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Hello This Is An Update For Dr Sharka I Am

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Posted on Sun, 9 Dec 2018
Question: Hello this is an update for dr Sharka I am still having the upper inner right sturnum pain as well as back pain no breathing problems heart rate is normal before bed sore neck and upset stomach a little bit of neasea that comes and goes so with all my recent tests and being off mertazapine for one month now can the neasea be from that ans again just would like to verify that this is not cardiac with all my symptoms above as my gp is not available till sat as always ur expertise is appreciated
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Follow up: Dr. Ilir Sharka (0 minute later)
Hello this is an update for dr Sharka I am still having the upper inner right sturnum pain as well as back pain no breathing problems heart rate is normal before bed sore neck and upset stomach a little bit of neasea that comes and goes so with all my recent tests and being off mertazapine for one month now can the neasea be from that ans again just would like to verify that this is not cardiac with all my symptoms above as my gp is not available till sat as always ur expertise is appreciated
doctor
Answered by Dr. Ilir Sharka (5 hours later)
Brief Answer:
Your symptoms are not related to the heart.

Detailed Answer:
Dear XXXXXXX

As a cardiologist I would exclude any possible cardiac issues, as your symptoms are not typical of any cardiac disorders.

In my opinion your symptoms could be related to gastro-esophageal reflux and costochondritis or fibromyalgia.

A viral infection can not be exclude either, considering the nausea.

Anyway, I recommend having some rest, using warm local packs and taking ibuprofen coupled with a PPI (omeprazole, pantoprazole, esomeprazole, etc.).

In case the nausea persists, I recommend taking Metochlopramide.

It is also necessary avoiding spicy food and coffee intake.

Regarding Mirtazapine withdrawal, I must agree that anxiety (probably related to Mirtazapine withdrawal ) may play an important role in all this clinical scenario.

For this reason, it is necessary closing your eyes, stop thinking and take some deep breaths.

It will help calm down your anxious mind.

Anyway, there is no need to perform any additional cardiac tests, because nothing serious is going on!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
Your symptoms are not related to the heart.

Detailed Answer:
Dear XXXXXXX

As a cardiologist I would exclude any possible cardiac issues, as your symptoms are not typical of any cardiac disorders.

In my opinion your symptoms could be related to gastro-esophageal reflux and costochondritis or fibromyalgia.

A viral infection can not be exclude either, considering the nausea.

Anyway, I recommend having some rest, using warm local packs and taking ibuprofen coupled with a PPI (omeprazole, pantoprazole, esomeprazole, etc.).

In case the nausea persists, I recommend taking Metochlopramide.

It is also necessary avoiding spicy food and coffee intake.

Regarding Mirtazapine withdrawal, I must agree that anxiety (probably related to Mirtazapine withdrawal ) may play an important role in all this clinical scenario.

For this reason, it is necessary closing your eyes, stop thinking and take some deep breaths.

It will help calm down your anxious mind.

Anyway, there is no need to perform any additional cardiac tests, because nothing serious is going on!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (17 minutes later)
Hi
Thank u lastly I have attached my most recent blood work to exclude cardiac
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Follow up: Dr. Ilir Sharka (0 minute later)
Hi
Thank u lastly I have attached my most recent blood work to exclude cardiac
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Dear XXXXXXX

I reviewed carefully all your blood lab test report and I am glad to confirm that they are perfectly normal:

- No signs of coronary artery disease
- No sings of infection
- Normal fasting glucose
- Normal blood electrolytes.

So, definitely you have nothing to worry about!

Just try to relax and follow the above recommendations.

Hope to have clarified some of your uncertainties!

Let me know about everything!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Dear XXXXXXX

I reviewed carefully all your blood lab test report and I am glad to confirm that they are perfectly normal:

- No signs of coronary artery disease
- No sings of infection
- Normal fasting glucose
- Normal blood electrolytes.

So, definitely you have nothing to worry about!

Just try to relax and follow the above recommendations.

Hope to have clarified some of your uncertainties!

Let me know about everything!

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (29 minutes later)
Thank u so much can I continue to exxersie then
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Follow up: Dr. Ilir Sharka (0 minute later)
Thank u so much can I continue to exxersie then
doctor
Answered by Dr. Ilir Sharka (8 minutes later)
Brief Answer:
No need for limitations!

Detailed Answer:
Yes, XXXXXXX

You can feel free to exercise as usual, because nothing serious is going on!

Your heart is OK!

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Best wishes,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
No need for limitations!

Detailed Answer:
Yes, XXXXXXX

You can feel free to exercise as usual, because nothing serious is going on!

Your heart is OK!

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Best wishes,

Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9534 Questions

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Hello This Is An Update For Dr Sharka I Am

Hello this is an update for dr Sharka I am still having the upper inner right sturnum pain as well as back pain no breathing problems heart rate is normal before bed sore neck and upset stomach a little bit of neasea that comes and goes so with all my recent tests and being off mertazapine for one month now can the neasea be from that ans again just would like to verify that this is not cardiac with all my symptoms above as my gp is not available till sat as always ur expertise is appreciated