Advice on angina in 26 yr old female

[moosejuice]

I know i am lucky to get this posted again so soon. Just wanted to ask few more questions. what is the chance that a 26 yr old female with below average cholesterol and no real family histry would have heart disease with normal cardiolite, stress test holter showing pvcs and EKG showing rbbb?
I have shoulder tip pain, breathlessness with excersise but mainly lifting and a sense that my nervous system is in overdrive, feel like electric in my chest and is followed by a run of pvcs. Pain is in wrist and hand veins and you can trace pain along them where it runs into my neck and feels like somebody is pressing a finger onto my neck behind my ear.I get dizzy and feel very poorly at same time. Does this sound cardiac in nature?
Most of the time my heart feels what i can only describe as unstable...when i go upstairs i feel a sensation in my gut which increases my heartrate and give me this pain.
I have no real family hitory but was once a heavy smoker for ten yrs and i drink too much..i have lost alot of weight(about70 pounds) This started 5 yrs ago as mild pain and is now so bad i feel ill just doing simple things..my arms feel weak and shaky and just need to sit down..some days are better than others.
Do i need to pursue further testing in the cardiac field as i feel i cant go on like this?
Would i be able to get an angiogram if i requested one even if one was not indicated?
I am on Verapimil(UK)  for suspected spasms and it does nothing nifedipine makes it ten times worse, i have hundreds of atacks in a day..i was on it for Raynauds and had to discontinue it.
Thanks

[CCF-M.D.-MJM]

Hello,

Congratulations on losign the 70 lbs.  That is a very difficult thing to do.

It is very rare indeed that a 26 year old would have angina from coronary disease -- in fact, I have never seen it before.  This does not mean it doesn't happen but I say this to emphasize how rare of an occurance this would be, especially with minimal risk factors.


Do i need to pursue further testing in the cardiac field as i feel i cant go on like this?

Your symptoms do not sound cardiac in nature.  If you have a normal stress test and echo, despite the RBBB, I would not recommend any further cardiac testing.

Would i be able to get an angiogram if i requested one even if one was not indicated?

Although it is not preferred, an angiongram can be done to prove to a patient that they do not have coronary disease.  Only  pursue this if this is what it would take to convince you that you are ok from a cardiac perspective.

I am on Verapimil(UK) for suspected spasms and it does nothing nifedipine makes it ten times worse, i have hundreds of atacks in a day..i was on it for Raynauds and had to discontinue it.

If the thought is that your pains are coming from coronary spasms, calcium channel blockers and nitrates are the standard of care.  A cardiac cath or angiogram with ergotamine would help demonstrate if you have coronary spasms.  I have ordered angiograms for this reason before.

I understand that you are in tough situation and hope you find peace soon.  Good luck and thanks for posting.

[mom4cem]

Have you been tested by a neurologist for possible cervical(neck) issues that could be causing that pain? Just a thought that nerves that are being pressed on or pinched could cause numbness, pain down to your wrist, pains in the chest and neck etc.

I'm sure if you persist they will do further testing.

[mom4cem]

sorry just wanted to add, that anxiety can certainly add to this. The pain is real and the more you worry about it, and have no answers, the anxiety level goes up. Disassociated feelings can certainly be caused by anxiety and stress.

I hope you get some answers soon.

[MinnieM]

Your symptoms could  be a problem in the Thoracic Outlet area. Do a google search and see if this fits.  TOS can mimic heart problems.  Good Luck to you.

[anacyde]

If it is truly angina, and if it makes you feel any better...

My grandmother was diagnosed with angina when she was 22.  She went to 73 before having any heart trouble to speak of.  At that time she had a double bypass surgery (her 40-something sons had the surgery BEFORE her).  She is now 77 and doing wonderfully.  If your tests are looking good, try to hang in there.  If you feel it is something that needs pursued (I'm sure AlDente will tell you it is good to listen to your intuition, and he'd be right) then pursue it.

As someone else mentioned, getting your neck looked at too won't hurt.  I have some wild heart-like symptoms from my neck going out.

[Pum]

I had very similar symptoms and found it had a lot to do with blood sugar.  You say you have lost weight, are you skipping meals, are you depressed or did you try to lose weight.  I found if I raced up stairs quickly and hadn't eaten all day then I got chest pains and very light headed.  I think it's a blood sugar thing rather than angina.  Also, women can get arterial spasms.  If you are anxious or stressed then anything in your body can get so tense it spasms.  that can explain muscular aches and pains.  Relax.

[carisue]

I've read all the comments and have to say this sounds like svt or sick sinus syndrome.  The symptoms, everything you mentioned is what I went through.  It took several years to find a Dr. who would listen to me.  It was easily diagnosed.  My family Dr. sent me to a EP Dr. and the EP Dr.  had me step up on a short step (usually on the end of a medical table) and then checked my pulse as well as heart rate.  That simple.  My heart rate was up past 150 from a few steps.  If you haven't yet had a 30 day event recorder this would be my suggestion before any catherization.  Your plumbing could be perfect but the electrical could be hay wire.  Moosejuice don't give up, there is hope.  Dr. I'm surprised you didn't suggest this first.  I went undetected for heart problems and all along it was indeed my heart.  Carisue