Dr. Anshul Varshney
Internal Medicine
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Patient's Query
Hi doctor,
I am 37 years old and normally take Hydrochlorothiazide for diastolic blood pressure and Zebeta for S node dysfunction. I am also on Metformin. My HbA1c is 6.1 %. Two days ago, I started experiencing dull cramping chest pain that was not continuous. I went to the ER and all the tests came back fine (chest x-ray, EKG and blood work). He did not know what was the cause for my pain. They gave me Nitro pill and Nitro paste on my chest which decreased the amount of pain. Up on release, my blood pressure was 101/55 mmHg and pulse 61 beats per minute. I had not taken my pills on the day this occurred or the last two days. It has been running around 104/63 mmHg and pulse 69 beats per minute. My diastolic BP without medicine usually runs around 95 mmHg. And my resting heart rate was 140 beats per minute before I started medicine, so this is a huge change for me. These are not new medicines either. I have attached all my test reports for your reference.
Hi,
Welcome to icliniq.com.
We are here to help you. From the way you are describing, it seems either you had an arrhythmia that time or you had angina pain. Since your blood pressure and heart rate are in normal ranges without medicines, you should avoid any medicines at this time. I would recommend for you a treadmill test that is a stress test to rule out any angina on exertion. If that comes out to be normal, then you would need to go for Holter monitoring. Take antacid drug like Omeprazole for this purpose as this would help you in fighting with acidity as a cause of chest pain. However, acidity is very unlikely to be a cause for that. I hope it helps you.
Patient's Query
Hi doctor,
I am sure it was not acidity as I have a history of GERD and ulcers before. It felt nothing like what I expected in the past. I worked a 16 hour shift and came back at 6.30 in the morning and this started at 9.30 PM. My blood pressure was 110 when I was working at 4 AM.
Hello,
Welcome back to icliniq.com.
With such a hectic issue, anxiety can also cause chest pain. However, we should be sure. So, I would recommend the tests discussed above along with anti-anxiety drugs like Etizolam for a short course. I hope it helps.
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Internal Medicine
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