The physical results of stress

[GMayne]

I am a 20-year-old male. I am also an anxious person by nature. In the past two months, I have exhibited a variety of symptoms, from mild chest pain, to some shortness of breath, to muscle twitches and tremors. About two months ago, I had my doctor perform a physical exam, including blood tests (thyroid, fasting lipid, blood count, metabolic panel). Everything came back normal. Shortly thereafter, I had an anxiety attack and went to the ER, where they checked me out and performed an EKG and chest x-rays, more for my own reassurance than anything. Those came back normal as well.

My family, my friends, my psychiatrist, and other medical professionals all seem confident at this point that my symptoms are based on anxiety. My psychiatrist today suggested I go see a cardiologist for my own reassurance, but I really don't have the money to spend just for a third "You're perfectly fine" notice.

But again, I still have the physical stuff to a certain degree. I get palpitations just lying around the house. Sometimes I get pressure just below my ribcage, feel short of breath for a couple of seconds, and then it's over. It's strange. I don't understand it.

My questions are these:

1). Based on two doctors (my physician, the ER doctor) listening to my heart with a stethoscope, the EKG, and the chest x-rays, should this be enough to accurately state that my heart is perfectly fine?

2). My 16-year-old sister and my grandmother have both been diagnosed with benign heart murmurs in the past few months. It sounds like I don't have a murmur now, but are the odds good that I will develop one in the near future? In other words, does this symptom have a genetic basis, or is this something they were likely born with?

3). Perceived "shortness of breath" is by far my most aggravating symptom. I seem to get short of breath by just being overly aware of my breathing. The thing is, this can go on all day, getting worse when I make a mental effort to "fix" it. What would be different, if anything, if my breathing concerns were heart-related?

4). Kind of a dumb question, in a series of dumb questions. Yesterday I powerwalked for 30 minutes around the neighborhood, nonstop. I am not a medical doctor, but is it fair to assume that if I had a heart condition of some sort this would not have been possible?

5). I'm afraid that if I see a cardiologist, it won't end there. It seems like no matter what one medical professional says to me, I need to run off and see another one. Maybe from there I'd go to see a lung specialist. What would you recommend?

Thank you very much for your time.

[Bekki]

Hi there gm. I sympathize with you and your symptoms. I have also seen three different doctors, and have been in the hospital for related symptoms as yours. I am 53 years old, and I have been very aware of my heart beating just about all the time, especially when I lay down. I was very concerned because of my not-so-young age. My "hearty heart" beats pretty hard, and it keeps me awake and worried......alot!!
I feel my strong pulse mostly in my neck and hands. Then, there is the very "weird" feeling I get in my head and neck upon standing up. This is usually after I have been sitting for about an hour at a time. It seems to be related to a positional effect. (does not happen while I am sitting)
Yes, I am aware of my "rather hearty" beating all the time. I sometimes have the weird pressure in my head and neck.
My hospital tests all came back normal. The only test that DID show abnormality, was my CT scan of my neck. This showed some degenerative disc disease of my 53 year-old upper spine.
Now - it gets complicated, because my EKG's and stress tests all came back......you guessed it - - NORMAL!!which in one way is good.The bad?? Not knowing what on earth this strange malady could be! Doctor says it is due to tension and anxiety. I am beginning to accept his diagnosis. I am stressed alot, and very unhappy with my present situations in my life.
So, I just want to wish you the best. I believe that yours is probably anxiety/stressed related, also. I too..have strong emotions....(I AM afterall, a WOMAN)Strong emotions / strong heartbeat. Related??
Could be. Much luck to you, and I hope all you have is an anxiety disorder. I DO believe it is just that....anxiety!!
JUST LIKE ME!!

[anya77]

Hi,

i'm so sorry to hear what you are going through. I hope it
will help you to know, that you are not alone. Many of us went
through exactly the same thing. I had the shortness of breath,
palpitations, chest pain, numbness and tremor in my muscles
and in my head. The symptoms were terrible and i spent many
hours in hospitals and ER. Did all kinds of tests you did, the
heart, the brain was fine. They discovered that i have a heart
murmur, though, but as far as i understand it is not a problem
while i am still young. It may cause a problem, but much much
later. Moreover, successful treatment of anxiety and panic
attacks sometimes reduces the heart murmur as well, which even
more motivated me to get treatment for my condition.

The anxiety is treatable, and you can do it. One of the
important steps is to educate yourself about it, get a good
psychologist and (depending on your condition) use medications.

In my case i remember the turning point in my condition. I was
reading a book about panic attacks that my physiologist
recommended. It was explaining the process that the body
overcomes when the panic attack happens. Humans have
unconscious response to danger, by elevating the blood
pressure, increasing the pulse, increasing perspiration and
others. Everyone once in a while though gets this reaction in
the presence of no immediate danger. This is the decision
point. Some people simply ignore it, and the condition go away
unnoticed. However, some people (including me when i first got
it) try to find the danger, and since there is no immediate
danger around we start looking for the danger inside us - like
a possible heart failure or some other disease. Once we find
the danger ( even though it is not real) the reaction gets
even worse, since our body is now trying even more to escape
the danger - thus the panic attack.

Once i understood this sequence of events, i realized that i
just have to learn to cope with the initial symptoms of the
panic, and not get scared. Your psychologist can tell you some
simple mental exercises you can do in order to get distracted
and calm in these situations.

I hope this will help a little bit to you as it helped me,
however, each person is different, and you may need to find
your own explanations and your own coping methods with panic
attacks.

Good luck to you, I'm sure you will get better!

[Roger Gould, M.D.]

Your symptoms are almost textbook perfect for anxiety, and everything you reported seems to rule out heart disease almost completely. If you have no murmur now, you probably never will. Your shortness of breath has nothing to do with the shortness of breath that comes with heart failure, which you definetly do not have.

[SNORCHY]

Anxiety and stress and bring on many scary symptoms...believe me...I've had them all!! Rule everything out for your own piece of mind, then it might be bebeficial to seek support from a therapist. Hope you are feeling better.

[ABCMomof3]

I'm sorry you feel this way, its awful, I know. I had the breathing problem too; my mother was on life support and I would sit by her hospital bed and I couldn't help by be aware of every single breath she took and then low and behold I became aware of my own breathing and the anxiety began to take over and I became a wreck.

I got the palpitations too...........those were really yucky because sometimes it would make me catch my breath (which I thought was short already) I needed every bit of breath I could get; I lived like that for months until I finally got treatment from a pyschiatrist.

I had all sorts of tests too; my heart is fine, my brain is fine, my insides and outs are all fine too!! It was all related to anxiety and depression. I feel 100% better and you will too.

I want you to know that there is hope for you, that you really will get better, even if you think you will never get better, you will. There are lots of treatment options today, and there in no reason for you to suffer anymore. A good dr. can fix you up and make you all better. I promise.

xx

[nervousva]

Hey, sorry to hear about your condition.

From reading your write up you sound like the classic 'general anxiety' or 'panic disorder' patient.  I went through a similar drill that you are thinking through, including spending $3,000 of my own $$ for an extensive cardiologist just to let him show me i am fine, no issues and show me on some xrays where the problems would have occurred if i had a condition.

I insisted that my PCP do extensive blood work, and to rule out a phemochromotoma as well.  All negative.

Oh yeah, had them do an MRI on my head as well thinking Brain Tumor.

Bottom line:  It made me feel better to rule out the other items, and finally realize that i did in fact have panic disorder.  Once i started on a path to the right drugs, after about 4 - 5 weeks i felt normal again.

There is hope out there, but you need to satisfy your own mind that your condition is mental and not physical (a hard thing to believe when you don't feel depressed but just anxious).  

Good luck with your treatment!