Still getting some chest and arm discomfort.

[johanni]

Being a wreck diver I thought about getting myself checked out,after almost passing out under water.Have had 3 stress echoes, a mibi scan, and a 64 ct angiogram because of chest discomfort, all in the past 4 months, which all came out clear.Still complained of chest pain that extended into the left arm and cardiologist suggested a cath,which was done a week ago,and found everything to be normal .I am a 39 yr old male with low cholesterol and no other problems, but do occasionaly smoke.Was wondering if stress and anxiety could be the culprit as I have been stressed recently.I also notice my heart racing and sometimes missing beats like its going to stop but then suddenly jump starts again.Any advice or insight would be greatly appreciated.

[Forum-M.D.-bkj]

johanni,

thanks for the post.

Stress and anxiety certainly can play a role, sometimes a very significant one. With all of your cardiac evaluation being negative, it would be unlikely that the pain is from your heart. There are other causes, such as musculoskeletal, pulmonary and GI causes that can often mimic cardiac pain. I would discuss this with your physician before solely attributing it to anxiety. I would also remember that anxiety is also a medical condition and without treatment (through therapy, medication or both) if this were the cause would continue to lead to recurrent symptoms.

good luck

[blankpagenurse]

Hi,
Anxiety and stress can certainly lead to symptoms generally associated with heart problems.  You are wise to have had them checked out, as many people ignore them until too late.  Did the doctor suggest that you might be experiencing panic attacks?  I don't remember reading, but do you have the pain at other times besides diving (diving would give me a panic attack for sure :))))?  Also, have you had tests run to check thyroid function?  Do you consume a lot of caffiene, or are you taking any health supplements that might contain a "natural" substance that could increase your heart rate?  You said that you smoked occasionally.  Because you mentioned it I think that you already know that it constricts your blood vessels causing your BP to go up, and usually your heart rate along with it.  As a diver, you probably do know about this physiology.  The last thing I would ask would be about whether you are staying adequately hydrated.  Not many of us, me included, drink as much water as we really should.  I know that when patients get "dry" as we call them, or dehydrated, we usually see a rise in heartrate.  I am just throwing things out there, but I hope that it helps.  I have a resting heart rate of between 98 and 110, and have been taking a beta-blocker for a couple of years. Mine was different in the fact that it was consistently high. I did have "episodes" where it would go higher, with the pounding, arrythmias, some pain in the arm, and lightheadedness.  I had cardiac work-ups, for the most part all was well.  I had had panic attacks when I was in my early 30's, they are very real, and mimic heart problems. The physician that I went to was great!  I did find out that I was anemic, but he reassured me that after ruling out other possibilities, that I probably had been experiencing panic attacks, and that they are real, and that they could be treated.  I was referred to another physician that treated me with a mild anti-anxiety medication, but also worked with me to find the cause for the anxiety.  After treating the anemia, and a couple of months of therapy that included biofeedback, relaxation and medication, the panic attacks stopped.  I think that it helped me to know that  a) it was real and there was a physiological element to it, the "fight or flight" response from the release of epinephrine(adrenaline) into the blood stream, b) I wasn't going to die, and , that there was an end to the attack, just as there was a beginning, and c) I could take control of my body when i felt the
attack starting.  I really do give a lot of credit to the physician that helped me to help myself!!  sorry this ran so long!!! BPN

[RCA7591]

Has a Patent Foramen Ovale been ruled out?

Generally, the best way to visulaize this defect is with a Transesophageal Echo w/bubble study.

There is a connection with PFO and diving (decompression).

-Ryan

[johanni]

Thanks for the advice and I will talk to my physician about my problem.Seems that when I get stressed out the symptoms do become worse.

[EchoTech]

The PFO won't cause chest pain.  It can cause strokes from the little bubbles of nitrogen crossing over the septum and going upstairs.

[claudaugh]

Hello,

I am very new to this site and don't know much about my condition (due to see cardiologist in May. .  Can anyone give me any insite to the successfullness  of pfo closure when a Atrial Septal aneurysm is present? I am really nervous because heart problems do not run in our family and don't really know what to expect. I am in a very stressful industry and concerned about recovery time from surgury as well as any other developing issues that happen

They say 25% of people have a PFO. Do people that have a ASA normally need surgury?

Thank you for any insite anyone can offer. .
Lauren