Thank you for your query at DoctorSpring.com
Kindly give complete history for me to be able to help you.
What kind of symptoms are you having exactly? What's your age and sex?
Do you have any history of heart disease/ hypertension/ diabetes?
When did the symptoms start? Are there any aggravating or relieving factors?
Awaiting your reply,
Patient replied :
No history of heart disease/hyper tension/ diabetes.
I am 21, male, only medical issues are chronic nausea and abdominal pain which has lasted for two years.
I have felt small pulses of tension in the middle of my chest a few times over the past few weeks. But today, about 4 hours ago, I started feeling light headed, fatigued, and just over all...strange? I've been working on a computer for hours, but when I would lift my head from the screen or turn, I got a quick rush of dizziness, but it is like a snap shot, lasts only 1-2 seconds.
In my chest, I started to feel like my middle chest was beating normally, but then would race for a few seconds and return to normal, or it felt as if my chest was swelling up with nervous tension then release. This sensation started to happen every 1-2 minutes for about 30 minutes. Deep breathing seems to make it worse, I took a shower and that made me feel less sluggish and fatigued. But I feel very strange. I care about my health I just don't want to go to an ER to get an EKG for them to say there is no abnormality and send me off with 1,000 dollar bill. Thanks for your help.
Thank you for your follow up.
From your complete history though it does not seem to be anything serious, but an ECG will be helpful in your case. Will it be possible for you to get an ECG?
There are two possible explanations. One is an anxiety attack. Have you been stressed about something or pressure from work?
The other possibility is an episode of postural hypotension. In this case, when a person suddenly chages his posture, like getting up from standing position, or getting up suddenly after a nap, the BP immediately falls down, due to vagal nerve, and heartbeat starts racing, to make sure the BP becomes normal again. This can happen very frequently in some people and cause distress. Though is there is no real cause of why it happens, but some people are more prone to such hypotension episodes. Over time, we need to learn what not to do to avoid getting such episodes. During a classical attack, the heartbeat gets faster, and there will be dizziness for about a couple of minutes, without a feeling of a blackout.
You need to get your BP checked, both at a normal posture and after a change of posture. ( like standing up after laying down for a period of time ).
Once you manage to get your BP checked let me know.
Patient replied :
I can get an ECG from my primary care doctor. I would agree about the posture change except for it began and persisted whilst sitting down for hours.
I can't get my blood pressure checked at the moment.
I've read a lot about silent heart attacks, and how they aren't like the classic heart attack you see in the movies.
I just wanted to make sure this wasn't the case. So you think I am safe to wait to see my Doctor vs going to the ER?
Yeah in some cases the hypotension episodes do persist.
This consult will be open for a month.
So when you do visit your primary doctor to get the ECG, you can request him to chekc your BP and let me know.
Please do not worry about silent heart attacks, those happen in chronic diabetic patients, where they have neuropathy, and because of that they won't manifest any pain, unlike general population.
You can wait but try to get it as soon as possible and upload the reports.
Try to avoid getting up quickly from sitting position, or getting up after laying down for a while. Just sit for dome time, may be change your posture a bit and then get up.
Patient replied :
I guess the best way I can describe this is,
I don't feel my heart (as in its just like normal) but every few mintues now, I will feel a harder "pump" but dead middle in the sternum and up just about an inch give or take.
Note: I have been on zofran for two years old patientand grandfather and grandmother are diabetic.
Thanks for all your help. I will see my general care doctor as soon as possible.
If you'd like I can close this out after your next response, as I'm sure my doctor can follow up from here. I just wanted to make sure I wasn't ignoring a heart attack. You read about all these horror stories, guys having silent heart attacks but not going to the ER for several hours, etc.
I still don't feel very well.
This is the last follow up reply.
However for you i would like to make an exception and keep the consult open, so please get back to me with the ECG and BP charting.
You definitely do not have a heart attack and to be very honest, postural hypotension attacks can be very distressing. So i understand what you are going through right now.
Kindly get back to me when you have the reports.