Fatigue and Chest Pain

[Mike]

I am a thirty three year old male, 6’1”, 185lbs.  I exercise regularly.  I have a history of slightly elevated blood pressure and cholesterol  (246 about a year ago).  

For two years now I have experienced bouts of disequilibrium accompanied by fatigue, a feeling of chill or fever, and significant ear popping.  These symptoms first came about in the middle of exercising, but are not limited to that now. I had an EKG when it first happened and my doctor determined it was normal.  I have had many inner ear and neurological tests since then including an MRI to try and explain the disequilibrium.  All came up normal.

I have recently started training for a bike race this summer, which has involved more intense exercise.
I am now experiencing chest discomfort on the left side and occasional pain in my left shoulder during intense exercise and the fatigue and other symptoms seem to be worse.  I am concerned that all of this is heart related somehow.  What do you think?


Thanks
Mike

[Cleveland Clinic, MD]

Dear Mike,

Making diagnoses over the internet can be frought with hazard and we tend to be very conservative in this area.  There are many things which may cause chest pain including heart related conditions.

Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), 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.

[Sue Clark]

Recently I experienced dizziness and thought nothing of it, but when I went to stand again., the dizziness was worse..I decided to go to my Dr's immediately, but on the way there, I experienced tingling in my left hand and numbness up to my elbow..the nurse took my bloodpressure and said my pulse was very irratic., they then took me to the Emergency room where my bloodpressure remained high for about 3 hours.  They did an ekg which came back normal, decided to give me a shot to help lower my bloodpressure but my bloodpressure went back down to normal.  They did a CT scan to rule out stroke which I didn't have.  I am 44 years old., my heart does skip a beat and they told me this was normal.  However, I still experience my bloodpressure shooting up anywhere from 186/112 to 135/112, they give me 5mg norvasc to help control my bloodpressure.  After my bloodpressure shoots up like this and then goes back down I am so totally drained that I don't know whats going on with me.  Do you have any ideas on what might be causing this?  I am also constantly flushed in the face when I am up and working, but when I am sitting and relaxed the redness goes away.  I have an appointment with a heart specialist in the middle of April, but thought maybe you could help me out somewhat of what might be going on that I have these episodes of bloodpressure climbing and falling.  I have never had high bloodpressure before.  Thank you

[Danna Malone for Mike]

Mike thanks for letting me know someone else is going through something similar to what we are going through. If you will email me with your email address I will keep you informed on what we have found out. We are trying some new things that have been recommended to us and are in the preliminary stages with our fingers crossed. Email address is ***@****. Thanks again. Danna Malone

[shirley baker]

How can I submit a question I would like answered?

[Tessie]

Hi i went to the doctor the other day for feeling dizzy. They did an eeg test for my brain and that was fine but she saw some irragular heart beats when i was almost a sleep. So i went to my doctor they did a ekg on me and said my heart was beating slow. So they are sending me to a heart speacialest they wrote on my referal BRADYCARDIA i was wondering what does that word mean?
Thank You Tessie

[cardiac sonographer]

This means a slow heart rate below 60 beats per minute

[dee7710]

A related discussion, chest pain, anxiety, heart disease was started.