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Stress, breathlessness, pain under breasts and armpit. Could it be a heart problem?

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Cardiologist, Interventional
Practicing since : 1996
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Hello i am 20 years old female with no health history past and normal healthy blood tests. It has been a month i am under extreme stress due to university examinations. I had a lot of shortness of breath which were caused from panicking.It has been four days i feel pain under my breasts and armpit. I just feel one second pain and then it goes away but i have that throughout the day. i was scared that this has to do with my heart because recently i heart a lot of people with heart problems. i went to a pathologist and he checked my palpitations and they were okay. he told me that the pain i felt was because of muscles.when i have that pain i feel like something pops . and i feel it either on theleft or right side. could it be a heart problem? i know its all on my mind but i want to be sure that my symptoms are just from stress.
Posted Mon, 21 May 2012 in Hypertension and Heart Disease
 
 
Answered by Dr. Raja Sekhar Varma 17 hours later
Hello,
Thank you for the query.

From the description of your pain, it is likely that this is due to stress and the resultant effect of stress on the chest wall muscles causing a feeling of tightness/pain.

At your age, it is unlikely to be of ischemic causes. However, if there is a strong family history of heart disease, and if there are risk factors like diabetes, hypertension, abnormal cholesterol and smoking, it will be wise to investigate further.

If there is a lot of anxiety over suspicion of heart disease, you could just get an ECG done during the episode of pain and upload the ECG here. I can review the ECG and give you a specific opinion. Echo of the heart can also be done to rule out other cardiac causes of chest pain like mitral valve prolapse, etc

I hope this helps to answer your query. Feel free to ask me any specific clarifications.
With regards,
Dr RS Varma
Above answer was peer-reviewed by
 
Follow-up: Stress, breathlessness, pain under breasts and armpit. Could it be a heart problem? 2 days later
So is it normal when someone is under stress to feel palpitations and muscle plain under the amrpits and breats? Also i feel my chest muscles tired sometimes because of hyperventilation and sometimes i have the "dreaming" like sense while i am awake. My blood tests were fine and when the pathologist "heard" my heart with the stethoscope he said everything is okay. is there any chance of hypoxia?
i believe it is stress because i can control the feelings sometimes.
 
 
Answered by Dr. Raja Sekhar Varma 18 hours later
Hello,
Thank you for the reply.

Yes, it is quite common to feel palpitations during times of stress. At these times, certain hormones are released which cause an increase in the heart rate and also makes the heart to beat stronger. This is perceived as palpitations by you.

Since you also tend to hyperventilate, the resultant loss of carbon-dioxide will cause respiratory alkalosis. This leads to feelings of light-headedness, muscular aches and cramps, etc.

Hypoxia is unlikely unless there are any lung diseases or any other condition that prevents oxygen exchange in the lungs.

I hope this answers your query. I wish you all the best for a healthy and happy life.
With regards,
Dr RS Varma
Above answer was peer-reviewed by
 
Follow-up: Stress, breathlessness, pain under breasts and armpit. Could it be a heart problem? 15 days later
Hello again doctor. i went today to a cardiologist and he performed and ECD along with an ultrasound Doppler. He checked my heart with the stethoscope as well and everything was fine. shape size valves everything. My chest pains are spams from muscles due to stress. it has been a month i am not moving much and i am under stress and when i walk my house stairs my heart feels like popping out and i did not have that thing. why is that even though all my exams came out normal?
 
 
Answered by Dr. Raja Sekhar Varma 2 hours later
Hello,
Thank you for the query and the follow-up.

There is an increased sympathetic nervous system response during times of stress such that the heart rate and the force of contraction are increased. The blood pressure also rises during these times. The heart, in effect, does extra work to pump blood against the raised pressure at a faster rate. This is to aid in the 'fight or flight' response to stress.

Therefore, even though there is no abnormality with the heart's structure and function, you feel a sensation of palpitations, the heart seems to beat faster and stronger and you can even feel it in your chest.

The effect is accentuated when there is lack of exercise and a general lack of physical fitness. Exercise or activity of any sort leads to an increase in the heart rate, increase in the systolic pressure and increased cardiac output. The amount of increase depends on the level of exercise. It has been shown that there are greater increases in sedentary people as compared to physically fit athletes.

These effects are physiological and not considered as abnormal. The best way to counter these is to improve your physical fitness through regular exercise, toning of the muscles and reduction of stress. The response from the heart will automatically improve.

To emphasize again, the treatment is to be directed against the stress and to improve your physical fitness by regular exercise and appropriate diet. The exaggerated physiological response of the heart will normalize in turn and your symptoms will disappear.

I hope this answers your query. Please accept my answer if there are no further follow-up questions.
With regards,
Dr RS Varma
Above answer was peer-reviewed by
 
Follow-up: Stress, breathlessness, pain under breasts and armpit. Could it be a heart problem? 18 minutes later
I am not in a XXXXXXX situation though when this happens?
 
 
Answered by Dr. Raja Sekhar Varma 6 minutes later
Hello,

The "danger" is from the stress and anxiety. There is no cardiac cause for worry.

Regards,
DR RS Varma
Above answer was peer-reviewed by
 
Follow-up: Stress, breathlessness, pain under breasts and armpit. Could it be a heart problem? 2 minutes later
is there any way or any medication that can help me cope with the stress? i dont want to take beta blockers because the only cause of my stress is university exams.
 
 
Answered by Dr. Raja Sekhar Varma 26 minutes later
Hello,

You need to be formally assessed about the stress and the effects that it is producing on your body by a qualified psychologist/psychiatrist.

The problem can be solved by rationalizing your response to stress. You should realize that some stress is likely to be present at different times of your life due to varying issues. How you respond to that stress makes the difference.

Beta-blockers are NOT stress busters. They only reduce the external manifestations of stress like fast heart rate. I would not recommend them for you.

If you understand that it is the university exams that is the cause for the stress, you can take remedial measures to reduce your reactions to it by preparing well for them, and realizing that these exams (though important) can be tackled by you just as you have tackled other exams before this successfully. Also, these are not once-in-a-lifetime happenings. Even if you do not do well for some reason, you will get opportunities to do better the next time. If you have studied well and prepared adequately, there is no need to worry at all. I am sure you will do well.

Wishing you all the best for a grand success in your exams,
Regards,
Dr RS Varma
Above answer was peer-reviewed by
 
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