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What Causes Chest Pain, Nausea, Fatigue And Insomnia?
Question: Hi Doctors,
I'm XXXX 28 years old, light smokers, i do a bit exercise like 20 min per day, i work a lot on computer...
Since one year i feel pain in my chest its not really a pain its like i have a weight on my chest and its getting worst with the time...i have mostly pain on left and in middle..i also feel nausea and tired all the tinme, i not sleep good at night...I have done cardiac exams 6 months ago like ekg, holter 24h and echographia and everything was ok... i often worry about my heart, because without i take atenolol ( small dosage 12,5 mg per day) i get tachycardia easily...with exams in the last 6 months with a cardiologist can i excluse any heart problems or i should make more exams???where all my problems can come from... i know im also anxious about my health condition but i really would like to feel better and restart a normal life again without worry anymore...can someone help me here?
My last question is can i use diazepam at small dosage even i use a betablockers?
I'm XXXX 28 years old, light smokers, i do a bit exercise like 20 min per day, i work a lot on computer...
Since one year i feel pain in my chest its not really a pain its like i have a weight on my chest and its getting worst with the time...i have mostly pain on left and in middle..i also feel nausea and tired all the tinme, i not sleep good at night...I have done cardiac exams 6 months ago like ekg, holter 24h and echographia and everything was ok... i often worry about my heart, because without i take atenolol ( small dosage 12,5 mg per day) i get tachycardia easily...with exams in the last 6 months with a cardiologist can i excluse any heart problems or i should make more exams???where all my problems can come from... i know im also anxious about my health condition but i really would like to feel better and restart a normal life again without worry anymore...can someone help me here?
My last question is can i use diazepam at small dosage even i use a betablockers?
Brief Answer:
you've got a problem with anxiety
Detailed Answer:
Hello,
since you've done all the necessary cardiologic tests and you're healthy, there is chance of heart disease. Many individuals with anxiety have tachycardia and chest tightness, these are very common presentations. If this symptom interferes with your life significantly then you should talk to a psychiatrist. Atenolol blunts the symptoms (you won't feel tachycardia or the need to breathe very fast).
Finally regarding diazepam, the answer is that you can take it with atenolol, although I would advise against using benzodiazepines because they may cause addiction and they have nervous system side effects like drowsiness, etc which may indeed interfere with your daily activities in a different manner.
If atenolol is not sufficient to suppress the symptoms you can try either a higher dosage or another beta blocker (like propranolol for example) but watch for a low pulse rate.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
you've got a problem with anxiety
Detailed Answer:
Hello,
since you've done all the necessary cardiologic tests and you're healthy, there is chance of heart disease. Many individuals with anxiety have tachycardia and chest tightness, these are very common presentations. If this symptom interferes with your life significantly then you should talk to a psychiatrist. Atenolol blunts the symptoms (you won't feel tachycardia or the need to breathe very fast).
Finally regarding diazepam, the answer is that you can take it with atenolol, although I would advise against using benzodiazepines because they may cause addiction and they have nervous system side effects like drowsiness, etc which may indeed interfere with your daily activities in a different manner.
If atenolol is not sufficient to suppress the symptoms you can try either a higher dosage or another beta blocker (like propranolol for example) but watch for a low pulse rate.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes i have severals questions more
Im not that healthy i feel really tired since couple of months but maybe its related to lacking of exercice and stress
1/ if i have done EKG HOLTER, EKG, ECHO last summer can i definately excluse any coronary diseases??
2/Where my chest pain can come from except heart?
3/Diazepam at even really small dosage help me like o,5mg per day, do i have any risk of dependance even with s small dosage like this?
4/i also have really difficulty to make full night, i wake up several times during night, what could i take for it?
Thanks for the time you invest for me.
XXXXXXX
Im not that healthy i feel really tired since couple of months but maybe its related to lacking of exercice and stress
1/ if i have done EKG HOLTER, EKG, ECHO last summer can i definately excluse any coronary diseases??
2/Where my chest pain can come from except heart?
3/Diazepam at even really small dosage help me like o,5mg per day, do i have any risk of dependance even with s small dosage like this?
4/i also have really difficulty to make full night, i wake up several times during night, what could i take for it?
Thanks for the time you invest for me.
XXXXXXX
Brief Answer:
coronary artery disease can be reasonably excluded
Detailed Answer:
You're welcome!
If you've done all the cardiologic tests (including cholesterol, triglycerides, blood sugar, etc) and they're all OK then coronary artery disease can be reasonably excluded.
Chest pain may have various causes including the following:
- heart disease (mostly coronary artery disease, but also pericarditis, myocarditis, etc)
- lung disease (pulmonary embolism, pleuritis, pneumonia, etc)
- gastroesophageal disease: diseases of the esophagus may cause chest tightness or pain usually with a burning quality.
- musculoskeletal disorders cause localized pain that can be reproduced by palpating the involved tissues.
- anxiety, may cause practically any symptom.
- conditions below the diaphgragm like gallbladder disease and stomach/duodenal ulcer (although the discomfort is commonly located in the upper adbomen).
The problem with any benzodiazepin is that you're going to need more and more to achieve the same result and you're going to get addicted if you don't use it for only a very short period of time.
Finally regarding your sleep problems, I believe that you should first focus on other measures like more physical activity (regular exercise). Sometimes sleeping difficulty can be a presenting sign of depression (which very commonly exists concurrently with anxiety). Feeling tired is another symptom of the same disease.
You'd better do some basic tests (your primary care physician can guide you through this) including thyroid function, complete blood count, urea, creatinine, etc (the very basic biochemical tests) to identify potential causes. If no cause can be identified (which is the most likely scenario) then you should focus on the psychological matters.
Kind Regards!
coronary artery disease can be reasonably excluded
Detailed Answer:
You're welcome!
If you've done all the cardiologic tests (including cholesterol, triglycerides, blood sugar, etc) and they're all OK then coronary artery disease can be reasonably excluded.
Chest pain may have various causes including the following:
- heart disease (mostly coronary artery disease, but also pericarditis, myocarditis, etc)
- lung disease (pulmonary embolism, pleuritis, pneumonia, etc)
- gastroesophageal disease: diseases of the esophagus may cause chest tightness or pain usually with a burning quality.
- musculoskeletal disorders cause localized pain that can be reproduced by palpating the involved tissues.
- anxiety, may cause practically any symptom.
- conditions below the diaphgragm like gallbladder disease and stomach/duodenal ulcer (although the discomfort is commonly located in the upper adbomen).
The problem with any benzodiazepin is that you're going to need more and more to achieve the same result and you're going to get addicted if you don't use it for only a very short period of time.
Finally regarding your sleep problems, I believe that you should first focus on other measures like more physical activity (regular exercise). Sometimes sleeping difficulty can be a presenting sign of depression (which very commonly exists concurrently with anxiety). Feeling tired is another symptom of the same disease.
You'd better do some basic tests (your primary care physician can guide you through this) including thyroid function, complete blood count, urea, creatinine, etc (the very basic biochemical tests) to identify potential causes. If no cause can be identified (which is the most likely scenario) then you should focus on the psychological matters.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will ask a last question doctor, is it normal that heart rate change a lot just from sitting position to stand up position like i sit and rest im around 60 and just stand go to 90 then go down 90 ... u will think im crazy i guess i just need someone tell me everything is ok am fine. im really worry to have heart problem.. last year i have make many panic attack and since that time i m worry about my condition, scare to do exercice like before always check my heart beat...not a life
Brief Answer:
it's just anxiety
Detailed Answer:
I strongly believe that your symptoms can all be attributed to anxiety. The change on heart rate is not normal. We do have a little higher heart rate when we stand but not that much. Anxiety makes you raise your heart rate. Since your cardiological workup was all right I believe that exercise will help. Exercise will help your mind get distracted from your anxious thoughts. If you think you can't cope with these symptoms on your own then consulting a psychiatrist may help.
Kind regards!
it's just anxiety
Detailed Answer:
I strongly believe that your symptoms can all be attributed to anxiety. The change on heart rate is not normal. We do have a little higher heart rate when we stand but not that much. Anxiety makes you raise your heart rate. Since your cardiological workup was all right I believe that exercise will help. Exercise will help your mind get distracted from your anxious thoughts. If you think you can't cope with these symptoms on your own then consulting a psychiatrist may help.
Kind regards!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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