Discussions By Condition: I cannot get a diagnosis.

21 Year old with constant chest discomfort

Posted In: I cannot get a diagnosis. 6 Replies
  • Posted By: MBarry
  • October 3, 2007
  • 05:52 AM

I have a discomfort in my chest that feels like my heart is pounding forcefully even when I am at rest. I can feel my heart beat radiate in my neck and arms. I first went to the doctors over two years ago. I explained of feeling pounding in my chest, like I had been running even when sitting still, skipped and irregular heartbeats, and occasional chest tightness. He first thought simply anxiety and stress (absolutely not the case). I continued to put up with it for a number of months before going back again. I had an echocardiogram, 2 week holter event monitor, chest x-ray, and all came back with nothing. I continued to deal with this most aggravating of symptoms for almost a year, noticing it peaked after physical exertion, eating, and drinking alcohol.

I was referred to an electrophysiologist who said it was simply “cardiac rhythm awareness”, that I could simply feel my heart beat in my chest more so than the average person. My PCP put me on low dose of the beta blocker nadelol, than increased it to 40mg when there was no reaction(he thought I had igh adreniline levels. I stopped after about 6 months since it did nothing. About 3 months ago I experienced severe tightening in my chest and went to the ER. They suspected a blood clot and did an EKG, CT scan, chest X-ray, Echocardiogram and blood work but still found nothing. The ER doctor prescribed 1 fill of Zanax saying it was simply anxiety. I feel these symptoms continuously and almost every day but am still told it is likely anxiety. Even the internet turns up little information on such symptoms.

My PCP recently put me on 25mg of Adenelol last week thinking a different beta blocker would work better. I have noticed no change and am beginning to lose hope. I live a healthy lifestyle: 6’2’’ 180pounds, no drug use, no caffeine or coffee, smoked for 3 years but quite 2 years ago, and have not had a sip of alcohol in over 3 months (though I was a moderate user before that, being a college student). I used to exercise regularly but it is difficult on days when the symptoms are severe. There are some cases of heart disease in my family but my PCP shows no concern. The only stress and anxiety in my life are the result of this set of circumstances, so I just can’t fathom that being the cause. Any Ideas? I could really use help my quality of life has deteriorated significantly.

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  • I have a discomfort in my chest that feels like my heart is pounding forcefully even when I am at rest. I can feel my heart beat radiate in my neck and arms. I first went to the doctors over two years ago. I explained of feeling pounding in my chest, like I had been running even when sitting still, skipped and irregular heartbeats, and occasional chest tightness. He first thought simply anxiety and stress (absolutely not the case). I continued to put up with it for a number of months before going back again. I had an echocardiogram, 2 week holter event monitor, chest x-ray, and all came back with nothing. I continued to deal with this most aggravating of symptoms for almost a year, noticing it peaked after physical exertion, eating, and drinking alcohol. I was referred to an electrophysiologist who said it was simply “cardiac rhythm awareness”, that I could simply feel my heart beat in my chest more so than the average person. My PCP put me on low dose of the beta blocker nadelol, than increased it to 40mg when there was no reaction(he thought I had igh adreniline levels. I stopped after about 6 months since it did nothing. About 3 months ago I experienced severe tightening in my chest and went to the ER. They suspected a blood clot and did an EKG, CT scan, chest X-ray, Echocardiogram and blood work but still found nothing. The ER doctor prescribed 1 fill of Zanax saying it was simply anxiety. I feel these symptoms continuously and almost every day but am still told it is likely anxiety. Even the internet turns up little information on such symptoms. My PCP recently put me on 25mg of Adenelol last week thinking a different beta blocker would work better. I have noticed no change and am beginning to lose hope. I live a healthy lifestyle: 6’2’’ 180pounds, no drug use, no caffeine or coffee, smoked for 3 years but quite 2 years ago, and have not had a sip of alcohol in over 3 months (though I was a moderate user before that, being a college student). I used to exercise regularly but it is difficult on days when the symptoms are severe. There are some cases of heart disease in my family but my PCP shows no concern. The only stress and anxiety in my life are the result of this set of circumstances, so I just can’t fathom that being the cause. Any Ideas? I could really use help my quality of life has deteriorated significantly.I have the same thing occasionally, though it's not constant. It happens a few times a month, maybe about 3-5 times or a little less, but I'm a 21 year old who has never had alcohol, cigarettes, or any kind of such lifestyle. No medical history either. Once the tightening in my chest was so bad I collapsed on my high school campus and couldn't breathe for about 20 seconds. I could swear I was having a heart attack it hurt so bad, but it eventually went down. My doctor thinks it could be asthma related so she put me on an inhaler and so far I've had less attacks.
    Anonymous 42789 Replies
    • October 3, 2007
    • 06:51 AM
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  • I assume when you had the Holter monitor, if you had an event, you would write down the date and time, and then they'd check the recording to see if there were any physiologic correlations. Did any match? I'm confused about whether your symptoms are actually physically real, or just perceived. Does your heart actually skip beats, start to race etc. and are witnessed by EKG's etc? And if they are really happening, are they then attributed to anxiety? or are they saying the events are all in your head? This is an interesting article about cardiac vs panic disorders. http://www.pslgroup.com/gpimgs/banners/psl/pe_ban_.gifCurable Heart Rhythm Disorder Can Mimic 'Panic Attack'DETROIT, March 9, 1997 -- Sinai Hospital reports a non-life threatening, but often debilitating, recurrent rapid heart rhythm produces symptoms easily confused with "panic attacks" -- a misdiagnosis made twice as frequently in women. Recognition and appropriate treatment of the cardiac disorder can eliminate panic-like symptoms in 90% of cases.These new findings are being reported in the March 10, 1997 issue of the American Medical Association journal Archives of Internal Medicine by a Wayne State University School of Medicine research team, whose senior member is Michael H. Lehmann, M.D., Clinical Associate Professor of Medicine and Director of the Arrhythmia Center at Sinai Hospital, Detroit, MI. The lead author of the article is Timothy J. Lessmeier, M.D., currently at the Heart Institute of Spokane, Spokane, WA.The researchers studied 107 patients (median age 40 years; 55% women) referred for electrophysiologic testing, a special heart catheterization procedure for rhythm problems. This test proved that the patients suffered from paroxysmal supraventricular tachycardia (PSVT) -- a recurrent, non-life threatening heart rhythm disorder (typically 150-250 beats per minute) that often stops on its own after several seconds to minutes.At the time of physician contact, however, the diagnosis of PSVT was made in only 48 (45%) of patients. Among the 59 initially unrecognized cases of PSVT, a median of 3.3 years elapsed until the proper diagnosis was made. Prior to that time, symptoms in 32 (54%) of these unrecognized cases of PSVTwere attributed (by non-psychiatric physicians) to "panic," "anxiety" or "stress" -- a diagnostic error made twice as frequently in women vs. men. In fact, 12% of patients with unrecognized PSVT sought the care of a mental health professional because of their symptoms.The potential for symptom overlap between PSVT and panic attack was striking. Of the 107 patients studied, two thirds had a PSVT episode frequency and symptom profile that met American Psychiatric Association criteria for Panic Disorder.Following the electrophysiology test, PSVT was treated either by another catheterization-like procedure designed to completely eliminate the abnormality called "radiofrequency ablation," or by medication aimed at suppressing recurrences.After a median 20 month follow-up period, 86% of patients were cured of their symptoms -- including 91% of those whose symptoms were attributed to "panic," "anxiety" or "stress."The fleeting nature and relative infrequency of PSVT episodes likely contributed to such initial misdiagnoses. Even the traditional portable 24-hour electrocardiogram recorder succeeded in catching a PSVT episode in only 9% (6 of 64) patients having this test.Far more effective, the researchers found, were "event monitors" which detected PSVT in 47% (8 of 17) patients so tested. An event monitor is a lightweight electrocardiogram recording device that is typically worn (like a beeper or wrist watch) over a 1-2 week period, and activated by the patient whenever he or she has palpitations or other symptoms.Also potentially helpful is a subtle suggestive marker of a tendency toward PSVT, called a "delta wave," which sometimes may be evident on a standard electrocardiogram. However, this diagnostically valuable clue was not initially recognized in over one third of the patients with this telltale electrocardiographic sign.The study's findings should help physicians to avoid overlooking PSVT -- a curable heart rhythm disorder -- as the basis for recurrent "panic"-like symptoms, especially in women. Research is now needed to define the proportion of patients with panic attacks actually suffering from PSVT. Except you had a holter monitor. Maybe you need to give it another try. Or, if it is a panic disorder, did the xanax help at all? Maybe some cognitive therapy would help.
    rad-skw 1605 Replies
    • October 3, 2007
    • 08:10 AM
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  • None of the medications I have taken (Nadolol, Adenelol, and the Zanax) have seemed to do anything. They did notice slight skips in beats on a few occasions about two years ago but said they were benign and harmless. It is the constant tightness in the chest that is the cause of discomfort though not the occasional skipped beats. If this discomfort I am feeling is truly anxiety than I must be extremely f*ckd in the head and need some serious anxiety or anti psychotic medication. Excuse the burst but I have become extremely frustrated as of recent (I left one of my class early today because it was bothering me so bad. The article below contains some interesting content, but fails to address that it is not my heart rate fluctuations that are the heart of the issue (ha-ha), but the feeling like I have just run a 100 meter sprint when at complete rest--not the speed but the forcefulness. If this is perceived than I might very well be schizophrenic.
    MBarry 2 Replies
    • October 4, 2007
    • 09:19 PM
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  • MBarry,I suffered from chest pains, heart palpitations, and other seemingly benign symptoms for the past 8 months. I was told these were chest wall pain symptoms and nothing to fret about. At one point, I was given Ativan through IV injection because obviously I didn't have anything but something going on in my head.Another ER doctor told, "if you have this pain again take two aspirin and go take a nap. You don't need to return here to the ER."In the past 8 months, I've been to the ER 10 times for the same thing.I finally got diagnosed this last week with pericarditis, something I wouldn't wish on my worst enemy. I had the signs and symptoms all along but no one put the pieces together. I was being seen by a primary care physician who noted the signs but still didn't do further testing with my chest pain symptom. And still to get diagnosed I had to go to the ER two days in a row! On the second day, I was admitted to the CCU with arrhythmias, tachycardia, severe sharp chest pain which nearly caused me to pass out, and a sed. rate nearly 4 times normal. For months my sed. rate was high, two times normal and no one made the connection. It's a long haul for recovery too. And I've been back to the ER once because of being under medicated. :rolleyes: I don't want to even talk about the $%^# ER doctor who sent me home the first time without pain medication and told me to take Advil or Motrin. Luckily, I had some left over Percocet from another diagnosis. If I didn't have that I would have been in the ER again that night.Apparently pericarditis can progress just like mine did with very mild symptoms and then continue to worsen. I believe the reason my symptoms stayed on an even keel was taking prescribed Aspirin Therapy as a prevention for Coronary Artery Disease. Taking that 162mg a day acted as an small enough anti-inflammatory to keep my symptoms mild.However, when I had to stop the ASA because of bleeding it was causing, only two days later after the bleeding completely stopped, I awoke with extreme, sharp pain radiating to my jaw.
    Anonymous 42789 Replies
    • October 4, 2007
    • 09:37 PM
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  • What sort of tests did you have performed? How was it finally diagnosed? The fact that this went undiagnosed for so long is not reassuring, but nonetheless why I am starting to vigorously perform my own due diligence, since I feel my young age gets my symptoms overlooked as benign. It seems strange however, that my symptoms, while fluctuating and seemingly cyclical over various time periods, has not necessarily “worsened” to any great extent since they began two years ago. Some days are worse than others, but the range of discomfort hasn’t changed much. This lets me tell myself it’s mental but my maintaining belief in my sanity still indicates otherwise.
    MBarry 2 Replies
    • October 4, 2007
    • 10:11 PM
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  • HI,My name is Ramesh and am from Dubai.I was having constant problem of skipping heart beats ,palpitation and chest discomfort.This is how i cured myself:I was constantly searching for alternative theoropy for the problem and i got SHIVAMBHU(Ancient indian theroupetic method), I.,e URINE THEOROPY.Believe me , you may laugh but it worked wonders in my case...This is what i did1. Fasting only on my urine and water for 10 days.2. Rub your skin with stale urine (you should store your urine for 7 days in separate bottle and boil the same to its 25% of quantity and rub the same on to your all parts).On 10nth day when i broke my fast i was out of my palpitation problem.Discalimer : This is to share my knowledge to cure not a must that every one should follow. If you have underlying problem like sugar and BP you should consult some URINE THEORPist(you can google them to find out).Believe me this works for more just let me know i would be happy to furnish mu id....
    Anonymous 42789 Replies Flag this Response
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