Brief Answer:
Follow the Advises..

Detailed Answer:
Hello XXXXX, Welcome to HCM,

I've gone through your query and understand your concern,

First of all, I'd advice you to please calm down and take a deep breath, sit down and relax for 10 min, observe yourself for the next 10 minutes, as most likely this is just anxiety attack..please follow this and let me know how your feeling..

The pressure symptoms which you've mentioned can very well be due to the chronic episodes of bulimia, as it not only worsens the acid-peptic disease but also causes several damages to the food-pipe(esophagus), which presents with these exact sets of symptoms..

You can take PPI/antacids like Cap PANTOPRAZOLE 40 mg Stat and once daily before 20 min before breakfast for next one month..it'll relieve some of those symptoms..

Yes, with the help of proper investigations we can certainly differentiate between bullimia and heart damage..

Even if you've had 30-40% block in the Left internal carotid artery, still chances are not likely to have angina just due to that..

Meanwhile I'd advice to simply schedule an appointment with a Cardiologist for a detailed clinical check-up and few relevant and specific investigations which'll clarify all these doubts (starting from a Repeated simple EKG, 2D-Echocardiography with Doppler, a stress test-this is most important to determine if there's any element of angina at all) further interventions can only be planned based on the results of the stress test..If none of these tests indicate any thing concerning, then the cause is definitely not cardiac related, and next possible cause to look for is the Gastro-esophageal structural damage(a Simple Chest X-ray and Upper GI endoscopy will be helpful to identify that)..

The feeling of heart-beat skipping is mainly ectopic beats which is very likely due to the anxiety..don't worry too much, just take your time , follow these advises which I've mentioned and get back to me..

Now with all those being said, if you feel that there's not much improvement and/ further worsening of the pressure symptoms/breathing problems/excessive sweating despite trying all these, then please visit your nearest ER for a prompt physical examination and some quick investigations accordingly..

Please let me know how you stay in the due course..

Take Care
Kind Regards

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Brief Answer:
routine and timely follow-up to be continued with the neurologist and/ cardiologist

Detailed Answer:
Hello XXXX, Welcome back,
Thanks for following up with the details,

Well the brain infarct was mostly related to the partial blockage of of the Left ICA (it's quite common in this scenario)..

Good that you've already visited the Cardiologist. so please get done those investigations as I've already mentioned, it'll clarify further..

Since there was a suspicion of brain infarct, I'd advice you to maintain a routine timely follow-up (after every few months, depending on how you stay clinically) with the Neurologist too..

No, even though last year there's no damage observed during the endoscopy (I'm presuming, since there's no comment by the gastroenterologist), doesn't rule out any at present (but it's secondary at present as the primary Cardiac causes should be ruled out as a first priority like I've already mentioned)..

At first have a Cap PANTOPRAZOLE/DOMPERIDONE (40/30) mg stat , wait for few minutes, then have some light food and then have a Tab PARACETAMOL 650 mg, observe yourself after this for the next 1 hour..

If still you feel no improvement, and there's any worsening of those symptoms i.e. pressure symptoms/breathing problems/excessive sweating then please visit your nearest ER for a prompt physical examination and some quick investigations accordingly..

Let me know how you stay later on..

Take Care
Kind Regards

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

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