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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Chest Pain. Have Anxiety Disorder And Taken Lorazepam. Can This Be Because Of Anxiety Or Something Else?

Hi.. I am having chest pains on myleft side of chest or breast area. I have been diagnosed with general anxiaty disorderby an er doctor. they only gave me a fewpills so i only take them when I feel im having a bad attack. Im taking Lorazepam .5mg. I have been hurting for 7hours. It hurts worse when i lay face down and lift my head. Could it be an anxiaty attack Im having or something else? I am a smoker. Should I be worried? what should i do?
Tue, 10 Sep 2013
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Psychiatrist 's  Response
thank you for your query. If a patient would have come to me with your symptoms, i would have first referred him for a thorough cardiological examination and would have advised an ECG/ Echocardiogram, and a chest x ray. Only if no cause could be found even after that, I would evaluate for the presence of a generalised anxiety/ any other anxiety disorder. A diagnosis of generalised anxiety disorder requires detailed history taking and a thorough mental status examination of the patient. if GAD is diagnosed, I usually prescribe an antidepressant (like setraline/ escitalopram/ mirtazapine etc.) along with a benzodiazepine (like clonazepam/ etizolam/ lorazepam etc). I prefer tapering off the benzodiazepine over a few months, before it forms dependence. depending upon individual case, i also refer for some relaxation excercises, behavioral therapy or biofeedback.
I would suggest you should visit a cardiologist followed by a psychiatrist for the proper evaluation and management for your condition. Hope i've been able to satisfy your query. please free to contact me for any further clarifications. best of luck.
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Have Chest Pain. Have Anxiety Disorder And Taken Lorazepam. Can This Be Because Of Anxiety Or Something Else?

thank you for your query. If a patient would have come to me with your symptoms, i would have first referred him for a thorough cardiological examination and would have advised an ECG/ Echocardiogram, and a chest x ray. Only if no cause could be found even after that, I would evaluate for the presence of a generalised anxiety/ any other anxiety disorder. A diagnosis of generalised anxiety disorder requires detailed history taking and a thorough mental status examination of the patient. if GAD is diagnosed, I usually prescribe an antidepressant (like setraline/ escitalopram/ mirtazapine etc.) along with a benzodiazepine (like clonazepam/ etizolam/ lorazepam etc). I prefer tapering off the benzodiazepine over a few months, before it forms dependence. depending upon individual case, i also refer for some relaxation excercises, behavioral therapy or biofeedback. I would suggest you should visit a cardiologist followed by a psychiatrist for the proper evaluation and management for your condition. Hope i ve been able to satisfy your query. please free to contact me for any further clarifications. best of luck.