Thank you for your query at DoctorSpring.com
The tachycardia, and the heart pounding indeed can be found in episodes of anxiety/ stress.
Since you yourself feel you're getting better, that is a good sign.
Since you're saying your fitness has dropped all of a sudden you can go for the treadmill stress test, and that will give us a better idea. Also a 2D- ECHO and stress test will be helpful. Any minor cardiac ailments will be picked up, and if both these tests come out to be normal, then there is nothing to worry about.
Chest pain will become a cause of concern, when it is associated with severe nausea, palpitations, and breathlessness. Right now it seems like you're having intermittent chest pains and palpitations due to anxiety.
But 2D ECHO with stress test is the best way to go about it. If you have the echo reports kindly share or mention the Ejection Fraction.
Patient replied :
I have done my echo at cleveland clinic (known to have the best cardiology facility in the world). I asked my doctor about a stress tests but she quickly became dissmisive after seeing my other test results. She said I have nearly impossible risk factors and a stress tests will not help with anything. This upset me, but then again she is an Internal Medicine doctor with a specializiation in heart failure so I wasn't going to be presistent on the subject.
Should I go back and ask her to do a stress test? How about a chest CT scan? When is that a viable option?
Below is my echo results from early August:
Date of service: 9/11/2014 11:39:17 AM
Age: 29 years
Primary rhythm: sinus.
Height: 175.26 cm BSA: 2.06 m²
Weight: 87.09 kg BMI: 28.4 kg/m²
Heart rate 72 bpm
Blood pressure 125/88 mmHg
Color Doppler was utilized to interrogate the cardiac valves assessed and spectral
Doppler was utilized to determine the flow velocities and pressure gradients
reported in this exam.
Value Indexed Value
Max aortic dimension 2.6 cm 1.26 cm/m²
Left atrium diameter 3.3 cm (M-Mode)
Left atrial volume 46.8 ml (Area-Length) 22.8 ml/m²
LV ID (diastole) 4.6 cm (M-Mode)
LV ID (systole) 3.3 cm (M-Mode)
IVS, leaflet tips 0.9 cm (M-Mode)
Posterior wall thickness 1.0 cm (M-Mode)
Left ventricular mass 147 g 71.3 g/m²
LV stroke volume 69 ml (2D biplane)
LV end diastolic volume 115 ml (2D biplane) 55.9 ml/m²
LV end systolic volume 46 ml (2D biplane) 22.3 ml/m²
Ejection Fraction 60 % (2D biplane)
The left ventricle is normal in size.
Left ventricular systolic function is normal.
Baseline left ventricular diastolic function is normal.
Mitral annular lateral E/e': 5.1. Mitral annular septal E/e': 7.4.
The right ventricle is normal in size.
Right ventricular systolic function is normal.
Estimated right ventricular systolic pressure is 28 mmHg consistent with normal
pulmonary artery pressures. Estimated right atrial pressure is 5 mmHg.
The left atrial cavity is normal in size.
The pulmonary venous pattern showed blunted systolic flow.
The right atrial cavity is normal in size.
Inferior Vena Cava:
The inferior vena cava appears normal measuring 1.8 cm. The vessel decreases
greater than 50 percent with inspiration.
The mitral valve leaflets are structurally normal. There is trivial mitral valve
regurgitation. The pressure half time is 60 msec. The peak mitral E/A ratio is
1.64. The average mitral E/e' ratio is 6.3. The mitral flow deceleration time is
The tricuspid valve leaflets are structurally normal. There is trivial tricuspid
There is no aortic valve regurgitation. Tricuspid aortic valve.
There is no pulmonic stenosis. There is trivial pulmonic valve regurgitation.
The visualized aorta is normal in size.
Measurements - Sinus 2.6 cm. Sinotubular junction 2.4 cm. Mid ascending aorta 2.5
The pulmonary arteries are normal.
- Exam indication: Palpitations
- The left ventricle is normal in size. Left ventricular systolic function is
normal. EF = 60 ± 5% (2D biplane) Baseline left ventricular diastolic function is
- The right ventricle is normal in size. Right ventricular systolic function is
- No prior echocardiographic exam available for comparison.
I have gone through your entire 2D ECHO report, and have reviewed it with our cardiologist in the panel too.
There is nothing wrong in your report and your heart seems to be in great shape.
Seeing this report, even i won't advocate unnecessary stress testing.
Chest CT SCAN won't reveal anything. The best diagnostic modality is always ECHO.
So safely we can heart disease has been ruled out.
So the palpitations are mostly due to your recent stress/ anxiety. Once you can overcome that, you will have no such problems. Also slight reduction in weigh will be helpful. I will advise rest for a few days.