Anyone please? Heart, anxiety, muscle?

[imanursenscared1]

Hello. Thanks in advance for any advice or suggestions. Sorry if this seems long, I will try to keep it as short as possible. Approximately two and a half weeks ago I saw my primary doctor for some concerns. This included: anxiety issues ( got off Celexa about a month ago), random jabs of pain in my left upper shoulder blade/neck area, very upper back. These pains would come last for a second and go, then return in the same pattern. He felt around the area and said there was muscle tension, most likely due to my anxiety, and basically told me to chill out. I told him I was afraid of it being heart related and he said I was too young ( I am a 27 y/o female) and if he in any way thought it was cardiac related he would send me for a stress test. That night my left upper back got all tingly feeling, almost like I applied Icy Hot to the area. I asked my doctor the next day about it and he said muscle tension and me fretting over it. Two days after that I left for vacation. Went on a cruise. On the second day of the trip, I was getting random pains in my left arm, some in the deltoid area, some in elbow, and wrist, little finger, thumb. Of course I got scared this was heart related and went down to the medical center on the boat and got checked out. BP and pulse were elevated, but I get EXTREMELY nervous when being checked out by doctors. They did an EKG, which was normal, and also believed it to be muscle tension and anxiety. They checked my BP and pulse before I left and it went down some. Throughout the rest of the trip I basically felt better, but I would still get the random pains in the left arm, that would come and go, not lasting more than a few seconds, no numbness or tingling. And also to add, the shoulder blade/neck pain seemed to have went away. Had one episode of heartburn throughout the trip ( I think it was anyways, I never get heartburn), after I drank a big mocha chocolately cold coffee drink on an empty stomach and then soda afterwards. Anyways the heartburn went away within an hour or so. No chest pain during any of this, althought I know you don't have to have chest pain to be having heart issues, just being thorough with my explanations. The day we came home from vacation I had the random left arm pains again and the shoulder blade pain seemed to be back. This is a VERY mild shoulder blade pain, that isnt a constant pain or lasting, best way to describe it is a twinge of discomfort, just like before, only lasting a second or two, then gone but then I feel it again a little while later. However, it moved down farther, not so much my upper now, more towards my lower shoulder blade. The arms pains could be described the same way, lasting only a few seconds, but achy I guess, or slight throbbing. Got home, followed up with my primary, he felt around the neck and shoulder blade area, moved my arms different ways, and said something about a trigger point in the muscle. I read up on trigger points, but I'm not sure I am convinced? It's somewhat tender to touch, but not BAD, and would a trigger point send pains down my arm like that? I also was seen in an urgi center place yesterday, and the doctor there told me I had some tension up there, and she really does not believe it is cardiac due to my age and that I am still menstruating, but I know it can happen even to young people! She didn't feel I needed another EKG being that I had one just recently, and thinks it's all due to muscle tension. I am just terrified that it really is my heart and these are "pre heart attack" symptoms, and that a heart attack is on it's way. She told me that with cardiac related shoulder blade or arm pain, it would more than likely last for several minutes, not be fleeting like mine are. Does all this really sound like it's just muscle, or the possibility of heart related? I just don't know where to go from here, because I feel like it's being dismissed because of my age. Just wanted some advice or some info on what anyone thought, and what the pain might feel like if related to heart

[skydnsr]

By "other somatic symptoms," I meant the tingly feelings, the throbbing, and the other bodily symptoms that you have, in addition to the aches and pains.  I truly do not know whether your physical symtoms -- any or all of them -- are caused by your anxiety.  That does seem to be the case for some people, but it might not be what is going on with you.  Another possibility is that you have sensations in your body that wouldn't be troubling except that your anxiety causes you to be, hypervigilant about them.  Many people who have similar sensations to yours, even chest pain or left arm pain, don't dwell on it or even necessarily wonder about what is causing it.  Anxiety can cause you to get very focussed and upset about a particular physical symptom that another person might barely notice.  

There have been cases of people who actually had heart attacks and did not know it until much later, when they had an EKG for some other reason, and the old muscle damage was discovered.  Someone like that would be at the opposite extreme from yourself.  Neither extreme is very adaptive.  It's not good to worry all the time about having a heart attack when you're not, and it's not good to have a heart attack without seeking medical help.  Where you want to be is in the middle of the spectrum, where you notice what is going on with your body, but you don't panic about things that your doctor has already told you are not dangerous.

Not being able to take Celexa right now might be a good opportunity for you to do some work on psychological methods of controlling your anxiety.  Again, cognitive-behavioral therapy is very effective.  It teaches you ways to control your thinking and behavior, so you don't go around scaring yourself all the time.  It usually takes somewhere between ten and 20 sessions of working with a therapist to make substantial progress.  If you have problems with insurance or funding, be aware that you wouldn't necesssarily have to do all of the sessions at one time.  It does help if you can do that many sessions in one consistent course, but some therapists have the skill to be more flexible.

[imanursenscared1]

Thanks for the input. I know I have anxiety, definetly health anxiety, I just don't know how to handle it. I can't exactly get on anti-anxiety medication, because my husband and I were planning on trying to start a family, which is the reason I got off the Celexa in the first place. By somatic symptoms, do you mean the anxiety is triggering these aches and pains?

[Occupant]

I only want to add that stress due to anxiety can lead to high blood pressure which then can cause inflammation of your arteries which in turn could result in developing plaque and later heart problems - so you, all by yourself, can make your prediction of heart problems come true.

[skydnsr]

This is my advice:  you need to get your anxiety under control.  After that, if you still have the aches and pains and other somatic symptoms, then perhaps there is some physical issue, in addition to the anxiety.  But right now, anxiety is what is coming through loud and clear in your post.  The fact that you are a 27 year-old female makes it almost impossible that your chest pains are from coronary artery disease.  I'm sorry you felt dismissed when you were told that, but it's a fact.  You simply haven't been alive long enough for sufficient plaque to have built up to cause chest pain.  Cognitive-behavioral therapy is of proven value for anxiety.  Treat the obvious problem first, which is the anxiety, and then you can treat anything else that is left to treat.  Good luck.

[imanursenscared1]

any advice please???