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Myocarditis, arrythmia, or anxiety?
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Questions in the Cardiovascular Disease Prevention forum are answered by Dr. Lee Kirksey, associate professor at The University of Pennsylvania School of Medicine.

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Myocarditis, arrythmia, or anxiety?

Dear Doctors,
28 year old male with no H.D. history, no family history (besides high chol.), good bp and good cholesterol, I don't smoke, good health, not obese

27 Dec 11 - wake up with severe nauseua and vomitting... severe dehydration and go to E.R. Kept overnight to monitor High WBC (which dropped) and hydration level (after 5 IV bags). No fever and labs back to normal- released.

A day or two later I developed chest pains in various places around the left and left-center chest cavity.
I then visited a prompt care P.A. who took vitals, noted the 100% oxygen sat. suggested that vitals were good and my history was good. Was told my experience likely a result of the recent illness.

A few nights later the chest pains still continuing with variety, with the most consistent being along the left side of the left sternum near the pectoral muscle. After a couple of nights where I felt like I had shortness of breath returned E.R. EKG normal, b-dimer test came back neg.

Chest pains (same varied "left side") continue over days and i see Primary care. He does physical, says vitals and heart sounds normal, suggests not to worry about "atypical" chest pains based on history.

That night I developed a weird "strained" sensation in left chest that seemed to radiate to left shoulder. Ignored it based on previous medical advice. Previous chest pains have faded at this point.

The next night, I had similar sensations and returned to E.R.. EKG normal, a series of 5 tubes of blood were taken, and chest x-rays were taken. All  normal and Xanax prescription for anxiety.

3 days later (today) I visited my Primary again with "unusual feeling" in left chest. On examination, he identifies a missed 10th heart unconcerned.To be sure, orders 24 hour Holter and stress Echo for next few days.

1. Does this sound like myocarditis/pericarditis?

2. Is this new arrythmia dangerous, what is risk of sudden death cardiac arrest?

3. chance this is serious?

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