Teenage Heart Problems

[Chrissy364]

Hello. A couple days ago I posted a question to Jeffrey R Boris, M.D. and I very much appreciated the long, detailed, response I received. And in the response, the issue heart attack was addressed but I would like for it to be further addressed for my personal reassurance and to just know all I can on the matter. Well, I've been having terrible anxiety lately with horrible symptoms. I get dizzy, out of breath, chest/rib pain for very long periods of time, sore muscles, back pain, left and right shoulder pain, jaw/toothache, inner and outer body tingles, chest tickles that cause a cough, extreme fatigue and weakness, upper abdominal pain below the left breast, and extremely fast, terribly freighting heart palpitations. Most symptoms come and go, but the heart palpitations and body/chest pains are usually there all day. I am only a 17 year old girl. I don't eat very well, but I am slender. Since my first panic attack on June 19, 2009, I don’t drink any caffeine (however, I drank massive amounts prior to that day). I also exercise. I don't drink or do any drugs. I also have normal blood pressure and usually a resting heart rate of 100 beats/minute. My uncle who is 53 just had a heart attack recently, but other then that I don’t have a history of heart problems in my family. Do I sound like a candidate for heart attack or another heart problem? Can teenagers with my history even get heart attacks? And if they can, what type of history do teenage heart attack victims usually have in order to get one? Do my symptoms sound like typical anxiety symptoms? And could I possibly be a rare case where even though my history is all good I have a serious heart problem? Or is that just pretty darn unusual? I am currently seeing a primary Dr. and had an EKG and chest x-ray that came back normal. I had blood work done but have not gotten the results yet. Sorry for the onslaught of questions, but I want to know if teenage heart attack is possible. Sometimes, one Dr. just isn't enough!

[Jeffrey R Boris, M.D.]

Dear Chrissy,

This does not sound like you are having a heart attack, nor does it sound that you are a specific candidate for one at this age.  Heart attacks are quite rare among children and adolescents, and none of your symptoms are consistent with this, which is good.  Typically, the chest pain is crushing and the worst pain ever; that’s not what you’re describing.  There is no tickling/tingling, cough, etc.; this is not a rare case of coronary artery disease, which leads to heart attacks.  It does sound/feel scary when you are experiencing it, but you do not sound like you are having a heart attack, which is defined as severe pain associated with heart muscle cell death from obstruction in the coronary arteries.  Without evaluating you and asking the questions that I typically would, the only thing that I can say that is not normal is that your resting heart rate of 100 is high normal for your age, with the normal range being 50 to 100.  It is not clear to me from what you are saying if there is more going on here, such as a dysautonomia or isolated panic attacks.  A dysautonomia is an abnormality of the autonomic nervous system that can cause a constellation of symptoms similar to what you are describing.  I do think that it would be important that you have this evaluated for what your symptoms are, not what they aren’t.  That means that a cardiology evaluation may be appropriate, if the cardiologist is used to managing patients with dysautonomia.  However, I also do feel that evaluation for panic attacks would definitely be important at this stage.

[EchoTech]

I am not a doctor, but I will share my experience with you.

Generally speaking, teenagers do not get heart attacks.  It has happened, but the number of cases is very small relative to the whole population of teens.  I've read about it in case studies, but I haven't seen or heard of one in the hospital I work at, and I've seen at least 6,000 kids in my 11 years of doing echos.  You are on the right path of cutting out the caffiene, and keep exercising.  If you are getting panic attacks, I would recommend seeing a mental health professional like a counselor to help you work through these attacks.  These can mimic some of the symptoms of a heart attack (especially the shortness of breath, chest pain, and fast heart rate), but the likelyhood of you having coronary disease is practically zero.  I know when you are having an panic attack, everything feels amplified.  Try to find out what trips these off and avoid them until you get the right help.  Good luck.

[Chrissy364]

Thank you for responding. I appreciate you sharing your experience; it makes me feel more relaxed. Also, thank you for understanding how having an panic attack makes everything feels amplified, it truly does. Thank you again for your time and advice! :)