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What Causes Chest Pain, Low Heart Rate And Numbness In Arms And Face?
Question: My son is 23 years old. We live in an area that does not have many specialist or large hospitals. He is having chest pains, low heart rate (50s lying down but jumps to upper 80s when he stands), hands, arms, and face go numb, is dizzy, nauseous, has lost 20 pounds in 6 months, feels like he is going to pass out and did the first time. He has had 6 EKGs, chest xrays, echo cardiograms, stress test (passed), tilt table test (passed), and is now wearing a monitor for 21 days. He has gotten to the point he can no longer work. Do you have any ideas as to what to do next?
Brief Answer:
get his serum vit B12 and Vit D3 level checked
Detailed Answer:
Hello,Mrs.XXXX,
I am Dr.Rajesh Teli,MD
Thanks for using HCM.
I have gone through your query.I can really understand your concern.
First of all let me assure you that since 6 EKGs,Echo,Xrays and stress test were normal he does not have heart problem leading to chest pain and these symptoms.lets wait for 21 days monitor to get information on rhythm disorder.
But we have to think for cause other than heart disease.I request you to check his Vit.B12 and Vit .D3 levels in blood ,as i have observed in many of my patients presenting like this having deficiency of these 2 vitamins.I would also request you to consider any psychological issue because of stress and anxiety.Many a times panic disorder may have similar presentation.
kindly furnish details of all other lab reports so that i can guide you better.
My best wishes,
Dr.Rajesh Teli,MD
get his serum vit B12 and Vit D3 level checked
Detailed Answer:
Hello,Mrs.XXXX,
I am Dr.Rajesh Teli,MD
Thanks for using HCM.
I have gone through your query.I can really understand your concern.
First of all let me assure you that since 6 EKGs,Echo,Xrays and stress test were normal he does not have heart problem leading to chest pain and these symptoms.lets wait for 21 days monitor to get information on rhythm disorder.
But we have to think for cause other than heart disease.I request you to check his Vit.B12 and Vit .D3 levels in blood ,as i have observed in many of my patients presenting like this having deficiency of these 2 vitamins.I would also request you to consider any psychological issue because of stress and anxiety.Many a times panic disorder may have similar presentation.
kindly furnish details of all other lab reports so that i can guide you better.
My best wishes,
Dr.Rajesh Teli,MD
Above answer was peer-reviewed by :
Dr. Yogesh D
What about POTS? Has been treated for anxiety but he has never had a panic attack. By nature he is not a person that worries. He Is not a big fan of where he works but has been there for over 4 years.
Brief Answer:
POTS may be a possibility
Detailed Answer:
Hello,
I have gone through your query.
Postural tachycardia syndrome may be suspected if there is rise of 30 beats or heart rate going above 120 after 10 min of standing without fall in blood pressure.It may be primary or secondary .It needs to be evaluated by a doctor expert in autonomic disturbances.
In many cases taking 2 to 3 litres of liquid ,increasing salt intake by 3 to 10 gram per day may be helpful .swimming may be helpful.There are many drugs tried like steroid ,beta blocker etc.
It is small fiber neuropathy. There are certain tests like QSART, which can be done in specialized institutes.
I suggest you to try few measures suggested and do let me know.
My best wishes
Dr.Teli,MD
POTS may be a possibility
Detailed Answer:
Hello,
I have gone through your query.
Postural tachycardia syndrome may be suspected if there is rise of 30 beats or heart rate going above 120 after 10 min of standing without fall in blood pressure.It may be primary or secondary .It needs to be evaluated by a doctor expert in autonomic disturbances.
In many cases taking 2 to 3 litres of liquid ,increasing salt intake by 3 to 10 gram per day may be helpful .swimming may be helpful.There are many drugs tried like steroid ,beta blocker etc.
It is small fiber neuropathy. There are certain tests like QSART, which can be done in specialized institutes.
I suggest you to try few measures suggested and do let me know.
My best wishes
Dr.Teli,MD
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you I will look into the lack of vitamins. I don't think he has been tested for that. What about Lymes Disease? We live in area with lots of ticks and he loves to work outside. Is that a possibility? We have asked for him to be tested and no one seems willing.
Brief Answer:
It may not be Lymes disease
Detailed Answer:
Hello,
Frankly speaking, I m practicing cardiologist and in our region we have no existance of Lymes.
But basically it is bacterial infection transmitted by tick bite, hence fever and constitutional symptoms should be present along with other symptoms. In absence of history of fever it seems less likely. There is a serological Lab test available and if we are not getting any other cause of his symptoms, it must be carried out as Lymes is curable with antibiotics.
My best wishes
Dr.Teli,MD
It may not be Lymes disease
Detailed Answer:
Hello,
Frankly speaking, I m practicing cardiologist and in our region we have no existance of Lymes.
But basically it is bacterial infection transmitted by tick bite, hence fever and constitutional symptoms should be present along with other symptoms. In absence of history of fever it seems less likely. There is a serological Lab test available and if we are not getting any other cause of his symptoms, it must be carried out as Lymes is curable with antibiotics.
My best wishes
Dr.Teli,MD
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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