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Suggest Treatment For Chest Tightness And Anxiety

Posted on Thu, 1 Jun 2017

Question: I have been having chest pains. They have been coming and going for a few months now . I have had several ekgs, 3 chest xrays,an mri and blood work . They cant find anything . Today i felt chest tightness and went to the er. Still nothing to be found . My chest pain feels electrial sometimes too. I am scared im gonna have a heart attack or go into cardiac arrest. What do i do

Answered by Dr. Rishu Saxena (1 hour later)

Brief Answer:
Can be a gastric or anxiety related event.

Detailed Answer:
Hi Dear,

Have noted all your details
Females have a hormone named estrogen which is a cardio protective hormone,before age of 65 a cardiac event in female is very unlikely;unless she is a smoker or she has a strong family history of cardiac disease.
As your EKG and blood work up is normal most likely its not cardiac pain.
However i would suggest you to go for two baseline tests of cardiology -
2d echo-Motion of heart will be seen.
Stress test-Functions of heart will be checked while exercising.
Both these tests combined together are more then 85% sensitive to rule out cardiac disease.
Once clearwed from cardiac side.
Consult a gastroenterologist as-

Gastritis often presents with off and on chest heaviness a ,The electrical feeling can be attributed to inflammation of nerves underlying mucosa of esophagus and gut due to gastritis or reflux of acid back into the oesophas. All these entities are treated with same class of medicines called proton pump inhibitors and antacids.
My suggestions are
Firstly don't panic

Get a echo stress test done(though cardiac event is highly unlikely yet in medical science there is no rule,any disease can present at any age ), Doctor will prescribe to you some medicines for gastritis, like proton pump inhibitors and antacid if cleared from cardiac side.

Please specify your anxiety levels?
Any history of panic attacks?
Your sleep cycle?

Waiting.
Thanks

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Rishu Saxena (29 minutes later)

Hi thank you for your reply . I am just a little uneasy because its been ongoing for several weeks now . My oxygen levels are always at 100% does that rule out any cardiac issue ?

Answered by Dr. Rishu Saxena (8 minutes later)

Brief Answer:
Follow up.

Detailed Answer:
Hello again dear,
Oxygen saturation is measured in peripheral vessels while cardiac pain originates due to blockage of coronary artery.Both of them are not at all related to each other.

As you are feeling stressed from your problem now best way is to get yourself thoroughly investigated.
The pain can either be cardiac or gastric or anxiety related.
Easiest way is to rule out each organ one after another by investigating properly.

Suggestion-
Go for stress test and echo.
A gastroenterology opinion can also be taken.

Follow up with reports.

Hope you recover soon.
Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (1 hour later)

Thank you . Ill do that . One more question . Lately im noticing when i breathe in and i have chest pain. Could that be cardiac related

Answered by Dr. Rishu Saxena (6 hours later)

Brief Answer:
Follow up answer.

Detailed Answer:
Hi again,
No i don't think pain on breathing is usually related to cardiac problem.However it can be due to costochondritis in which the cartilage joining ribs to sternum is swelled hence leading to pain on moments(inspiration).Easiest way to rule out costochondritic pain is to take Tylenol tablet(OTC)and see if pain responds to it or not.Pin responding to anti inflammatory is likely muscular.
However initially go through the tests i suggested you.

Regards.

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

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