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Suffering from chest pain, dizziness, nausea and sweating. ECG and urine test normal. Was a regular cocaine user. What is the diagnosis?

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Orthopaedic Surgeon
Practicing since : 1998
Answered : 4917 Questions
Hi, I have been suffering with a great deal of healthcare problems for the past five months and my GP admits to not having a clue what is wrong so I am seeking advice. I am 30 years old, 90kgs (moderate weight) and generally in reasonable shape, although I do drink more alcohol than recommended. My problems started around five months ago when I went out for lunch at work and suddenly experienced sharp chest pains and pain shooting down my left arm into my fingers. This was accompanied by dizzyness/lightheadedness and profuse sweating. I had been feeling slightly light headed and nauseous for a few days but nothing more than that, Given the chest pain symptoms an ambulance was called and they did an ECG in the ambulance which was clear. They took me to A&E where they did a further ECG, chest x ray and blood tests, all of which came back clear. They therefore discharged me from A&E although even on leaving I felt terrible and had terrible chest pains and nearly fainted shortly after leaving. Ever since that experience I have suffered from a huge number of other symptoms and had the occasional "attack" where I have ended up back in hospital, where further ECGs and blood tests have been performed which have always come back clear. I have experienced that many symptoms that it is hard to even remember them all, but a broad summary is as follows, roughly in order of when they materialised: - Chest pains. Always on left side, although does not seem worse with exertion. - Excessive sweating - Terrible reflux and belching. PPIs reduce acidity but still suffer from less acidic reflux. - Muscle twitching/fasciculations in various places - side of chest, upper arms, shoulders, thighs - Pain and aching in left arm, which can be upper arm, forearm, wrist or hand - Tight and painful jaw - Severe headaches, particularly around the temples and back of head - Pain and stiffness in neck, left shoulder and left back/lat - Strange pain in right rearside flank, almost like a stitch, which seems to persist 2 or 3 days then go. This has recurred several times. - "Weird" feeling inside my head - Difficulty concentrating/remembering - Shaking feeling internally - almost like world is shaking around me - Shaking in hands/fingers - notice mobile phone shaking when I hold it - Jaw tremor/teeth chattering - incredibly regular throughout the day - Blurred vision, particularly in low light. Always at medium/long distance. Very noticeable when reading something up close, and have blurred vision when look up - Strange feeling in right eyelid and feel like something in right eye constantly - Cramping in thighs ... and I am sure there are some more that I cannot even recall. Tests and results I have had so far: - Full blood screen, all of which came back normal with the exception of slightly inflamed liver which is likely due to alcohol intake. Key things like thyroid and B12 levels normal. - Lyme disease blood test - negative - Cardiac blood test - normal - 5 x ECGs - all normal - 2 x exercise ECGS - normal, although sweated excessively and felt faint following short exercise session - Cardiac echogram - normal - 24 hour cardiac monitor - short periods of slightly faster and quicker heart rate but considered normal - Brain and spine MRI - Waiting results but apparently would have called by now if problems identified so likely all clear. - Urine tests - all clear I have seen several GPs, 2 neurologists and 2 cardiologists. The GPs suggested anxiety, but I was not remotely anxious when these symptoms occurred and although I am not probably anxious about what could be wrong, I very much doubt the severity of the physical symptoms have been caused by anxiety. In hope, I have tried every anti anxiety medication suggested (xanax, valium, citalopram, respiridone), all of which have not helped at all. The cardiologists do not think it is cardiac related given my age and the various non cardiac symptoms. My only risk factor in this respect is that I was previously a regular cocaine user. The neurologists seem to think it is unlikely to be a sinister neurological disorder, although the brain and neck MRI will hopefully give a more definitive answer on certain possibilities like MS. There is a history of Parkinsons on my mothers side. I am suffering terribly every day and struggle to leave the house for a reasonable period on any day as I feel so bad. The physical symptoms really are dehabilitating. I am really desperate to get a diagnosis and I would really, really appreciate help.
Posted Thu, 5 Dec 2013 in Medicines and Side Effects
Answered by Dr. Vaibhav Gandhi 4 hours later
Brief Answer: Your all system tests looks normal Detailed Answer: Hello I have studied your case As per your symptoms there is possibility of lesion in your brain so let contrast MRI brain results come. I will advise you to do PET scan to look for any source of malignancy if clinical signs suggest for cancerous condition. As you are losing your weight there is possibility of malignancy so I will advise you to do PET scan to detect any abnormality in early stage . If all tests are normal you can consult psychiatrist for needful guidelines. Lifestyle Modifications will help to reduce symptoms - Proper nutrition - Regular physical activity - Adequate sleep - Stress reduction strategies; keep your self busy in creative activities. - Identify and avoid triggers (e.g., tobacco smoke, or sprays). Many of my patients have found good relief with SKY [sudarshan XXXXXXX yoga], meditation and pranayama so you can also start as adjuvant treatment with your medication. Till time continue your medication. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care.
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