Re: Chest pain, panic attacks, anovulation treatment

Posted By CCF Neurology MD - AY on December 26, 1998 at 23:18:25:

In Reply to: Chest pain, panic attacks, anovulation treatment posted by Jennifer on December 26, 1998 at 17:05:42:






I'm a 23 year old female; the only major medical history is of chronic kidney stones beginning at age 9, no treatment being given as it comes and goes throughout the years, had 4 lithotripsies (ESWLs).
I was on Depoprovera for 3 years, ending this past January. Since then, I've had no periods and had pain with lumps in both breasts.  Mamogram (mammogram) and sonogram showed nothing, but doctors recommend a biopsy of these large "fibroids" just to be sure.  As for the lack of periods, they did blood tests for prolactin and TSH levels, both of which were normal.  My doctor gave me Medroxyprogesterone (10mg for 5 days) as part of a Progesterone Withdrawal Challenge to determine why I'm not ovulating.  During the course of the hormones (which ended 5 days ago, I started my period today) I've had recurring panic attacks, elevated pulse rates (usually 100-130 bpm, and I could feel my heart beat all throughout my body), rapid cycles of cold sweats then hot flashes, feelings of faintness, and my hands and feet were extremely cold (no matter how many blankets and socks I put on). I realize many of these are a result of the panics, but I would like your opinion on that.
The chest pain began 2-3 days ago. It's located toward my breastbone and over my heart.  The pain also traveled to my back (in the same location) at times, and up to my clavicle area.  It is a constant pain/ache.  I went to the emergency room yesterday for this reason.  They performed an EKG, chest x-rays, cardiac fluids (?) blood test, and several other blood tests (which ones, I'm not sure). All of these came back normal and clear.  I was told that I had an inflammation of the rib joint (between rib and breastbone), and was dehydrated.  They gave me Vicodin and Clinoril prescriptions for the pain and inflammation. They also recommeded I get my Thyroid levels checked as soon as possible and recommended a breast surgeon to perform the biopsy.
Since my period began this morning, I do not feel "panicky" much anymore, certainly no panic attacks as of yet. The pain medication is helping ease the chest pain.  I write to you because no one has been able to connect all of these symptoms and explain the why's and how's of them.  Any information you could give me would be extremely appreciated.
Sincerely,
Jennifer




Thanks for your question.  After carefully reviewing the set of symptoms described in your message, it appears unlikely that they have a neurological cause.  Additionally, given the temporal correlation between these symptoms and the hormonal treatment changes, it is most probable that fluctuation in the hormonal levels are the explanation for most of the described symptoms.
I hope this information is helpful.  Best of luck.