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What Causes Chest Pain While Breathing With Palpitations?

Posted on Mon, 3 Mar 2014

Question: My name is XXXX, I have quite a bit going on. I don't know if its stress, anxiety, or if it could potentially be actual heart problems. I can't tell if my body is trying to tell me something is going on or going to be. I have high anxiety, moderate to severe obstructive sleep apnea, as well as many heart conditions: Murmur, thickened mitralvalve, bicuspid aortic valve, stenosis of the aortic valve (it leaks blood as well), 4.3cm ascending aorta aneurysm, and a sinus arrhythmia. I seem to breathe heavy when I get off work, and occasional pain in my chest. My heart double beats a lot, tons of head aches/migraines, racing heart, palpitations, left arm discomfort/pain, chest pain/discomfort, and in the left side of my chest it feels warm a lot and almost like a balloon inflation. Any thoughts...?

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer: Please follow the answer below... Detailed Answer: Hi XXXXXXX I read your query very carefully. Based on the data you provided you have Aortic valve problems together with ascending aortic aneurysm. This findings are asymptomatic unless the aortic stenosis is severe or the inner wall of aorta tear (aortic aneurysm dissection). Your complaints may be more related to anxiety disorder or/and sleep apnea. However i suggest that you should follow up your cardiologic status every sixth months to measure the progression of aortic stenosis and more important progression of aortic aneurysm. I recommend to run the following exams: - ECG and 24 h ECG monitoring - ECHO - Angio CT If the diameter of the aortic aneurysm is more than 5.0 cm or a growth rate of 1 cm/year or faster is an indication for elective surgical repair. At the present you don't need to do anything just relax and don't worry to much. Hope it was of help! Dr. Benard

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (41 minutes later)

So how can i tell if its something of concern? My father passed away recently in XXXXXXX 18th, from MS and heart things such as stroke heart attack and congestive heart failure. Pneumonia too. So yes it is much stress, but how do i know when its an issue, my blood pressure gets high often. Xanax helps but my doctor doesnt approve. Also taking 25mg lopresser twice a day and taking flonase. Are these palpatations possible eptopic beats and what are the risks of those. Heart disease does run in the family but not till later in life. If this is anxiety as most suggest, what can i do to relieve symptoms? I refuse anti depressants, and am hoping for a cpap. What can i do? Also i did a 24 hour holter monitor. I had over 7000 skipped/premature beats in that 24 hour period.

Answered by Dr. Benard Shehu (12 hours later)

Brief Answer: Hi, Detailed Answer: Thanks for writing back. Sorry for the delay in my response. Any new abnormality detected in the tests I suggested above can be considered an indication of worsening of your condition. Also, it is an alert line to plan required interventions. As in case of the aneurysm if the diameter of the aortic aneurysm is more than 5.0 cm or a growth rate of 1 cm/year or faster is an indication for elective surgical repair. Anxiety can worsen the heart condition by triggering premature beats or undefined arrhythmia. I do recommend strongly that you be placed on Xanax or other variants for your anxiety. I suggest you to take a second opinion from another Psychiatrist. Palpitations or arrhythmia you are having could be a combined effect of both anxiety and preexisting heart condition. I would consider it a better option to alleviate the anxiety at the earliest.

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Above answer was peer-reviewed by : Dr. Raju A.T