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25 Year Old Female Fear of Heart Attack with SYMPTOMS

I am a 25 year old female and I am in CONSTANT fear that I am having a heart attack.  

About 2 months ago I just didn’t feel right, I was at work and my heart started racing and I felt like I was going to faint.  I went to the ER, had an ECG and blood work to check my heart and everything came back fine.  I had been to the hospital about 5 times since then with similar symptoms; I saw my primary care doctor and a cardiologist.  All are stating that I have anxiety which I think can very well be.  I had a stress test, numerous ECGs, blood work and everything came back normal.  When this all first happened in October my blood pressure was kind of high (140/90) so my primary care had put me on Diovan which made my blood pressure too low and my pulse too high (110) so he switched me to the lowest dosage of Metroprolol which I took half of one and felt VERY dizzy so I stopped taking any blood pressure meds and my blood pressure has been perfect since (120/80).  My primary care doctor seems to think the blood pressure was high due to me feeling anxious so I had a physical and my cholesterol levels were HDL Cholesterol 30 mg/dL and LDL Cholesterol 155 mg/dL.  He told me that my HDL levels are low so I need to eat healthy to make sure the bad cholesterol is lower.   He also mentioned that my Iron levels were a little low.

I do not smoke, I used to smoke socially maybe 1 cigarette on the weekend but I haven’t smoked a cigarette in over 2 months now. I am 5’9 and I weighed 262 but since this started I lost 20lbs by eating healthy and only drinking water so I am now 242.  My next step is to start exercising to continue the weight loss but with my fear of having a heart attack I am so afraid to get my heart rate high. My resting heart rate is around 80-90 in the morning it is around 70 but during my stress test it reached around 180, the cardiologist said it’s because I am over weight and out of shape, he said I have sinus tachycardia but the beats are normal.

I am now taking a .25mg of Xanax when feeling really anxious and 10mg Lexapro daily along with a B12 vitamin in the morning.

My grandmother passed away at 68 of a heart attack this past July and her father (my great grandfather) died of a heart attack at 53 back in the 60s so heart disease does run in my family but both of them were heavy smokers for years.

My concern is I hear that “feeling of impending doom” is a symptom before a heart attack, also my arms and fingers get Charlie horses (both but more so on my left), I am very tight on my left side in my neck and back, the cramping has only been going on about 3 weeks and I told my primary care and he thinks its because I sit at a desk for work and type a lot all day. I have mild heartburn everyday but I have had issues with heartburn in the past years.  I do not know what else to do, I am thinking I might call the cardiologist and ask if I can get an angiogram to make me feel more at ease. ANY ADVICE?? PLEASE HELP : ( This is affecting my everyday life and I do not know what else to do.
15 Responses
Avatar universal
Your heart has been checked out a number of times and has passed with flying colors.  You are young and female, which means your heart attack risk is already low.  Your weight is a concern, but you are working on that. I think you can rationally rule out a heart problem here.

On the other hand, you have been told you have a problem with anxiety, which can cause a hyper-awareness of one's heart, even though the heart itself is perfectly healthy.  You should know that the feeling of impending doom you describe is a classic hallmark of panic attacks, as described here (along with other accompanying symptoms):


I think it might be time to see the proper doctor for treatment of this condition, which would be a specialist in anxiety disorders.  It can't hurt, and there's a good chance it will restore your pleasure in life.

For the record, I suffer from panic attacks sometimes, and have found Lexapro to be one of the SSRIs that somewhat increases my sense of agitation during these times, whereas Zoloft does not.  You might want to try a different med in this class.

Avatar universal
Thank you very much for your advice.  I am going to try Zoloft, you are not the first person to say they have had good results from it.  Its amazing that I can tell myself it is anxiety yet, I STILL feel like I have a arterial blockage in my heart and I am pending a heart attack.  It is like I am just waiting for it to happen.  Hopefully I will get back to being myself soon.

Thanks again,

Avatar universal
Well I went to the doctor about 11 days ago because my joints hurt so much and they found strep in my blood stream.  I was on amoxicillin for 10 days 875mg twice a day and the symptoms started going away but yesterday and today they seem to be getting worse again.  I got tested for lymes disease and it came back negative.  I am not sure what else to do.
Avatar universal
Hmmm, joints hurting and anoxicillin do not sound heart-related.  Obviously something else is going on.

Which joints were/are involved, if I may ask?  
Avatar universal
My back hurts when I bend, my chest is a little tender to touch like my collar bone area the doctor said I have costochondritis but this has been going on for months on and off.  My shoulder joints bother me the most on both sides it feels like someone is pouring acid on the joint but I also have pain in my knees, ankels, hip randomly.  The pain isn't constant but it just happens out of nowhere.  Also, my menstruation has been VERY off the last 6 months, ive missed periods and they are always very late which isn't common for me at all.  I went to the OBGYN and he said everything was fine and he doesn't understand why I am not ovulating every month.
Avatar universal
I was also tested for Lyme's Disease twice, came back negative.  They ran all sorts of blood work to rule out immunity issues and everything came back normal they said.
Avatar universal
If you have symmetrical joint pain, for example, both shoulders, or both knees, or both wrists, it is time to see a rheumatologist.  

If you have asymmetrical pain, a knee for a while, then say, an ankle on the opposite side, then one hip, and the pain wanders around, it's still time to see a rheumatologist.  Ask me how I know.

It is perfectly possible to have autoimmune-type arthritis with negative blood work; it is called 'seronegative spondyloarthropathy.'  Some of these conditions appear to be triggered by infection, as is the case with Lyme, but there are other types.

Anyhow, in your shoes, I'd take myself to a rheumatologist for a consult about now.   Wouldn't worry too much about anovulatory cycles at this time.

Avatar universal
okay I will schedule an appointment with a rheumatologist tomorrow. Also, do you know what heart related back pain would feel like? I don't know why I'm so scared of this being my heart. I guess because I have arm chest back and neck pain. my back hurts when I bend and move certain ways and also when I sit for a while. My grandmother had back pain the night before she passed away from the heart attack  
Avatar universal
You say you don't know why you are scared of the idea that this might be heart pain.  The reason is simple, given the tests you have undergone:  You are most likely suffering from an ideé fixe, a kind of obsession.  It is not rational, and will respond only to psychotherapy and possibly a tad of medication.  I am not making a moral statement or a value judgment here; this is simply a matter of your biology.  It is the way you were born.

Try to take comfort from this fact: True heart pain does NOT correspond to changes in body position or tightness of various skeletal muscles.  There is an enormous difference between somatic and visceral pain (you can google this).  


A good therapist will help you understand why you are a slave to your fixation on heart disease--and will give you some techniques to defuse this situation.
Avatar universal
I am a 25 male also. I feel the same way as you. I have mild chest discomfort. But same symptoms as you. You are not alone.
Avatar universal
I have been seeing a therapist once a week for the anxiety and it is helping I guess but I feel worse than ever.  I got my blood results, everything was considered normal but the following:

antistreptolysin was 433 (normal is <200)
RBC 5.40 (normal is 3.80-5.20)
MCH was 22.6 (normal is 26.0-33.0)
MCHC 30.3 (normal is 32.0-35.0)
RDW 16.0(normal is 11.2-14.8)

so basically I had step and I am anemic.  I think my red blood cell count was high because I was taking vitamin B12 everyday for a few weeks at the time my blood was taken and I know B12 helps with red blood cell development at least I hope that is why. I have an appointment next Wednesday (1/29/2014) at 12pm with a Rheumatologist so hopefully I will have answers soon and when I do I will let you know what happens.  I have developed some different symptoms now which are extreme fatigue, tingling in both hands, left wrist pain, headache around my eyes and muscle weakness but I still have the joint pains. I am getting very concerned but I am just crossing my fingers for answers soon.
Avatar universal
So, I went to the rheumatologist today.  Basically he took more blood for more specific tests and I go back on the 12th, my blood pressure was a little high but that's because I was feeling anxious.  I took my blood work results with me for him to see. He is checking for more viral infections and checking my rheumatoid factors. I will update when I go to the doctor again.
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