Suffering From PTSD. All Test Results Normal. Have Chest, Back And ?shoulder Pain. Reason

Posted on Sat, 15 Jun 2013

Question: I am suffering from PTSD since my husband died of a heart attack 2 years ago. I in past two years I have had a echocardiogram, a mri or cat scan (i'm not sure what it's called) of my heart and lungs, and just yesterday had a stress test. All these tests came back great and the doctors always say my heart is fine. I have also been to the hospital twice in the past 6 months as I thought I was having a heart attack. EKGs are always normal. I was so nervous during the stress test yesterday I had pains all over my chest, back and arms. All day today chest, back and shoulder pain all day. Why am I having this when I am told everything is fine. I know stress can cause alot, but this is getting ridiculous.

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

Dear patient,

Sorry about your loss. It seems that you have had very extensive workup that is negative for heart disease. For your reassurance, a good quality negative stress test predicts less than 1% chance of a heart attack within 1 year; now, from my experience in these types of cases when extensive cardiac workup continues to be negative over and over, alternative causes other than the heart are usually responsible for the pain.

Anxiety disorders, including panic attacks and PTSD can give symptoms to the patient so grave that they feel a sensation of doom when having chest discomfort. I would explore these options with your cognitive-behavioral therapy and medication (anxiolytics, antidepressants) can make a huge positive impact.

Hope that is helpful, wish you the best health.

Dr Brenes Salazar MD
Cardiology
Mayo Clinic MN

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Jorge Brenes-Salazar (8 hours later)

Thank you for your answer. I am still concerned as last night I woke up twice in a cold sweat and with pains and alot of indigestion. I was prescribe xanax to take for a few weeks but haven't started it. I thought I could control all this on my own. I also get tightness and tingling in my arms. What do you think?

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

I think you should start the medication as prescribed; it may be difficult to control just by "your will" and you could become more frustrated and worried with continued symptoms.

Many times xanax is initially prescribed and once symptoms are more stable other maintenance medications could be prescribed to decrease frequency and severity of symptoms

Hope that helps.

Best regards

Dr Brenes Salazar

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Jorge Brenes-Salazar (7 hours later)

Thank you doctor Salazar. I have also been to a rheumatologist and had much bloodwork done. Everything is normal. For the past few weeks I have had much tightness in my chest, back and shoulders--I guess all due to stress. When I try to exercise it hurts more, thus the anxiety that I am having a heart attack. I had mono many years ago and after that was told I had Epstein Barr. Do you think this tightness and pain could be due to that? Thank you for your time..I may seem a bit paranoid but I have a 13 year old autistic son that needs me..I need and want to stay alive for a long time. XXXXXXX

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

dear XXXXXXX

thanks for the reply. It would be unusual as a long-term consequence from mononucleosis to have such symptom, so other possibilities costochondritis, muscle sprain, etc might be more reasonable contributors. It seems according to what I have seen that you have a good cardiovascular health; perhaps some low grade exercise such as tai chi or pool exercises might be beneficial to continue to have good cardiovascular health. Cardiovascular health is indeed a big blessing, I encourage you to enjoy that blessing...

warm regards,

Dr Brenes Salazat

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Jorge Brenes-Salazar (2 hours later)

Dr. Brenes-Slazat: Thank you for your answers and time. I am trying to enjoy every blessing I have and I do thank God each time I hear good news. I will try to stay positive. Thank you.
Sincerely, XXXXXXX

Answered by Dr. Jorge Brenes-Salazar (1 hour later)

Best wishes to you, stay strong. I am glad you take time to look at the blessings around you.

All the best.

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

Above answer was peer-reviewed by : Dr. Vaishalee Punj