20 years old, worried about my heart

[Mark246]

Basically, ever since Freshman year of college I've been having chest pain and little bouts of "anxiety." However, last year the pain started to become more frequent, including a fast heart beats at time, which led me to several unsuccessful trips to the E.R.. I say unsuccessful because no matter how many times I've gone to the hospital or doctor they haven't been able to tell me anything. They give me an EKG, a chest x-ray, and then send me on my way. I've also been experiencing head fuzziness/headaches and strange pains in my shoulder, left hand, left thigh,and even in my fingernails and toenails. The most disconcerting part is the pain in my nails. I've had my cholesterol levels and everything checked and there doesn't seem to be any sort of concern with my numbers. I'm wondering if anyone has had these types of symptoms before or have any idea on what they might be. All help is appreciated. Thanks. (Also, my pulse can be anywhere from the high 60's to high 80's).

[Bhupinder Kaur, MD]

Hello,
I can understand your concern but if the EKG is normal then there is little to worry about. Moreover at such a young age, chances of cardiac disease are less. Pain in the chest, left shoulder and arm can be due to a no. of causes.It may be related to nerve impingement (pinched nerve), which can originate in the neck (cervical spine). This condition called “Brachial Neuritis”, or “Brachial Neuralgia”, is due to the involvement of the group of nerves exiting from the spinal vertebrae, called the “Brachial Plexus”.

You need to get a MRI spine also done to rule out this condition which may mimic a heart condition.
I hope it helps. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Paderla Anitha, DNB]

Hi, anxiety causes an increase in the pulse rate. As all the tests done are normal, its unlikely you have angina. But angina many a times can be missed by a routine ECG. In which case, a treadmill or an exercise ECG may help. So it would be advisable to have a treadmill ECG done. If this can be ruled out, then the pain can also be due to orthopedic related causes like cervical rib, cervical spondylosis or disc prolapse. A simple x-ray will help and an orthopaedician can guide you. Good luck with your therapy. Regards.