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Chest pain, racing heart rate. EKG echo normal. Wore heart monitor, given calcium channel blockers. Thoughts?

Hi im 34 years old I do smoke about a half of pack of cigarettes a day. I have never had an issues with my health. I recently in feb went to the er with chest pain, they said I was having heart palpations and was dehydrated. I left there felt good for 5 days then went back to the er with chest pain and racing heart rate, I think it was 140 and my blood pressure was 110/108 they admitted me did an EKG and a echo cardigram, they said everything was fine. I wore a heart monitor at home for 2 weeks the. Went back to the cardiologist, he said a resting heart rate of 90 was ok but gave me calcium channel blockers to take when I felt my heart racing, bu if nothing is wrong with my heart why should I be taking these?? I can lay down and feel my heart beat and it feels like its pounding through my whole body and I have been getting little sharp pains that feels like its coming from my heart. I don't know if that's normal or if I'm just concentrating on it to much since everything happen. Are the echo cardigrams pretty accurate? Should I go get a second option? I'm a single mother of 2 and I just don't want anything to happen to me.. And thoughts would be great.
Asked On : Mon, 15 Apr 2013
Answers:  1 Views:  46
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

It is easier and is often necessary to treat many conditions than to diagnose the cause....
There are two approaches to treatment – 1- Symptomatic relief 2- Disease modifying / Your doctor has justly given symptomatic treatment.

You must stop smoking
You need further investigations...

Anaemia / Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much coffee, cola) / Medicines like Phenylephrine used for ‘cold’; Salbutamol used for asthma and so on are common causes.../ Fever / Thyroid / Vitamin D, calcium and magnesium may all have a role... / Illicit ‘drugs’ like Amphetamine are notorious to cause abnormal beats / At times, abnormal nerve paths in the heart (bypass tracts) are responsible!

     HOLTER (24 to 48 hour ambulatory monitoring) is done to analyse and plan for further management, if a routine ECG does not show. It may also detect silent (no symptom) ischemia.
     ECHOcardiogram is necessary to see the heart valves (Mitral Valve Prolapse) / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
      TMT (Treadmill exercise ECG) is done to exclude Ischemia (reduced blood flow).
     LABORATORY work-up is routine - like blood counts, sugar, urea, electrolytes (potassium in particular), thyroid (over-active) and so on.
     If there are no clues and if the problem is still bothering to the extent of interfering with life style, there is advanced techniques of investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Mon, 15 Apr 2013
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