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How is chest tightness treated ?

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General & Family Physician
Practicing since : 2010
Answered : 157 Questions
Hello, I am a 39 year old male, 5'10, 220lbs. Currently I am taking 10mg of Lexapro for anxiety/depression. I do not smoke or drink and try to run 10-20 miles per week. I have run some half-marathons and one full last Oct. In my family there is no history of heart disease but a history of anxiety/depression. About this time last year I thought I was having a heart attack and was taken to the ER. Tests done included the nuclear XXXXXXX test, stress test, blood work, etc. everything came back as normal except I had a high CK level. The day prior to this episode I ran 10 miles and was dehydrated after the run. This episode was a severe panic attack and went to a therapist to try to work things out. Fast forward to about four months ago and my anxiety levels began to increase. I went to see my GP and was put on Lexapro. I also made an appt with a cardiologist and he reviewed my charts from the hospital visit and also did an echocardiogram. Everything checked out to be fine. The medication helped and was feeling better up until 2-3 weeks ago. Anxiety levels are back along with symptoms that include: chest tightness (pectoral muscles feel like they are always contracted), arm numbness that has been coming and going (feels like I hit my funny bone), minor insomnia, clenching my jaw. My anxiety cycle comes from the aches/pain that I am having. I am fearful that there is something still wrong. Here is my question, is it still safe to exercise while having these anxiety symptoms? I have a big run coming up and I realize this all might be due that. Any help is appreciated.
Posted Sun, 29 Apr 2012 in Lung and Chest disorders
Answered by Dr. Sunil.N 2 hours later

Thanks for your query.

After considering your cardiac work up being normal, I find nothing against continuing with your exercise , anxiety symptoms are not the contraindications for exercise.

Exercise is a natural stress buster and anxiety reliever. Research shows that as little as 30 minutes of exercise three to five times a week can provide significant anxiety relief. When doing exercise, your mind will be distracted from thinking something anxious, and your body will be healthier, less symptoms of anxiety will occur.

As you are on the treatment for the anxiety it would be better if you consult a psychiatrist ,along with the medications there are other modes of treatment like Cognitive behavioral therapy which is equivalent to the medications and it will surely help you to combat the anxiety.

Regarding the symptoms of heart attack, if you experience sudden heaviness in the chest or crunching pain which radiates to the left arm or left part of the jaw or to the upper abdomen along with sweating, dizziness, nausea you must rush to the ER as these indicates the possible heart attack.

In addition to the above you can follow the Relaxation techniques such as meditation , XXXXXXX breathing techniques etc.

Before the big event i suggest you to consult a psychiatrist and follow his suggestions.

Hope this helps you.If you have any follow up queries I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: How is chest tightness treated ? 40 minutes later
Hi Doctor,

Thank you for responding. I went yesterday to my doctor and she is increasing (slowly) my daily dose of Lexapro over the next few weeks. Along with returning to therapy I will be trying yoga as a relaxation technique.
As I mentioned before I have chest tightness (no pain), that comes and goes. I also tend to have my left side cramp for extended periods of time. The lat muscle down to my obliques feel contracted or cramped. Is there any over the counter medication I could take to see if this goes away?
Thank you again.
Answered by Dr. Sunil.N 1 hour later

Thanks for your follow up query.

Feeling of chest tightness is because of your anxiety and you will get relieved eventually as your practicing the relaxation technique.

Muscle cramps are common in the athletes , and i'm not able to draw an clear reason for the cramps but i think it might be because of the electrolyte imbalance that can happen in your routine exercises and proper hydration during the exercise will decrease the muscle cramps.Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak and also the cramps can be stopped if that particular muscle is stretched.

No need for the OTC medications but if the cramps worsens you can consider taking Vitamin E 400 units , magnesium supplements 50-100mg etc daily . But how much will it be helpful cannot be predetermined.

Cramps are inevitable, but if possible, it would be best to prevent them.
You can follow these simple tips :
1)Adequate warm-up and cooldown, to prevent cramps that are caused by vigorous physical activity.
2)Good hydration before, during, and after the activity is important.
3)Excessive fatigue, especially in warm weather, should be avoided.

Hope this helps you.If you have any follow up queries I will be available to answer them.

Wish you good health.

Above answer was peer-reviewed by
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