Need your help explaining what's wrong

[Al_10]

In order for me to explain, where I'm coming from, I must explain the situation that happened to me a few months ago.  I started to get a headache, and i felt I couldn't control my breathing and my heart was pounding heavily for about 3 hours.  I went to the ER and they ran 10023042304 tests on me and found nothing wrong.  All they said was to lay of the caffeine (I was a regular caffeine user and only had about 2 Coca-Cola's that day)  I haven't had caffeine since.

Anyways, lately I've been having certain euphoria's when I'm eating or standing that give me the urge to pass out.  My heart always appears to be beating hard, and at certain times I have little 10 second moments where my heart pounds really hard and it feels like I will pass out.  This will happen about once a week.  I've been having a more difficult time breathing during exercise, I'm in pretty decent shape and am an athletic kid.  And daily I've been having pains in my heart.

If those tests proved nothing wrong at the hospital, what could be the matter?

[Jeffrey R Boris, M.D.]

Dear Al,

Although I can’t be sure without examining you, this sounds like a common problem that many adolescents have.  The heart beating hard, headaches, near-passing out, etc., is caused by not having enough fluid in your tank.  Even if you are not thirsty, you are probably running yourself a bit dry.  What I recommend is that you have four 8-12 ounce glasses of fluid a day and a salty snack (pretzels, saltines, pickles).  Also, you should not skip meals and you should totally eliminate caffeine.  This tends to help the large majority of patients whom I see with these problems.  If this does not go away despite these interventions, or you have other symptoms, you should see your primary care provider for more evaluation.

Oh, and, the over 10 trillion tests that you said were performed on you are typically negative with the exception of the urine specific gravity.  This is the test that tells how concentrated your urine is.  My guess is that it was fairly concentrated, which would go along with the relative dehydration that you were experiencing.   The only other thing that would be important to know was whether you had an ECG and if the corrected QT interval (QTc) was within normal limits.