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What Causes Intermittent Slight Chest Pain, Fatigue, Sweating And Headache?

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Posted on Tue, 14 Jul 2015
Question: I am 37 year old male, obese, was having slight chest pain, which was on and off, not very severe for last 10 days, was feeling fatigued and low on energy, even doing minor work, I was sweating in cold weather also. The only problem I have is migraine headache, which has become very frequent these days. I also had asthma as a child until 10 years of age. I underwent some blood work recently and the following were abnormal, please advise what could be my problem and future course of action:

HsCRP          1.39     (1.00 - 3.00 - Average Risk)
Homocysteine     50.5     (Normal <30)
Folic Acid     2.7     (normal > 5.38)
BUN          7.76     (normal 7.9 to 20)
serum globulin     2.3     (normal 2.50 to 3.40)
vitamin D     8.11     (deficiency <20)
doctor
Answered by Dr. Riyanka Chail (2 hours later)
Brief Answer:
Kindly visit a cardiologist for cardiac function tests

Detailed Answer:

Hello Sir,
Thanks for writing in to us at HCM.
I am Dr.Riyanka glad to be helping you with your query.

I have gone through your complaints.
The C reactive Protein level indicate inflammation in atreteries thus correlating to the future risk of cardiovascular events.
Since even the homocysteine levels are increased it shows increased risk for coronary artery diseases.

Since the folic acid levels are lesser and so is the vitamin D level ,
supplements such as :
1. Multivitamin Tablet containing vitamin B6, B12 ,folic acid- one tablet per day may be useful for three months. Also increase the consumption of green leafy vegetables and fruits in your diet.

2. Tablet (calcitriol (Vitamin D), Calcium Carbonate) one tablet per day for 4 months. consume foods rich in calcium- fish, skimmed milk and its products.

Since you are obese, i would like to suggest that kindly exercise regulary. do brisk walking everyday twice for atleast 45minutes. Opt for healthy diet rich in fibres. Cut down on fats and carbohydrates. Eat whole wheat rotis . Reduce rice intake. Consume other cereals lie oats and ragi.

Also, the most important thing is kindly consult a cardiologist and get the below mentioned tests done:
1. ECG - to know the electrical activity of the heart.
2.Echocardiography - to know the mechanical activity of the heart.
3. Lipid profile - If found higher , you will be put on cholesterol lowering medications to reduce the risk of cardiovascular events.
4.Liver Function tests.

Donot worry about BUN and Serum globulin levels as they are little lesser than normal .

For the migraine kindly take a painkiller paracetamol 650mg as it is the safest medication. Since you have been getting headaches kindly get your blood pressure checked regularly, it could be due to high BP.You may need antihypertensives.

Hope this answers your query .
Please feel free to write back to us.

Regards,
Dr.Riyanka
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Riyanka Chail (12 minutes later)
Thank you for your quick response, here are few more points, I would like to add, my iron studies are normal, my lipid profile values are also within normal range, but are at the high normal range (example total cholesterol is 178 range is 125-200), but the following were also abnormal, i got this report separately, so could not share these previously:

monocytes (absolute count)     0.14     0.20-1.00
basophils (absolute count)     0.01     0.02-0.10
total rbc               5.62     4.5-5.5
MCHC                    30.8     31.5-34.5
RDW-SD                    48.5     39-46
RDW-CV                    14.2     11.6-14

My doubt is am at risk for heart attack or is there any other issue?
doctor
Answered by Dr. Riyanka Chail (19 hours later)
Brief Answer:
Cardiovascular causes of chest pain and sweating need to be investigated

Detailed Answer:
Hello Sir,
Thank you very much for writing back to us.

I understand your anxiousness regarding your health.

The above readings of monocyte count, basophils and Rbc count is just little deviated from normal range, thus it is not significant. The Red cell distribution width (RDW -SD, CV) is also ok.

Since your cholesterol levels are high normal, I think controlling your diet and adopting a healthy lifestyle shall help you bring the levels back to normal range.

About your doubt of risk for heart attack:

1. Since you are obese , so there are chances of coronary artery diseases if you dont control your diet. Therefore kindly bring down your weight in a healthy way by brisk walking and eating healthy fibrous rich diet.

2. You have been complaining of slight chest pain and sweating hence an ECG and Echocardiography is a must to exclude any cardiovascular causes of the same.

3. Get your B.P checked regularly since you have been having recurrent headaches. Hypertension is also known as a risk factor for heart diseases.

Hope your query has been answered.
Take care.

Regards,
Dr.Riyanka
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Riyanka Chail

General & Family Physician

Practicing since :2009

Answered : 818 Questions

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What Causes Intermittent Slight Chest Pain, Fatigue, Sweating And Headache?

Brief Answer: Kindly visit a cardiologist for cardiac function tests Detailed Answer: Hello Sir, Thanks for writing in to us at HCM. I am Dr.Riyanka glad to be helping you with your query. I have gone through your complaints. The C reactive Protein level indicate inflammation in atreteries thus correlating to the future risk of cardiovascular events. Since even the homocysteine levels are increased it shows increased risk for coronary artery diseases. Since the folic acid levels are lesser and so is the vitamin D level , supplements such as : 1. Multivitamin Tablet containing vitamin B6, B12 ,folic acid- one tablet per day may be useful for three months. Also increase the consumption of green leafy vegetables and fruits in your diet. 2. Tablet (calcitriol (Vitamin D), Calcium Carbonate) one tablet per day for 4 months. consume foods rich in calcium- fish, skimmed milk and its products. Since you are obese, i would like to suggest that kindly exercise regulary. do brisk walking everyday twice for atleast 45minutes. Opt for healthy diet rich in fibres. Cut down on fats and carbohydrates. Eat whole wheat rotis . Reduce rice intake. Consume other cereals lie oats and ragi. Also, the most important thing is kindly consult a cardiologist and get the below mentioned tests done: 1. ECG - to know the electrical activity of the heart. 2.Echocardiography - to know the mechanical activity of the heart. 3. Lipid profile - If found higher , you will be put on cholesterol lowering medications to reduce the risk of cardiovascular events. 4.Liver Function tests. Donot worry about BUN and Serum globulin levels as they are little lesser than normal . For the migraine kindly take a painkiller paracetamol 650mg as it is the safest medication. Since you have been getting headaches kindly get your blood pressure checked regularly, it could be due to high BP.You may need antihypertensives. Hope this answers your query . Please feel free to write back to us. Regards, Dr.Riyanka