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Chest Pressure
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Chest Pressure

Hello to all,

In the past when I read about the warning signs and risk factors for heart disease I used to breath a sigh of relief.  While my father has high blood pressure controlled with meds there is no other history of heart disease in my family, no heart attacks, etc.  My mother actually has low blood pressure.  I'm young, 26, only about 5 lbs overweight, excercise 3-5 times a week, watch what I eat, don't smoke.  I do take oral contraceptives.  No past history of health problems at all.  No apparent cause for concern.

In mid Sept I started noticing some strange symptoms.  The first symptom was a feeling of a "knot" so to speak just below my sternum.  It felt like I had swallowed somthing and it wouldn't go down.  I felt this steadily for a couple of days.  About a week later I began waking up at night with my heart racing.  I thought I was having axiety attacks.  It affected my sleep for about three nights.  During the day I'd feel like I had a pulled or tight muscle in my chest but the knot had gone away.  Except for the other symptoms I'd have thought I pulled a muscle wile lifting weights.  I also had a slight feeling of chest congestion.

After about a week I developed a minor cold but the other symptoms went away.  Within a week, though, I was waking up with night racing again, anxiety, chest tightness.  This lasted about three days.  Then it subsided to the knot again.  

I have continued have minor symptoms for the last couple of months.  Once every two or three weeks when I first go to bed my heart will race.  It bothers me for bit until I fall asleep and then I'm fine, no feeling of anxiety (I guess I've grown accustomed to it).  I'll go several days or a week without any symptoms at all.  Sometimes the knot will return and sometimes I have a feeling of pressure under my sternum.  It is pretty centralized, no radiating.

Other occasional symptoms include very minor (2-4 out of 10) chest pain that lasts only second or two.  This occurs maybe a few times a day a few days a week.  Sometimes I feel some tingling in my left bicep although this may be associated with my work which involves a lot of typing.  The knot is usually associated with some abdominal bloating (burping, etc).  I also have an occasional heart palpatation, maybe one a day, one day a week.  

While this may be completely unrelated, lately I've noticed an increase of symptoms after I consume some alcohol.  This seems strange to me because I used to drinking moderately (1-2 drinks a week) but regularly.  This last week I'd felt fine for several days until Tuesday when I had two beers at a social gathering in the evening.  I felt fine until I went to bed when I noticed the heart racing.  Since then I've had the chest pressure or the knot pretty steadily.  I had a quarter of a beer last night and the knot became worse.

While I'm sure I need to go to the doctor these symptoms seem so disjointed I don't really no what to tell her.  Has anyone experienced anything similar?  Any suggestions would be appreciated.

Thanks
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238668_tn?1232735930
Dear Jennie,
While it's unlikely that your chest pain is due to coronary artery disease there are other potential cardiac causes including pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.

Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.

Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.

Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).

Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.

As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause.  A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.
4 Comments
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Avatar_n_tn
What can I expect if I just up and stop taking meds? I am on a low dose of beta-blocker and calcium channel blocker.
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Avatar_n_tn
Jennie, your symptoms sound alot like my mothers and she was diagnosed with a hiatal hernia.  Better to play it safe and have it checked out though, if nothing else just for peace of mind. Worrying and guessing will only aggravate your symptoms.
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Avatar_n_tn
Jennie, print this out and take it to your doctor if you don't know how to describe it.  It says it all.
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