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Chest pain; angina or anxiety?

Hi;

I've been experiencing a range of chest related symptoms over the last 6 months. Sometimes a sharp stabbing pain that lasts for a few minutes, other times a heavy feeling that may last for 5 - 10 minutes which also effects left shoulder / arm. The pain is completely absent during exercise (where I regularly get my pulse up to 140+ bpm), but comes on as I'm cooling down.

I also get regular shortness of breath (although I'm almost convinced that it's chronic hyperventilation syndrome), that does not coincide with any chest pain. It is a nuisance though.

I have diagnosed health anxiety / panic disorder.

I saw a cardiologist 2 months ago and underwent a resting ECG, exercise ECG + echo. All results fine. Spirometry shows lungs all okay.

Question is this: Do I make another appointment for more tests related to heart / lungs / possible angina, or have there been enough findings to rule out heart problems? I'm concious that constant trips to my GP have a tendency to reinforce the health anxiety, however am also concious that I don't want to take any risks related to my heart.

Thanks.
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976897 tn?1379167602
From what I've read, this isn't always so easy to diagnose. Sites I've looked at seem to suggest an ECG 'usually' picks up the problem, echo 'sometimes' picks it up and a chest xray only shows it up if there is in excess of 200ml of fluid, making the heart look enlarged. It seems that if there is very little fluid, most tests seem to reflect nothing to show this condition, that is with the exception of blood tests. Apparently troponin is usually raised? Do you think this means this condition could easily go undiagnosed?
Helpful - 0
367994 tn?1304953593
You can have significant pericardial effusion and experience no signs or symptoms, particularly if the fluid has increased slowly. This is more common when the cause of pericardial effusion is a chronic inflammatory disorder, such as rheumatoid arthritis.

Chronic pericarditis is usually associated with an accumulation of excess fluid around the heart (pericardial effusion). Often painless, the most common symptom of chronic pericarditis is shortness of breath.

"Depending on the type, signs and symptoms of pericarditis may include some or all of the following:

■Sharp, piercing chest pain over the center or left side of your chest
■Shortness of breath when reclining
■Low-grade fever
■An overall sense of weakness, fatigue or feeling sick
■Dry cough
■Abdominal or leg swelling:"

Helpful - 0
976897 tn?1379167602
Does it take the presence of fluid with this condition to obtain severe chest pains or is the inflammation sufficient on its own?
Helpful - 0
367994 tn?1304953593
If you have acute pericarditis, the most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of your chest. However, some people with acute pericarditis describe their chest pain as dull, achy or pressure-like instead, and of varying intensity.


If I remember correctly pericarditis was cause of similar symptoms you express.  Pain not associated with exertion, but more likely at rest, but typical chest pain (made worse by supine position, improved with leaning forward, pleuritic, constant).
Helpful - 0
Avatar universal
wheres the pain? ive been told if anyone has a pain down centre of chest go to a and e, but if your doc says your fine then your fine, if he had any idea of something seriously wrong he would of sent you for more tests, you'd be worried if had a pain whilst exercising that isnt right, you have anxiety so do i and you will make youself think you are really ill if you dont stop worryning bout this, it is very common for people with anxiety to worry bout there hearts, you can exercise all you want you've done an exercise ecg this was fine all tests were fine, forget bout it and carry on normal looking forward to something is helpful too
Helpful - 0
976897 tn?1379167602
The symptoms you describe are certainly out of the boundaries of normal stable angina. With this condition, the more you exercise, the more the heart struggles due to restricted oxygen supply and then when you rest, the heart relaxes and the discomforts go away.
What you describe is quite the opposite.
When you had your tests, was the discomfort present? I ask this because unstable angina is where a coronary artery goes into spasm, but there is no guarantee when this will happen. It can be triggered by a variety of factors and in most people the reason is unknown. Smoking has been shown to irritate coronary arteries in some patients, causing the spasm to occur but I assume you are a non smoker? I understand your concerns about your heart, this is absolutely normal and until you get an absolute answer then you are bound to want to persue the matter.
Helpful - 0
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