Why do I have chest pain & palpitations despite normal results?
Patient's Query
Hello doctor,
I am 28 years old. Last year, while on a journey, I experienced a sharp pain on the left side of my chest accompanied by heartburn. All the passengers suggested that I get off the bus.
I consulted a local doctor who checked my blood pressure, which was 150/90. I was very anxious and felt like I was going to die. My heart rate was 140. The doctor concluded that it was acid reflux and anxiety. The next day, I visited a cardiologist who conducted various tests, including a blood test, echocardiogram, ECG, and TMT, all of which came back normal.
I achieved 99 % on the TMT and had a 67 % ejection fraction on the echo. The doctor informed me that the chest pain was due to GERD and a panic attack and suggested that I consult a psychiatrist. Again, the psychiatrist reiterated the same conclusion. Since then, I have consulted several cardiologists, and all have said the same thing. I even contacted an Icliniq cardiology specialist. They all agree that the pain is not related to my heart.
However, for the past 1.6 years, I have been consumed by the fear that I have a heart problem. The chest pain and palpitations persist, and I sweat a lot. Whenever I hear about someone dying from cardiac arrest, I feel like I am going to die too.
I cannot concentrate on my daily routines, and I feel like I am going crazy. Please help me and assure me whether my heart is healthy or if there is any issue. I still experience sharp pain in my chest and palpitations. Please, I truly need your assistance.
Please guide.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concerns.
If you have been evaluated multiple times at various levels and all cardiac evaluations turn out negative, it is unusual for you to have a cardiac reason for concern.
If you want to rule out cardiac pain, you can proceed with a stress thallium test or angiography just to assure yourself that there is nothing wrong. I think you should regularly engage in walking exercises, yoga, or meditation to help control your anxiety.
You may need beta-blockers like Bisoprolol and anxiolytics to manage your symptoms. It is possible that you will be able to withdraw from the medication after a gradual tapering period.
I hope I have addressed all of your questions and concerns. Please follow up whenever needed.
Thank you.
Patient's Query
Hello doctor,
Thank you for your response.
The doctor told me that all the tests are normal, so there is no need for angiography. However, whenever I hear about a young adult dying from cardiac arrest, I start to think that I might die too.
My heart rate will increase, I sweat a lot, and I become anxious. I also experience some sharp pain in the left side of my chest.
Please guide.
Hello,
Welcome back to icliniq.com.
It is your anxiety that is causing the increase in your heart rate. You need to treat your anxiety, which may require behavioral modification, counseling, and group discussions. For some, anti-anxiety medications may be necessary for a period of time.
Regular exercise and meditation can also help. Try it; you will be fine. Although it is tough to control our minds, it is worth the effort.
I hope I have addressed all of your questions and concerns. Please follow up whenever needed.
Thank you.
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