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Hello, For The Past 6 Hours I’ve Had A Dull
Question: Hello, for the past 6 hours I’ve had a dull pain in my right chest with episodes of losing my breath. This has prevented me from being able to get any sleep. I took about 4 Tums antacid tablets to see if this is heartburn. The pain has not subsided.
I have a long history of panic disorder and severe panic attacks, so I’m used to dealing with seemingly life-threatening symptoms, but am often okay. I recently have had EKGs, echocardiograms, and a tilt table test, which all showed healthy heart function in the past month. These tests were ordered due to dizziness and fainting episodes that they attribute to changes in my medication.
My blood pressure prior to the changes was on the low side (80/50) and now my BP is on the high side (150/100). Should I be concerned about having a heart attack at 31 years old — or is this likely another manifestation of panic?
I’d rather not go to the hospital again if I don’t have to.
I have a long history of panic disorder and severe panic attacks, so I’m used to dealing with seemingly life-threatening symptoms, but am often okay. I recently have had EKGs, echocardiograms, and a tilt table test, which all showed healthy heart function in the past month. These tests were ordered due to dizziness and fainting episodes that they attribute to changes in my medication.
My blood pressure prior to the changes was on the low side (80/50) and now my BP is on the high side (150/100). Should I be concerned about having a heart attack at 31 years old — or is this likely another manifestation of panic?
I’d rather not go to the hospital again if I don’t have to.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that it is really very likely that your symptoms could be related to panic attacks.
At your age, a heart attack or coronary artery disease would be really exceptional.
For this reason, an optimization of your therapy may be needed. I would also recommend checking lithium plasma levels, in order to be sure that you are taking the right dose.
The high blood pressure could be related to increased anxiety during this situation.
A possible treatment option would be to increase the dose of clonopin up to 1mg during the night and the dose of propranolol to 40mg twice daily in order to help relieve anxiety.
If this does not help improve your situation, I would recommend performing an exercise cardiac stress test and pulmonary function tests in order to exclude a possible cardiac or lung disorder.
It is also important checking thyroid hormone levels in order to exclude possible thyroid gland dysfunction, which could mimic this clinical situation.
If the dull pain is triggered by shoulder movements, deep breathing, etc., it could be indicative of a musculo-skeletal disorder. In such case, ibuprofen would help relieve the pain.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Wishing all the best,
Dr. Ilir Sharka,Cardiologist
I would recommend as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that it is really very likely that your symptoms could be related to panic attacks.
At your age, a heart attack or coronary artery disease would be really exceptional.
For this reason, an optimization of your therapy may be needed. I would also recommend checking lithium plasma levels, in order to be sure that you are taking the right dose.
The high blood pressure could be related to increased anxiety during this situation.
A possible treatment option would be to increase the dose of clonopin up to 1mg during the night and the dose of propranolol to 40mg twice daily in order to help relieve anxiety.
If this does not help improve your situation, I would recommend performing an exercise cardiac stress test and pulmonary function tests in order to exclude a possible cardiac or lung disorder.
It is also important checking thyroid hormone levels in order to exclude possible thyroid gland dysfunction, which could mimic this clinical situation.
If the dull pain is triggered by shoulder movements, deep breathing, etc., it could be indicative of a musculo-skeletal disorder. In such case, ibuprofen would help relieve the pain.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Wishing all the best,
Dr. Ilir Sharka,Cardiologist
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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