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Need for NUCLEAR STRESS TEST after normal STRESS TEST.

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Hello, I had an ekg and a stress test last week and now my doctor is ordering a nuclear stress test. My stress test came back normal but the doctor said there was an irregularity on the ekg so he wants a closer look.

I sometimes have a pain under my left bicep. I'am 26 years old patientold and have normal blood pressure, dont smoke, or have diabetes or have a family history of heart disease, although iam about 50 pounds overweight. I drink alcohol occasionally. Sometimes i have chest pain which is sharp and usually on my left side.

I'am also extremely light headed which has become worse since the doctor ordered my test i believe due to stress and anxiety but iam not sure. I have been light headed nearly all day for the last 5 days or so.


Category: Family Physician-GP

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Category: Family Physician-GP
Dr. Mayank Bhargava is online now

Expert:  Dr. Mayank Bhargava replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

Since you had a normal no ischemia related changes in the EKG and stress test the left sided chest pain is definitely not due to a heart problem. Same should be the case with light headiness. It could be from anxiety, stress or something totally unrelated. You do not have multiple major risk factors and your age is also in favour. So at this point you can be relaxed and be sure that there is no major issue with your heart.

Did you Doctor reveal what kind of irregularity you have in the EKG ? Do you happen to have a copy of the EKG ? If so please share. Many individuals have minor EKG variations which are not significant. This could be something like this. Upto 1 out 10 EKGs can have artefacts or minor non significant changes. Were you suggested any followup ECG or medications ?

Regards


Patient replied :

I was not prescribed any medications, and i dont know what an ecg is. Sometimes when my heart beats my left arm hurts. Iam fearing the worst. Sometimes my chest pain is sharp and sometimes it is generalized.


Expert:  Dr. Mayank Bhargava replied 3 Days.

Hello,
With a normal EKG, stress test and nuclear study I do not think that you have any major structural or functional heart disease. The arm pain and the chest pain is unlikey from the heart. It could be a musculoskeletal problem or from anxiety. Stress, anxiety and being over occupied with thoughts of heart disease is know to produce these kind of symptoms. For the time being you can take a pain medication like Ibuprofen 400mg twice a day if the chest pain is troubling you.
If you are on treatment of the depression and schizoactive disorder, please do continue. Hope you are on proper followup and review. Anxiolytics can be considered if this pain is worrying you too much. Keep yourself occupied. Let me know how this evolves. Do keep me posted.
I do not think your require any further followup for your heart.
Regards


Patient replied :

I have seen the cardiologist and as it turns out my heart is fine. However, the lightheadedness has continued and i went to see an express doctor and they said i had an ear infection. However, I also have a weird sensation on the top of my head. Could this be due to the ear infection? I'am thinking i have a brain tumor.


Expert:  Dr. Mayank Bhargava replied 2 Days.

Yes your heart is fine and i also told you the same earlier.
The light headedness can definitely be due to the ear infection, and it is very important that you localise where exactly is the infection and start appropriate treatment, because ear infections can lead to blockage in the eustachian tube, leading to headache, light headedness, vertigo ( e.t.c ). So the weird sensation you say you have been experiencing can mostly be attributed to the ear infection that your express doctor diagnosed.
Please do not be worried about brain tumor. You're too young for that.
If you unnecessarily get stressed about that, your light headnedness will persist.
I am you doctor and your health is my priority. If i feel something is wrong from your history, i will right away advise you what needs to be done. Right now you should relax, since your heart is fine and take appropriate treatment in consultation with an ENT specialist.
Regards.


Patient replied :

OK thank you doctor. Is it weird if my weird sensation on the top of my head does not get worse when i bend over? Can you please explain a little more fully how I'am too young to have a brain tumor because I know st. Jude hospital specializes in cancer in children and they're younger than me.


Expert:  Dr. Mayank Bhargava replied 1 Day.

Hello,
I have reviewed your entire history and i found nothing suggestive of brain tumor.
Yes definitely there are children suffering from astrocytoma and other malignant childhood tumors. But they have symptoms such as excessive persistent headache, epistaxis, unconciuousness, loss of weight ( unexplained ), anemia and other symptoms. Since you do not have those symptoms, brain tumor is not a diagnosis that comes up in what we need to rule out. In your case an ear infection has already been established and it explains why you're feeling light headed.
I am trying to reduce your anxiety because it is detrimental towards your health from such an young age.
But if you are still worried about a brain tumor, you can get a CT SCAN done, becaue it will provide a conclusive result and that will erase all the anxiety from your mind.
There is no relationship between bending over and the weird sensation. However it is extremely critical you take the appropriate antibiotics because ear infections can lead to sinus infections, which can further lead to throat infection, since all of them are connected.
Regards.


Dr. Mayank Bhargava
Category: Family Physician-GP
Experience: 
Fellowship: Gastroenterology, Chotiram Hospital & Research centre, Indore, 2009
Residency: General Medicine, Rajasthan University Jaipur, 2008
Medical School:  MBBS, Rajasthan University Jaipur, 2004
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