
Suggest Treatment For Chest Pain, Dizziness,and Palpitations

I have a question about some recent tests I have done due to symptoms such as chest pain, dizziness,and palpiatations. I am a 27 year old female, non smoker, exercise regularly with no symptoms during exercise. I was born with a diaghram hernia that was surgically repaired after birth. I also have GERD and take 20 mg of Omeprezole daily and also have anxiety that I do not treat with medication. I recently had a Echo, Stress test, and Holter. I have had episodes in the past of fainiting however each time I was dehydrated. All my recent came back normal except when reading the report myself I noticed the doctor noted a "quiet midsystolic click". There is no evidence of MVP on my echo only a trace of mitral regurgitation. Do you think it is safe to say my heart is not causing these symptoms and I can stop worrying there is a cardiac issue at play here? Could my anxiety be causing my issues? I feel like these issues are stopping me from living life fully as I am scared something is going to happen. My doctor is linking all my symptoms to anxiety and gerd.
Under Reveiw of System:
Cardiax exam reveals a regular rhythm with a quiet midsystolic click but no murmur or gallop.
Below are my test results:
Holter:
Patient wore holter monitor for 24 hours. During that time she remained in a sinus rhythm throughout with a maximum heart rate of 147 bpm, a minimum heart rate of 54 bpm, and a mean heart rate of 78 bpm. The had had no ventricular or supraventricula arrhythmias. The patient had no pauses or other evidence of heart block.
Echo:
Normal sized left atrium. Normal sized left ventricle. Left ventricular systolic function is preserved. Right side chamber normal in size. Trace triscuspid regurgitation noted Trace mitral regurgitation noted.
Your cardiac profile is Ok from the reports.
Detailed Answer:
Hi
Thank you for asking HCM.
I have gone through your query. Your cardiac profile is ok. Regurgitations you have is mild and it is not compromising heart. You should have a follow up check up with your cardiologist yearly. He/She may ask you to repeat echocardiography in such intervals.
Anxiety can be the cause of variation of heart rate in holter monitor. As long as no arrhythmias you are fine. Be relaxed.
Anxiolytics and breathing exercises for relaxation will be helpful for you. Sit relaxed and take deep breaths. Small dose betablockers like metaprolol will be helpful if anxiolytics are not working.
Hope this may help you. Let me know if anything not clear.
Thanks.


Also in the past when I fainyed., I was dehydrated and has smoked marijuana, which I no longer do. Do you think that was the reason for fainting?
Can be due to a mild MVP.
Detailed Answer:
Hi
Thank you for your follow up query.
The mid systolic click can be due to a mild MVP. Such MVP are there in 25 % of population. Even i have that. That won't be evident all time. You can go for a follow up echocardiography yearly.
For such people excess coffee, drugs like marijuana or excess alcohol can cause evident symptoms and chest discomfort. So better to avoid such things.
Anxiolytics are usually given for such episodes and betablockers are given if this is not effective.
So you don't need to worry. Be relaxed and enjoy your life.
Let me know if anything not clear.I am happy to help you.
Thanks.

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