Hi

Thanks for posting your query on XXXXXXX

First I will answer your second question. In my experience an attack of urticaria lasts for 4 - 6 weeks. It may finish off earlier if the trigger (source has been removed) Usually if the source has been removed then the attack may clear up within a day or two. You may drink lots of pure water to flush out chemicals as a result of mast cell activation in the blood. May also clean your bed and mattress and take bath with curd or yogurt rather than soap.

Now coming to your first question. Chest tightening and jaw pain warrants an ECG to rule out heart problems. Since it is occurring at night it may be angina - the Variant or Prinzmetal type. This is a type of angina that happens at rest, typically after mid-night. Diagnosis is made by doing ECG during an attack. It usually happens when there is migraine or cigarette smoking history.

Let me know If you need more clarification.

Regards

Dr Vaishalee

---

Hi again,

If you can describe the chest pain in detail, I will be able to figure out the source of it. Do you get the chest pain with position change or breathing? From how long are you having the symptoms? Any other relevant characteristics of chest pain you may have noticed. What are the medicines you are taking? I will also suggest a lipid profile along with other detailed blood tests.


I hope they did the ECG during an attack. If not, then we can ask for exercise tolerance test like stress echocardiography and maybe something can come up on it.

Since ECG is negative and you are having pressure on face and behind ears on both sides, it may also point towards temporomandibular joint disorder. This joint is below the ears and helps in the movement of lower jaw. Due to pain or stiffness in this joint the overlying muscles may become spastic and result in pain. In such a case a dental consult is of help.

Last but not the least, stress can cause similar symptoms. I will advise a few lifestyle changes that may help.

1. Take fruits and vegetables at least 5 times a day. Take low calorie diet. High calorie foods are milk products (cheese, butter, cream, ice-cream, etc) and non-vegetarian food. Take hygienic food and pure drinking water. Drink lots of water to flush out toxins and excessive medicines.

2. Exercise for at least 20 min a day. Exercise can include walk, gym, yoga, cycling, swimming, etc

3. Relaxation techniques: Help by eliminating the physical effects of stress on body. For example during a stressful time a person tends to breathe heavily. It results in symptoms of hyperventilation. In such a case a breathing technique can help that regulates the breathing pattern.

I will describe a few examples of relaxation techniques. You may try and see if something works for you.

There are four major types of relaxation techniques:

Autogenic training: The person imagines a peaceful place and then focuses on different physical sensations, moving from the feet to the head. For example, one might focus on warmth and heaviness in the limbs, easy, natural breathing or a calm heartbeat.

Breathing technique: For example XXXXXXX XXXXXXX (available in some cities of Australia)

Progressive muscle relaxation: This technique involves slowly tensing and then releasing each muscle group individually, starting with the muscles in the toes and finishing with those in the head. This works best during acute stress and office environment.

Meditation: this helps too

Regards

Dr Vaishalee

---

Hi again

Though I am not much of a poet but understood this poem and appreciate the gesture. I should have understood this aspect from the smile on your face.

Thank you

Dr Vaishalee

---