Dr. Isaac Gana
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
For two years now, I have been experiencing a fast heart rate of 130 beats per minute four times a day, and also these little flicks in my chest. I have seen a cardiologist who said I had left posterior hemiblock and PVC. Fast forward to the last four months, I have the most severe chest pain that is burning and squeezing in my left breast. I have underarm pain as well. I also have pain in my jaw and a burning right shoulder, and these little flicks or even spasm. I have been having tachycardia five times a day, and the pain is so bad sometimes I am bedridden. I went to a doctor, and she said they were esophagus spasms and GERD and put me on Nexium. The pain is still there, and I have seen a cardiologist who said I have PVS and sinus tachycardia, and trivial pericarditis, and he put me on Cardizem for PVC and Cholochicine trial for pericarditis. Slight improvement, but still there is severe chest pain and underarm pain. I stopped Cholochicine three weeks ago and went to ED yet severe chest pain. ST depression was found, and the doctor said that my heart is fine. I went to my GP, and she gave me Nitroglycerin, which helps sometimes, but the doctor says that it can also help with GI issues. I am at a loss, and I am so confused and lost. I would love some advice. I have a family history of heart attacks. My cholesterol was slightly high, and fine now with my diet. I do not drink and smoke five times a day. The chest X-ray, blood work, and whole abdomen ultrasound were fine, and H. Pylori was negative. I will add some reports. Please go through them and help me.
Hello,
Welcome to icliniq.com.
Sorry to hear about your health situation.
I have gone through the results of the investigation (attachments removed to protect the patient's identity). The majority of the results are normal or borderline. I do not see any changes that suggest you have a heart problem. Although your results do not show any significant abnormality, your symptoms and family history of heart attack and smoking history are a cause for concern. Please answer the following questions for a better understanding of your problem:
Revert with answers.
Regards.
Patient's Query
Hi doctor,
Thanks for the concern. I have been smoking for 15 years. Sometimes I do burp and get a bit of acid coming up. There is no pain on exertion. There is pain all day, even at rest. Pain varies sometimes. The shoulder blades hurt, and sometimes it radiates to the left-hand side, goes to the underarm, and then the right jaw.
Hello,
Welcome back to icliniq.com.
Smoking for 15 years is enough of a risk factor to predispose you to heart disease. In addition, your family history makes it worse. I suggest you do a stress cardiac MRI (magnetic resonance imaging). This is a more advanced test that will check for blockages. I suggest you speak to a GP (general practitioner) to write the test order. It is also very important that you stop smoking immediately.
I wish you a quick recovery.
Regards.
Patient's Query
Hello doctor,
Thank you. I have attached my Holter monitor results for you to check. Does this mean I have arrhythmia?
Hello,
Welcome back to icliniq.com.
I have gone through the result of the electrophysiologist report (the attachment is removed to protect the patient's identity). The result is basically normal. The report noted a few ectopic beats. These are benign findings and do not pose a threat. Are you still experiencing chest pain? What relieves the chest pain?
Revert with answers.
Kind regards.
Patient's Query
Hi doctor,
Thanks again.
Sorry, this is the second report and I am still in pain.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I have gone through the report (the attachment is removed to protect the patient's identity). The second result shows you had a period of tachycardia. Your heart rate went higher than 90 beats per minute. This is caused by ventricular ectopic beats (premature ventricular beats). This can present with fast heartbeats or dizziness. They can be triggered by coffee consumption and stress. This is usually not an issue for people with no underlying disease. This does not usually cause chest pain.
Hope this helps.
Kind regards.
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Cardiology
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