Variety of symptoms including shortness of breath and sharp chest pains

[Keystone95]

Hello, let me give you some background on all this. I am a 19 year old male. In March I had to call 911 with immense head pressure and rapid heart rate, and was diagnosed and hospitalized with serotonin syndrome. I was taking an SSRI at the time and one doctor thought it may have reacted with tryptophan in a protein shake I was taking. They had to yank me off of Cymbalta and Trazodone cold turkey. A little while after I was released, my doctor suggested I could try taking the two meds again. Well, I had a reaction to both Cymbalta and then later Zoloft when we tried it. Rapid heart rate and eye flashes when I close my eyes. (I have been on anxiety meds since I was 5 by the way.) My doctor even prescribed my a beta blocker, atonolol, to try and bring my heart rate down.

So, that is just some backstory on this. I was in the ER a few times in the recent months for really bad chest pain on the left side and high heart rate. I've gotten like 10 EKG's and they've all been fine. Around the time, about a month and a half ago, when I started the atenolol, I started getting really short of breath after minor activity. I mean, I went from being able to mow more than an acre of grass with a walk-along, to getting gassed just going up the stairs in my house. So, after a couple weeks, we weened myself off the atenolol, thinking it could be the culprit of the shortness of breath. I continued to have horrible shortness of breath after minor activity, however. I get pinching sharp pains around my chest. My heart pounds in certain positions, especially when I lay flat. I get this burning sensation in the center of my upper body after standing up and moving for a while.

Since my symptoms have continued, and even gotten worse, my doctor has worked with me and we've ordered a myriad of tests. I had a chest x-ray while in the ER. Nothing. I had every bit of blood work possible drawn, including a blood gas. Nothing. I had an MRI of my brain just to make sure. Nothing. I had an echo-cardiogram. Nothing. I even had a stress test. Now, with this one, there wasn't any blockage noticed. Which makes sense considering I am 19 and generally in decent shape. However, my heart rate went up to 160 very quick at a slow walk. I also got short of breath around this time as well, way too quick. The heart doctor said that shouldn't be happening with a 19 year old, so we saw him in his office a week later.

The heart doctor said it's very hard to diagnose, but just wanted to get my heart rate down. He prescribed me propranolol. He also referred me to an electrophysiologist. I went to see him, and he said everything looked fine, nothing dangerous. He said he sees some people who get really high heart rates for whatever reason. In my case, though, this all came on so sudden, and this hasn't been a past issue for me, so I am just concerned.

As of right now, the propranolol has honestly helped to an extent with my shortness of breath. I can move around more. But, I still have it somewhat and all the pains are still there.

Could all this be related to coming off those meds back in March? You are supposed to slowly ween off of those types of meds, but obviously for safety reasons I had to abruptly stop them.

Thanks to anyone who can give me some suggestions or info.

[Keystone95]

Thank you very much for taking time to help me out!

[db0704]

If you have been on medications for that long, I would say definitely your body is having problems adjusting without them, plus you may have now developed some sort of sensitivity to them.  There are so many things like this that doctors really don't know and if they've never experienced the symptoms, they have no clue how bad it can be.  My advise would be to get as healthy as possible.  Eat as healthy as possible.  You might be surprised if you cut out certain foods such as sugar, how much better you may feel.  Some foods cause inflammation and can make you feel terrible, including increased anxiety and depression.  There are supplements you can take that also help.  Fish oil is great for depression, choline for neurotransmitters and NAC is also good for depression.  Also, a good daily multivitamin is also a good idea.  You might do some research or ask your doctor about other natural remedies.  I can say I've seen some amazing results with something as simple as yoga or meditation.  You have to do it and practice it and it has been proven to actually change brain patterns in people with certain conditions such as anxiety.  I've seen it work!  You may even be able to find some youtube videos that could help you learn.  As far as an abdominal aortic aneurysm, it sounds like they ruled that out.  I still say your body is still reacting to the withdrawal of the medications it was so used to.  I'm sure different people have different symptoms.  Hang in there, give it time and truly, get as healthy as you possibly can.  Good luck!

[Keystone95]

I was in an ambulance and the paramedics were worried about my CO2 levels because my breathing was perfectly fine. They were waiting for it to go back up, and it never did. I got a blood gas test later that day and it still showed low CO2 levels. I got a Pulmonary Function Test about a week and a half ago. Have not heard back on that, though I'm sure if they saw something they would have called me.

I'm not on any antidepressants now. My psychiatrist prescribed me Lamictal and Seroquel because I have had bad anxiety since coming off meds. He said we should try mood stabilizers since I have reactions to SSRIs. They haven't really helped. I'm constantly worrying about my well-being, naturally because my symptoms aren't going away. I've had to take Ativan more now just to cope. Only 1.5 to 2 mg a day though.

I was on my previous meds since I was 5 years old. The doctor in the hospital said sometimes as brains develop and you age, your meds might no longer be compatible with you.

They checked my thyroid on blood work, everything blood work-wise came back fine.

I do feel like some doctors love to look at my meds and start focusing on anxiety and stress. I mean, I don't think anxiety can make me short of breath going up stairs.

The heart doctor said my shortness of breath was probably due to my fast heart rate. Which makes sense considering the propranolol has helped to an extent. I went to an electrophysiologist and he said everything looked fine. I was on a Holter monitor for 48 hours and everything looked fine there. He said he sometimes sees people who get spiked heart rates easily, and said my meds withdrawal could possibly be related to the sudden symptoms I've had.

I've also had an echocardiogram along with a stress test and they've shown nothing, other than my fast heart rate. I also had two chest x-rays that were normal.

I will mention my adrenal glands to my doctor. I don't know if the extensive blood work I've had might have already shown that though.

I am indeed under a lot of stress due to all these symptoms. I do not and have never smoked. My blood pressure has been a tad low. My diagnosis for my meds my whole life was "not otherwise specified". I was very nervous when I was a young child. I also had rages a lot too. A child psychiatrist put me on Zoloft and Risperdal at 5 years old and I was "fixed". Not much family medical history, Those in my extended family who have smoked have had problems. My mother has high cholesterol and high blood pressure. My father had one of the worst thyroids my doctor had ever seen. Both are on meds to help with those.

Coming off those meds cold turkey has been awful. It has spiked my anxiety and I have had a few panic attacks, of which I have never had before. I know you are supposed to ween off of them, but naturally I had to stop them abruptly because I was having a serious reaction to them.

I tried both Zoloft and Cymbalta and Trazodone after some time out of the hospital. I had a similar reaction to all of them. Fast heart rate and eye flashes.

Right now, I am still having a lot of symptoms. But, I've has all these tests that have come back normal and my parents are getting frustrated saying no more tests. I think a lot of this is all related to the meds being messed with and my brain going through a lot.

One thing I should mention, though, is that I've been having these shakes or tremors deep inside me in my abdomen. I get this thumping in my abdomen when I lie flat or sit up very straight.

I know those are symptoms of a possible aortic aneurysm. I even went to the ER two nights ago to get it checked out. They did another EKG and an x-ray which were both normal. The doctor also did a physical exam of my abdomen, which was normal. I've also had the echocradiogram which I've heard can see an aneurysm.

Is there any chance, with all those tests, I could have that? That scares the hell out of me to be honest. But, I know I have like no risk factors.

[db0704]

The low C02 is probably related to rapid breathing, in that you blow of C02 when you breath and the faster you breath the more you blow off.  Of course, I can't be 100%.  Just a thought.
Are you on any antidepressants now?  It sounds like you have a real sensitivity to them.  How long were you on them when you had the serotonin syndrome?  I'm sure they checked your thyroid but that's another thought too, just in case they didn't.  It sounds like at least you have been taken seriously by your doctors.  Often times, if you are on any antidepressants or sleep meds or anything else, doctors love to blow you off as "not serious" or "crazy."  I'm a RN and see that all the time by doctors.  Also, the shortness of breath can definitely be caused by your rapid heart rate.  The blood carries oxygen and if you heart is beating too fast, the ventricle are not having enough time to refill adequately before they empty again, causing blood flow to be decreased, therefore lack of adequate oxygenation and definitely a decrease in blood pressure.  You are on a beta blocker, propranolol, which will keep your heart rate lower and hopefully help relieve some of your symptoms.  Have your adrenal glands checked.  Most doctors don't think of that but you never know.  They are after all, the glands that control stress and produce cortisol.  Are you under a lot of stress?  Do you smoke or do any other types of drugs?  How is your blood pressure?  What is your diagnosis for the meds you were on?  Family medical history?  
Cold turkey off meds like that can be horrific for some people, but mainly causing more depression and who knows, maybe anxiety too.  Doctors love to take people off meds quickly, but tapering is the best way, although I guess it makes sense why they did what they did.  Did you start them again after you got out of the hospital?  As I said before, it sure sounds like you've found some docs that at least are taking you seriously.  Heart rates that high are not to be fooled with, that's for sure!  

[Keystone95]

I forgot to note, when I had the blood gas test done, my CO2 levels were low. I got a pulmonary function test last week and have not heard the results.