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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could The Tightness In The Chest Be Due To Anxiety And Stress?

hello
Hello im actually asking a question for a female friend. Shes 32 and does stress out and has anxiety at times. But she complains about chest pain(tightening pains) on the left side over her breast which id assume thats her heart. She has rapid heart beats sometimes, sweats and overheats, pain in her back and fuzzy feelings on her right arm and leg all when her heart acts up. She does have some kinda valve heart disease if i remember correctly which has something to do with the valves not opening or shutting enough to give the heart blood. I think thats what it was. Anyways she said doctors always tell her she just has anxiety but theres gotta b more to it then just that. Shes scared and it worries me. Its a good friend of mine.
Wed, 16 Apr 2014
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Psychiatrist 's  Response
Hello,
This is more lilely an organic case in which the heart is not well enough and in events of stress - becomes more vulnerable and has such presentation.
She should definitely get her stress test done- TMT which will determine the capacity of her heart muscles to endure physical stress. She should also get blood pressue reading, an ECG and may need an ECHO as well.
One should always investigate such conditions throughly (in cases where there is already a compromised heart). Only after ruling out any new cardiac problem one should move to psychological reasons to blame for the symptoms.

So, it is more like a mixture, but first and foremost it is necessary is to take care of heart ( as this can affect life directly).

she can take sertraline 25mg in morning for her anxiety. For acute attacks- clonazepam 0.25mg usually suffice. Can be kept under the tongue for faster response.

Hope the reply is useful
Dr. Manisha Gopal
MD psychiatry
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Could The Tightness In The Chest Be Due To Anxiety And Stress?

Hello, This is more lilely an organic case in which the heart is not well enough and in events of stress - becomes more vulnerable and has such presentation. She should definitely get her stress test done- TMT which will determine the capacity of her heart muscles to endure physical stress. She should also get blood pressue reading, an ECG and may need an ECHO as well. One should always investigate such conditions throughly (in cases where there is already a compromised heart). Only after ruling out any new cardiac problem one should move to psychological reasons to blame for the symptoms. So, it is more like a mixture, but first and foremost it is necessary is to take care of heart ( as this can affect life directly). she can take sertraline 25mg in morning for her anxiety. For acute attacks- clonazepam 0.25mg usually suffice. Can be kept under the tongue for faster response. Hope the reply is useful Dr. Manisha Gopal MD psychiatry