Resolved question:
Hi there. I am a 27 year old female of normal weight with no immediate family history of heart disease or early cardiac death.
I have been experiencing chest pain for the last 8 weeks, sometimes as a tightness or heaviness where I feel as though I can't inhale fully and sometimes as a sharp stabbing pain. Mainly under my sternum and on the LHS of my chest but sometimes on the RHS.
I have been to A and E twice and to the GP surgery three times. All my blood test results have come back normal. I have had a chest x-ray which was normal and two ECGs which were "satisfactory".
In addition to my chest pain, I have been experiencing pain in both arms and shoulders. I have also experienced palpitations and a feeling that my pulse was irregular at times. In addition, I am far paler than usual with bluish lips on occasion and am constantly fatigued.
I have also been experiencing a twitching/ tingling sensation in my arms, chest and legs.
I have been prescribed lansoprazole to treat possible indigestion problems. This was not effective. I have also taken difene and then vimovo and xanax to treat possible musculoskeletal causes or costochondritis. Again, none of these medications have been effective.
This condition is really impacting upon my day to day life and I am concerned that there is a cardiac issue. Please help!Do you have any ideas what the problem could be and what steps should I take next?
Submitted:
4 Days
Category:
Cardiologist
Hello
Thank you for your query at DoctorSpring.com.
I understand your concern.
You are suffering from atypical chest pain and palpitations. Also you feel you are pale and cyanosed. Although you are extremely low risk to have a coronary artery disease on account of your age and history you still could get a 2D ECHO and stress test done to rule out any cardiac cause of the pain.
For palpitations I would suggest you get a 24 hour Holter done to rule out any serious arrhythmia. If you could get an EKG during the palpitations that would be as good as a Holter examination.
As far as pallor and cyanosis is concerned if your examining physician too feels that you have pallor then you could get a simple test like Hemoglobin level done. Measuring blood Oxygen saturation with a pulse oximeter would be a simple test to rule out cyanosis. I am not aware of the health care system of your country and if you can demand these tests. However, they are advisable to allay your fears and rule out a cardiac cause of these symptoms. It may be anxiety after all.
Feel free to discuss further.
Regards,
Dr Vivek Mahajan,
MD Medicine, DM Cardiology.
Thank you for your reply, Doctor.
I will ask my GP about gettin a holter fitted and having an echo done. Although I did have a 2D echo and treadmill test 6 months ago for the same problem, both were satisfactory at the time. Should the tests be repeated?
I do get a little anxious when the pain presents so perhaps some of my symptoms are anxiety related as you said.
I was just wondering if you think the problem may be something neurological due to the pain and tingling in my arms?
I have also noticed that I become short of breath when lying on my left side. My chest feels quite tight then. Would there be an obvious cause for this?
Thank you
?
Hello. Thank you for writing to us again.
Since you had an echo and tmt in the last 6 months you need not do it again. If these were within normal limits you probably do not have a cardiac etiology for your symptoms. Of course the holter will give some information whether the palpitations are due to amy arrhythmia. It could be a neurological disease if tingling and pain in limbs occur. However other symptoms cannot be explained. The chest tightness also doesnt seem cardiac. You may see a neurologist to allay your concerns. But the chest tightness and breathlessness cannot be explained by neurological etiology.
Feel free to discuss further,
Regards
Dr Vivek Mahajan