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Chest pain, palpitations

  I've been under a lot of stress for a couple of weeks with work and juggling some studying/coursework outside of work which I completed a week ago... up until a week ago I was waking up with palpitations, rapid pulse, sweating etc.. walking to work I'd get a shaking sensation in my chest/abdomen... Last week while sat at my desk I started breathing rapidly, heart rate increased, got palpitations... went to a walk-in clinic and had an ECG (which was normal) the doctor said it was anxiety. Since then (over the past week) I've been less stressed and haven't had the episodes of palpitations, rapid pulse etc.. much... I do however keep on getting pain on the left hand side of my chest - under the upper left section, left breast area, left armpit and lower down on the left under the rib cage... every so often I also get a pulse or twitching from those areas... is this normal with anxiety? I'm slightly concerned about it, my reason for the previous stress (coursework deadline has gone as of a week ago) presumably the pain is muscular? My slight concern about it still being cardio related is that the twitching sensation from those areas is in time with my pulse - is it possible for muscle spasms to be in time with a pulse? On a couple of occasions I could also see my abdomen twitching in time with my pulse. Could an artery be in spasm as a result of previous stress anxiety? The pain seems to come and go at random whether sitting down or at rest... along the side of the rib cage, under the left armpit and below and on the right edge of the left breast it comes on as a sharp pain, when it occurs on the left breast I can definitely feel a pulse in that area... I do sometimes feel a duller, more prolonged pain in that area too.
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4610897 tn?1393869202
Hello. Thank you for your question.

The symptoms you are describing of palpitations, tachycardia (rapid pulse), and chest discomfort. Symptoms such as those warrant an evaluation.

Even if your ECG was normal when you went to walk-in clinic, it only means your ECG was normal for the 6 seconds you hooked up to the ECG machine. The best way to evaluate palpitations and symptoms like it are to wear a Holter monitor, which is an ECG that continuously records for a specific period of time depending on how frequent your symptoms are (i.e. 24 hours, 1 week, 1 month, etc). Along with a symptom log, you can record when you are having symptoms and a cardiologist can interpret your ECG at that time you are having symptoms after you return the monitor. It is extremely helpful because it can detect dangerous arrhythmias (abnormal electrical rhythms) and can also put your mind at ease if you have a normal ECG when you are having the symptoms.

Chest discomfort can be evaluated with a stress test.

Ask your physician about having a Holter monitor and stress test performed.

Thank you,
Dr. S
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