HomeAnswersCardiologychest discomfortI am having unexplained chest tightness and heart rate changes. Please help.

How to manage unexplained chest tightness and heart rate changes?


The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 11, 2023
Reviewed AtDecember 8, 2023

Patient's Query

Hi doctor,

I am a 38-year-old male with no current known medical conditions or history of heart problems. I am fit and active. Currently training for my second ultra marathon, and my diet is relatively healthy. I do not smoke. I used to drink two to four beers a week. I have previously been a heavy drinker (4 to10 standards a day for 2 to3 years, but that ended some years before). I have not consumed any alcohol for the past two to three months.

About four weeks ago, I had the flu, which included four days of 38.5 Celsius fever. I was feeling well again and commenced running easily again. This feeling lasted about five to six days. I started experiencing chest tightness that was present regardless of what I was doing. I noticed my heart rate (monitored by a chest strap heart rate monitor) was 20 to 30 BPM (beats per minute) higher while running, even at a slower pace than normal. This is also the case while walking. I am finding it more difficult than it normally is, particularly upstairs. I can always feel my heart pounding in my chest, even while resting at a 60 BPM or lower HR. I can even feel the heartbeat to the point I can count beats without using devices. I saw my general physicians, who ordered a number of tests. The three of relevance were blood pressure - 140/80 mm Hg, ECG indicating ‘Sinus Rhythm R > R in V1/V2 Incomplete Right Bundle Branch Block’, and elevated GGT (64 U/L). He was unable to hear anything with a stethoscope. He referred me to a cardiologist, but the wait time is significant. So I am looking for more of an idea of what could be the issue, whether I should avoid any running, and whether there is anything else I should avoid. I am particularly concerned about driving with my children in the car if something happens.


Welcome to icliniq.

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

So, in summary, you are fit and active but a drinker, have an issue with palpitations, have slightly raised GGT (gamma glutaymyltransferase), and have recently noted heart rate is higher than usual. Alcohol is the cause of all diseases and social evils, even if consumed in small quantities. Alcohol is a hepatotoxic, cardiotoxic, neurotoxic, genotoxic, carcinogen, and sexual life killer. Last year, the World Heart Federation has admitted that even a small quantity of alcohol is harmful to health. Alcohol causes cardiomyopathy, which results in raised heart rate and shortness of breath. This can be one of the causes of your palpitations and increased heart rate. Anxiety can also cause a raised heart rate. Fever can cause a raised heart rate. Palpitations are unusual awareness of heartbeats. It occurs when one intentionally focuses on heartbeats. Regarding raised GGT, this can also be because of alcohol. Stop drinking alcohol. Have an ultrasound abdomen, chest x-ray, and ECG (electrocardiogram) also done? Could you send me your ECG?

Also tell me, apart from GGT, how is the rest of the liver profile like bilirubin, ALT (alanine transaminase), AST (asparate aminotransferase)?

Thank you for consulting me.

You can always come back and reach me at icliniq.com

Investigations to be done

ECG, CBC, Ultrasound abdomen, X-ray chest

Patient's Query

Hi doctor,

Thank you for the reply.

Thanks, to clarify, I am not a drinker and have not drunk in two to three months. I have a history of heavy drinking but have not drunk heavily in the past 3 years. I have attached the blood and ECG results.


Welcome back to icliniq.com.

I read and understand your concern.

An incomplete right bundle branch is usually a normal finding in the ECG of many peoples. Sometimes it is secondary to lung issues like a past history of pulmonary embolism or COPD (chronic obstructive pulmonary disease). Hope that is not your case. Good to know you stopped drinking alcohol, but you have to stop it completely. Also, do not take other medicines which damage the liver, like Paracetamol, in high doses until the liver injury is excluded. To see the synthetic function of the liver, have PT/INR done. To see the liver's size and shape, have an ultrasound abdomen done.I suggest you take a vitamin E supplement like capsule Evion 400 milligrams twice a day for 15 to 30 days. The rest of the reports are fine. Regarding palpitations, get an ECG when you have palpitations to see the heart's rhythm. In between, ECG will be expected.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq


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