Chest Pain Wont go away

[Josh829]

I am a 25 year old male.  About 7 months ago I started having panic attacks.  When I went to the doctor I thought I was having a heart attack, but they did an EKG, chest x-ray, blood work, and a thyroid test.  Everything came back normal.  They put me on Effexor XR and xanax for the panic attacks.  Still, my chest continued to hurt on the left side, in my left arm, and my back on my shoulder blade.  So I went back to the doctor and they did another EKG and all was normal again.  This pain seemed to go away for about a month, but now its back and I cant get it off of my mind.  I dont know if it is heart related or if its my anxiety.  Is an EKG and the other tests sufficient enough or should I go to a specialist.  Does anyone have some advice i am desperate.  Thanks so much

[Josh829]

My weight is normal, I eat well, and exercise regularly.  I do smoke cigarettes but all else is normal.  So you are saying that the EKG's that I have had could have been wrong??  Is this something I need to get done immediatly??  If it were a heart problem, do you think it would have sent me to the emergency room over the last seven months??  If there was a serious problem why wouldn't it show up on an ekg, blood test, thyroid test, chest x-ray??  Please let me know as soon as possible

[Douglas Bogart, MD]

Since you've continued to have the chest pain, I'd recommend you get a stress echocardiogram to further evaluate your symptoms.  This test will evaluate your heart for structural heart disease and blockage in your heart arteries.  The test should help to determine if the symptoms are due to anxiety or your heart.  

I'd also recommend you carefully have your risk factors evaluated.  This would include blood pressure, fasting lipid panel, tobacco abuse, regular exercise, diet, and weight (ie are you currently at your ideal body weight).  This will help to guide you long term in maintaining your cardiovascular health.

Doug Bogart