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Stress, heart attack, chest tightness, arm pain. Muscular pain or anxiety ?

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Practicing since : 2002
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I think I am having a problem with anxiety. I've been under alot of stress lately. A few months ago I went to the ER because I had all the symptoms of a heart attack, and it lasted about 24-48 hours. I was working tons of hours an office job at the time. They did an ekg, some blood test for heart attack and a chest xray. They said it could be muscular or anxiety but said I wasn't having a heart attack. But now every once and awhile I feel uncomfortable feeling on the left said of my chest and sometimes my left upper arm like under my bicep feels tense.
Posted Mon, 23 Apr 2012 in Anxiety and Stress
Answered by Dr. Robert Galamaga 26 minutes later
Hello and thank you for your query.

Let me provide you with some information reassurance and some suggestions regarding what is going on. As far as your symptoms it certainly could be due to anxiety. I am glad you went to the emergency department to make sure there was nothing else going on. It would be exceedingly rare for a patient as young as you to have a real heart problem.

As far as anxiety goes you can present in many different ways. Some patients begin having some sweating on their palms or their feet. Other patients may have chest discomfort or difficulty breathing. Still others may have other symptoms which may not be typical of your anxiety. It can be sometimes difficult to decide if the symptoms are due to anxiety or something else.

In your case we have to consider if this is true anxiety. If you think about everything that is going on in your life are you currently stressed out either at home or at work or otherwise? Are you sleeping enough?Adequate sleep is at least seven or eight hours per night. In addition regular exercise is absolutely important at least four or five days per week in order to have a good impact on stress and anxiety.

It sounds to me that your case is most likely a case of mild anxiety. Let me tell you that you are certainly not alone in having this kind of issue. I would say the majority of patients I see in my office have some anxiety at least at some point in our life. I would consider all of this and deciding if this is what you truly feel is going on.

As far as things you can do to help with the anxiety I would suggest a few things. First in addition to exercise I would recommend some degree of meditation or yoga. I have had patients do excellent with this type of thing. In addition there are some medications which may be of benefit but usually I would consider that if everything else is not very helpful.

Again I thank you for submitting your question. If you have additional concerns I am available to address them.


Dr. Robert.
Above answer was peer-reviewed by
Follow-up: Stress, heart attack, chest tightness, arm pain. Muscular pain or anxiety ? 1 hour later
Thank you very much for your reassuring answer. Makes me feel better already.
I have more additional question for you, which you may or may not want to answer. It is totally unrelated to my first question. I understand fully if you do not want to provide insight.

Although I know a few doctors, I rather not ask them this personal question.

I have a undergrad degree and a very well respected professional designation and earn a good living (alot of work though). One of the main reasons I am going through so much anxiety is that I am considering trying to make an attempt a career change. I've always wanted to be a doctor, but now at the age of 25 I am considering making an attempt at this dream. It would require much effort and time for me to even be considered to medical school.
My question to you is, how do you like being a doctor? What are some things you like about the job, and some things you do not like? Did you enjoy medical school and residency? I am not concerned about the money because my current profession is an area which is rewarding financially. I would continue to work until I get accepted to medical school. Passing my professional exams is a moment someone in my field remembers for life and is the highlight of my professional career (probably because of amount of work I put into it). Did you find that medical school was a very rewarding experience? I would probably be entering medical school at 27-28 years old.

Again, feel free to ignore my message if you do not want to answer.
Answered by Dr. Robert Galamaga 4 hours later
Hello again.

Let me say that I feel strongly that if your heart is drawing you toward the field of medicine and you are inspired to pursue this type of education then you should seize the day and start on the path to obtaining that goal.

I am very happy to be a physician. Money is secondary to everything in my case. I wake up enthused about what I will be challenged with in the clinic or hospital. I love collaborating with other physicians to take care of my patients as well. I also appreciate it when a patient expresses gratitude to me for helping improve their quality of life.

It is a lot of work - studying, exams, training and such BUT it is worth it. You are still quite young my friend. I was 24 at start of med school but felt I had gained maturity by working and growing personally prior to med school. You will be on this earth for possibly another 80 why not pursue the dream which your heart and mind seem to be calling you to pursue.

School and residency and fellowship are difficult but not unbearable. You will make many friends who will be sources of support for many years.

Finally you seem like a very genuine, intelligent and reasonable gentleman. This would suit you perfectly to become an outstanding physician.

I wish you all the best.

Dr. Galamaga
Above answer was peer-reviewed by
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