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Having headaches, breathing difficulties and heart palpitations. X-ray and blood test normal. MRI done. What could this be?

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Practicing since : 1998
Answered : 1257 Questions
Hi There,

I'm a 35 year old female. About 1 month ago I started having slight problems like headaches which I never get, then later breathing difficulties once in a while, with heart palpitations. Then I noticed if I used ear plugs in the evening, I could hear my heart beat n my left ear and feel my pulse in my arm at the biceps area. A few days later I woke up soaking wet with palpitations. I went to a walk-in clinic, I got put on a holter monitor, I had blood tests done. They came back fine. My doctor told me it's probably a very bad case of panic attack.I have not gone back to work, I wanted to make sure I rest, and won't have stress. I also went to the Hospital, where they did blood tests, X-ray. They also came back fine. But the symptoms never went away. I have arm pain, headaches, hand twiches once in a while and it all seems like its an artery on the left side of my shoulder that gives me trouble, I can feel it vibrate sometimes in my whole arm, goes up in my neck as well and in the chest area, had mild nausea a few times as well. Sometimes I have mild twitches in my leg too.
I have already seen 5 doctors in walk-in clinics, and my family doctor,they all say different things, they don't think it's anything serious, I asked for MRI ( I thought it might be a blood clot as well ), they are not giving me a referral. I do feel better than 3 weeks ago, about 60% better, but I just think that it shouldn’t be left as it is. I’m thinking that if I don’t get referrals, I need to go to the private clinic and get an MRI done.

Thank You: XXXXXXX
Posted Fri, 27 Sep 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 12 hours later
Brief Answer:
Partly agree with your doctor, need workup

Detailed Answer:
Respected Ma'm
1. The feeling of pulsations in your biceps area as well as hearing of heart beat in ear can occur with excessive sympathetic stimulation or in hyperdynmaic circulation. These are quite frequent symptoms in patients under stress/ anxiety. Sympathetic stimulation can also cause palpitation. Twitching in legs, arms, frequent headaches, vibrating sensation can all occur in a patient with stress. All these features favor the stress/ panic version of your doctor. However that's only one side of coin. Before a cardiology clearance a person has to take an ECHO and a stress test or a stress ECHO combined. ECHO will also confirm presence of any cardiac cause for hyperdynamic circulation. You can discuss with your cardiologist.
2. Other symptoms like headache , nausea and neck pain require a neurological opinion and a work-up only of your neurophysician thinks it is required. I do not think that directly going for an MRI will benefit you fully.
Hope this provides some insight into the problem.
Feel free to discuss further.
Sukhvinder Singh
Above answer was peer-reviewed by
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