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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering From Pain In The Chest. Guidance

I am an IT specialist and when I am at my desk typing something about some software, I’ll feel a big thump inside my chest that’s so strong it takes my breath away. Then as the day goes on, the feeling of pressure like someone is pushing against my chest will start to build up. And if I stand or move the area of my chest around my sternum and a bit high will feel real sore even to touch. Then by the end of the day the feeling of pressure has continued to increase to the point that even laying down it feels like a ton of weight on my chest. If I lay on my right side, there is pain associated with the pressure. If I lay on my right side, same only a little less painful. So I have to lie on my back but even then there is a lot of pressure but not the pain. It takes about 45 or more at night for the pressure to subside to the point that it’s comfortable to sleep. 1) When did these symptoms start – how long has this been going on? Answer : Started aboutr 1 ½ yr ago
2) How often does this happen? Answer : Daily
3) When was the last time this happened? ? Answer : While I was sitting in the lobby waiting for this appt
4) Have the symptoms gotten worse over time or remained pretty much consistent? Answer : The pressure seems to be getting heavier but the rest is consistent.
5) In the type of work you do, do lift any thing over 10 of lbs (or what ever number would be relevant)? Answer: My job does not involve any lifting. I am an IT Software Support Specialist. I do analysis of software problems and work with the users, programmers and other analysts to resolve the problems.
6) Do you notice any other pain when this happens that you didn’t mention? Answer: Yes, some times there will be a sharp pain near my left shoulder blade but not always but doesn’t feel severe.
Thu, 9 May 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

A long list of questions and answers! - but lacking in important data!...You have not stated your personal habits, family history or co-morbidities, even age, gender...which could have an influence on the diagnosis and outcome...
This conglomeration is highly suggestive of Anxiety Neurosis... Yet, it should rather be an exclusion diagnosis than a primary proposition. See a cardiologist first.
A thorough history and physical examination is the first step -
ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination.
     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) / clots...
      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.

Your Internist shall suggest based on the situation. They are necessary to exclude - if not to rule in / even if the chances are little... If negative, go for Psychological assessment and assistance...

Take care
Wishing speedy recovery
God bless
Good luck
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Suffering From Pain In The Chest. Guidance

Hi friend, Welcome to Health Care Magic A long list of questions and answers! - but lacking in important data!...You have not stated your personal habits, family history or co-morbidities, even age, gender...which could have an influence on the diagnosis and outcome... This conglomeration is highly suggestive of Anxiety Neurosis... Yet, it should rather be an exclusion diagnosis than a primary proposition. See a cardiologist first. A thorough history and physical examination is the first step - ECG (Electrocardiogram / EKG) – Routine 12-lead – is part of clinical examination. 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) / clots... 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. Your Internist shall suggest based on the situation. They are necessary to exclude - if not to rule in / even if the chances are little... If negative, go for Psychological assessment and assistance... Take care Wishing speedy recovery God bless Good luck