Anxiety vs a Cardiac Event

Hello. I have some concern and I wanted to get your opinion.

In the last few days I have been feeling some discomfort in my chest and light headedness, and some nerve twitching in my eye (and some tingling in my hands). This is the holidays and I have traveled far to visit my disfunctional family (there is a lot of drama going on right now, so it is understandable that there is a lot of stress/strain). My question is should I just relax, pop a Xanax, and work through this? Or, do you think this is a cardiac event? I would rather not make a trip to the ER, but will if necessary.

Here is some more information that puts a little perspective to things:

1. I am 43 years old and in descent shape.
2. I have work-out routinely and have run 2-3 miles a day 3 days this week. No issues and I felt great.
3. I have been under a lot of other stress/strain other than this family stuff too.
4. In February I experienced something similar and went to the ER. The Dr's were nice, but laughed at me. They did all the tests and said my heart was strong and I was not having a heart attack. They thought it was reflux or an anxiety attack.
5. My regular doctor had me get a calcium CT scan (I hope I am calling it the right thing) to check to see if there is any plaquing in my heart or exiting vessels. Amazingly, the radiologist stated there was 0% plaquing.
6. My cholesterol is not super low, but not too high (~190). Trig's are low.

So, should I just relax and take a Xanax, or make a trip to the ER? With my history, I am wondering if a lot of this is up in my head. (but I am not an expert)

Thoughts?

[Lee Kirksey, MD]

Hello
Holidays can be stressful with the travel and family dynamics that everyone experiences. I would not venture to offer you direct advice on what could potentially be a life threatening condition. The inconvenience of a timely trip to the ER is far outweighed by the potential opportunity to save your life if indeed your discomfort were related to your heart.

I would say that you should take the opportunity to also consider how you manage stress. When stress begins to cause physical symptoms, that usually suggests that its relatively poorly controlled. And remember that everyone has it. Its a matter of how we choose to manage it. Stress does impact our health and over time can have the same impact as unhealthy behaviors like smoking and overeating

My book Your Guide to Personal Health: Building Your Personal Wellness Wheel spends a chapter describing some of the techniques for managing stress