Chest Pains- Heart Related?

[adriancighi]

Dear Doc,

I started having chest pains about 5 months ago. They last sometimes for hours. Sometimes it is just a dull pressure, sometimes there is a brieft stabbing pain in the heart area (it feels that somebody is stabbing my heart, or squeezing it and then letting it go).
I have had numerous test and i have seen 2 cardiologists at duke. test: ecgs, stress echo, holter monitor, crp (which came at 0.09). I even had the stress cardiac mri done. cholesterol level is 134, ldl 72. i am 27, normal weight (6'2" and 195) with no real family history of heart problems (my dad has high blood pressure and is overweight). all my tests came normal; they ony discovered a pfo. my blood pressure is 120-75.
aside from the chest pains, i had numbness and tingling of the arms (sometimes it is left, sometimes it is right). about a month before the chest pains started i got bit by a tick in nc. none of the docs here believe it is lyme disease, because "there is no lyme in nc". one doctor has started treating me with antibiotics, and the neurological symptomps seem to go away (the tingling, etc). still, the chest pains sort of come for a few days, then go away for a week or so, and then they return.
i am worried that my chest pains might be heart related. the cardiologist say they are confident, especially after all these tests, that i am ok. please give me your thoughts. have you seen lyme patients with similar symptoms. ( I will have the western blot test next week).  thank you!!

[CCF-M.D.-MJM]

Hi Adrian,

Let me reassure you first.  While there are some people your age that have heart problems, there are about 2000 people who think they have a heart problem for every 1 that does.  25% of the population (1 in 4) have a PFO, so I would not give that a second thought.

Duke is a great medical center.  If they have examined your and done all these tests and still don't think you have a heart problem, you probably don't have a heart problem.

The quick answer to the lyme question is to get a lyme antibody test.  If it is positive, that means you have been exposed to lyme disease but does not necessarily mean you have it.  In any case, if you had a positive lyme study, your internist should treat you for lyme (I doubt you will find a cardiologist that will treat you for lyme disease).

I want to be very honest about your most likely diagnosis so you can look into treatment early.  You are the right age for an axiety disorder to start.  It tends to affect males in their mid to late 20's and the symptoms fit.  The problem is most doctors recognize the anxiety disorder but never tell patients they have it because it is so complicated to explain.  Telling you don't have heart disease takes 5 minutes, explaining an axiety disorder and convincing you it isn't heart disease can talk a long time and most of the time patients won't believe us because of the negative stigma society places on anxiety and depression.  It would interesting to see if paxil or zoloft improved your symptoms--i bet they may.

Good luck and thanks for posting.

[adriancighi]

I forgot to mention that I was put on Protonix (40mg) for heartburn about 2 months ago. Also, for the numbness/tingling, I had both an MRI and a month later an MRA, both of them normal.

[CCF-M.D.-MJM]

The numbness and tingling in the hands and arms is thought to be from hyperventilation--people tend to hyperventilate when they are anxious or have anxiety attacks.  Cardiac chest pain usually comes on with exertion--I bet yours gets better during exercise and worse when you are not busy or not exerting yourself.  That is when anxiety tends to cause the most symptoms.

[Erik36]

The doctor hit the nail right on the head. He described exactly what I went through about 15 years ago. I had all the same symptoms as you. Prozac and now Paxil has worked wonders for me.

[shubunkin]

Same for me also! Ran up thousands of $ for heart test. Turned of to be Panic/ Anxiety. Paxil works great for me. All I take is 12.5.a day. Best of Luck, Danielle

[JANE10]

I've been experiencing similar chest pains under my left breast that comes and goes for no apparent reason several times a year.  They generally last from 24-48 hrs and I have yet to find anything that will subside the excruciating pain.  I have to lie flat on my back and wait for it to pass.  I started wondering if it could be panic related after every single test I've had done turns up negative.  My question is that I did take prozac about 6yrs ago and still had the pains.  I don't think I'm depressed now but do experience some panic symptoms ocassionaly such as increased heart rate/shortness of breath.  I wonder if I should try paxil or another form?  This is so very frustrating to me and I've tried posting questions to the doctor for months but can't seem to get in.  I'm beginning to wonder if this is in my head because it doesn't seem logical that I am feeling such horrible pain and no one can figure out what it is.  I am a 30yr old female no previous health problems...weight 110..no smoking or drinking ever.  Please help!

[jhoot]

I am also having these pains switch from left breast are into armpit and upper arm then to the right area.  I had 2 weeks ago tingling in my hands and clammy so I went to the hospital.  They ran ekg, stress tests and came back negative.  I had Afib this past summer but they said the ekg was fine with sinus mode. My regular doctor is trying to figure out what it is.  One person said it could be tietze?  I see some of your responses said anxiety and one said intercostal neuralgia. I want to find out what causes mine too but its costing me $ and dont know what else to do.  How can they tell if its tietze, axiety, intercostal, or some other problem?  If a doctor could please respond.  Thanks!

[Shea24]

I'm 24, and have been having similar symptoms (numbness/tingling in left hand/arm, chest pains) since about August or so (4 months). Recently I have also been having difficulty breathing. I go to the gym regularly, I'm 5'11, 170 lbs, and eat well. All of my grandparents passed away from heart attacks, but they also all smoked alot and lived well into their 70's.

My EKG, chest x-rays, and CAT scan were all normal, but it's driving me nuts, I can't stop thinking about it. On my last visit to the doctor, he told me it was probably psychological (I'm not sure if he meant the symptoms were in my mind, or whether my mental state was causing my symptoms). I don't feel like I can go back to him now.

The only stress I'm under is the result of worrying about these symptoms! I don't understand how they could be anxiety related, I wasn't under any stress or anxiety prior to their onset. It seems like it HAS to be heart related. I don't know what to do anymore.