Posted By Morgan on July 18, 1999 at 17:55:36
I am a 31 year old man who suffers from anxiety. My anxiety began about a year ago when I thought I was having a heart attack from jogging. Ever since then I have had anxiety about my heart. I went to see a cardiologist shortly after my scare, because I was having rapid heart beats, and he gave me an ekg and a stress test, and a blood test all which came back normal. The doctor told me to exercise because I had borderline high blood pressure. Since that time I have lost 35lbs, and I have achieved a normal weight, and my blood pressure is mostly normal now unless I am really stressed out. I dont smoke or drink either. The problem that I have been having ever since my scare is that once in a while I get this strange sensation in my chest. The sensation is in the center of my chest and it feels like pressure. The sensation never lasts for more than a second, and sometimes I go for a couple of weeks without it happening. I feel fine after the sensation, and I have never had it happen more than once a day. I also noticed that the sensation usually occurs if I am very stressed out or the day after a very stressful day. I a wondering if it is a skipped beat or something else. It really scares me when it happens. Also, I do aerobics five days a week, and I have never felt the sensation before after, or during exercise. Thanks
Posted By CCF CARDIO MD - CRC on July 19, 1999 at 10:20:09
Thank you for your question. Chest pain that lasts seconds is not due to blockages but may be due to arrhythmias such as PVC's.
Below is a brief summary of what a PVC is, what causes them and the treatment (if any) for PVC's. You can find additional information in an article in New England Journal of Medicine, May 7, 1998, Vol. 338, pages 1369-1374. Your local medical library will have a copy of this. Hope this helps.
PVC's (premature ventricular contractions) are "extra" heartbeats occurring out of sync with the normal regular rhythm of the heart. PVC's may cause no symptoms at all or may be felt as a "irregular" heartbeat or as the sensation of a "hard heartbeat". PVC's are common findings in persons with otherwise normal hearts, in which case the prognosis is excellent and there is no decrease at all in life expectancy. On the other hand, they may indicate that there is an underlying abnormality of the heart muscle (from any number of reasons). If there is an abnormality, then the prognosis and treatment depends upon the specific problem of the heart. The usual evaluation of PVC's is a history, physical examination, and electrocardiogram (ECG). Also your doctor may wish to check an ultrasound of the heart. If all those tests are normal, then you would fall into the category of people who have PVC's but otherwise no underlying heart problem. In that case, treatment depends on how much the PVC's bother you. If they are essentially asymptomatic, then no treatment is required. If they bother you, then a medication called a "beta-blocker" may reduce the frequency of the PVC's. PVC's can't be "cured", but the medication can decrease their frequency. The potential side effects of beta-blockers are tiredness, impotence in men and breathing difficulties in individuals with underlying lung disease. Be sure to discuss these issues with your doctor and under no circumstance should you take medications for the heart without the supervision of a doctor.
Below are some web sites with additional information about PVCs.
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist
Posted By Nancy on July 19, 1999 at 18:58:03
I'm, of course not a doctor, but you might also look into the possibility of acid reflux. Last year I had pressure in the center of my chest and was sure it was my heart. I had no heartburn or indigestion so was real surprised at the diagnosis. I had a stress test which was fine and then an upper GI showed reflux with an inflammation of the esophagus. I started Zantac (prescription strength) and it went away, for the most part. Every once in a while, it comes back when I'm stressed, usually for periods of time then goes away for a while. Good luck!!
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