facing you right now, since you've adopted a very healthy diet, are maintaining an excellent weight, and drink only moderately, is the elimination of tobacco.

I hope this all serves to ease your mind and helps to explain what's going on. If you have any further questions or concerns please do feel free to bring them to us here. Best of health to you, congratulations on the (healthful) weight loss, and best of luck with learning to manage the anxiety problem.
 zabzinda - Wed Nov 19, 2008 3:31 pm


First off, I must thank you for my personalized response Mr. Kenyon. I couldn't believe it was that quick.. I thought it would be at least a few weeks. What a great website. Thank you again.

The response you wrote me is very encouraging. I know I have a strong mind, which unfortunately has led me to my anxiety, however I am confident my strong mind will be able to overpower my anxiety.

This was the first time I've read my post since I wrote it, because it was waiting for approval from the webmaster, and I would like to add a correction or clarification. The pain in my chest that I noted was "2 inches to the left of my left nipple", I should have stated that it is "2 inches to MY left of my left nipple" (your right if you were looking at me). Is this how you interpreted it?

Thank you again, for your encouragement and quick response. It meant a lot.
 John Kenyon, CNA - Wed Nov 19, 2008 4:04 pm

User avatar Hi again -

We do our best to stay on top of things. It can be a challenge, but we do try. You're very welcome and I'm glad the response was helpful.

As for the location of the pain, I took it exactly as you'd intended it, and again, that is classic for what we're talking about.

I'm happy to know that you have strong self-confidence and I'm sure this and your intelligence will help you get the upper hand of the anxiety problem. Best of luck to you and please stay in touch.

| Check a doctor's response to similar questions

Are you a Doctor, Pharmacist, PA or a Nurse?

Join the Doctors Lounge online medical community

  • Editorial activities: Publish, peer review, edit online articles.

  • Ask a Doctor Teams: Respond to patient questions and discuss challenging presentations with other members.

Doctors Lounge Membership Application

Tools & Services: Follow DoctorsLounge on Twitter Follow us on Twitter | RSS News | Newsletter | Contact us