What tests are needed to rule out cardiac issues in young adults?

Question

Hello doctor,

About four hours ago, I experienced sudden, severe chest pain. It felt like intense pressure, and I struggled to breathe, feeling as if I were suffocating. I tried to take deep breaths and checked my heart rate, which was 144 bpm during the episode. By three hours ago, my heart rate had decreased to 88 bpm, but I still have a lingering headache that started during the pain.

I am a 20-year-old female with asthma, and I am currently on the following medications:

Nexplanon (contraceptive implant) - Etonogestrel.
Singulair (10 mg) - Montelukast.
Breo - Fluticasone furoate and Vilanterol.
Spiriva - Tiotropium.

I am worried about whether I should go to the emergency room to get checked or if it is safe to wait. Could this episode be related to my asthma or something more serious like a cardiac issue?

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your symptoms are concerning and resemble those of a heart attack, but given your young age, the most likely possibility could be gastritis or gastroesophageal reflux disease (GERD). However, it is important that you go to the emergency room (ER) to have an electrocardiogram (ECG) done to rule out any cardiac issues.

In the meantime, here are some recommendations to help manage your symptoms:

Avoid fatty, oily, and spicy foods.
Take a walk after meals instead of resting right away.
Opt for multiple small meals throughout the day, rather than heavy meals.
Maintain regular sleep habits and try to manage stress.
Include plenty of green leafy vegetables and fruits in your diet.
Avoid smoking and alcohol, if applicable.

You can try taking Pan DSR 40 mg (Pantoprazole and Domperidone) once a day before breakfast for 2 weeks. If symptoms persist or are not sufficiently relieved, consider adding Syr Sucral O (Sucralfate) or Gelusil (Magnesium Hydroxide, Aluminium Hydroxide, and Simethicone), taking two teaspoons three times a day for a week.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.