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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having Pain In Chest, Breathlessness, Sweating And Fatigue. Suggestions?

Hi! I am 34, average build i.e. weight around 71, height 5 10. For the last few days 15-20 approx I have strange feeling in my chest , which pains inbetween, specially after I exert little. Even if I climb few stairs I have breathlessness, sweating which is more than what i normally sweat. Also my pulse is generally above 90 and even sometimes above 110. Even after walking little i get fatigued as if I did lots of hard work. My overall working capacity has also gone down drastically. Whenever i feel pain in chest it then radiates to my left arms also sometimes, and I also feel lots of pulse beats on my right arms, or legs. Sometimes even after I eat food, i start to sweat more than normal. In between I have nauseating feel too. Feeling very weak nowadays. Can t stand for longer time, feel like taking rest. With these symptoms I went to doctor, he checked BP first which he didn t tell me, then asked me for ECG , which showed borderline ECG and since I didn t have earlier ECG he asked me to get it done again after 5 hours, which also came same. The markings in the ECG came as some early R/S transition seen in V2, and in second ECG it came as V1 and V2. He was not so bothered, asked me to take rest for couple of days and then go for ECHO, which also came as normal. LVEF was 63 %. Now since last 2-3 days my heaviness in chest has increased with breathlessness when I do minimal physical work and after I rest for sometime, It becomes normal. Pain is also there on the left side but it is not continuous pain, it comes sometimes, maybe 6-7 times in day. By the end of the day I am totally exhausted that just by lying on bed I sleep. I m worried cause, heart disease is common in my family and so it diabetes and BP. just recently my Mom had a bypass. Now at my age when I should be active I am unable to do hard work. Should I go for stress test? TMT? what is the reason of my symptoms? Continuation to above, I did TMT, I could not complete all the cycle, as started feeling pain in chest, the Cardic surgeon known to me was serious as he told me there are variations and that too significant in 1 lead. But the cardiologist said its negative, and nothing to worry much, although I should go for CT Angio just to be sure, than he asked me to do ECG after 1 hour which was similar to my earlier ECG i.e. 1 lead i.e. iii minor deviation. He said its nothing to worry though. I got my lipd profile down which showed cholestrol on higher side although not too high 233 was the reading and was given medicine for it. I am worried cause my symptoms are getting difficult, I am feeling too weak, sweat a lot with pain, and since last 2 days have strong ir-regular palpitations felt on my right arm, although they last few seconds but inbetween they are so prominent that my entire arm gets vibrated. Please help me, and I am very sorry for writing so big story.
Mon, 30 Sep 2013
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Cardiologist 's  Response
Hi,

You are not mentioning if you checked your blood sugar level, and what were the results to exclude diabetes.

It is also important to lose weight, The mediterranean diet is one of choices I recommend to my patients.

At the end, you should go for coronary ct, if everything is ok, then, you should repeat cardiac ultrasound and TMT after 6 months.

You can use pain-killers (orally and locally), depending on the intensity of your pain.

It is advised to go for physical activity step by step by increasing its intensity.

For example, 1 day walk for 5 minutes, then add more minutes other days. Try to climb the stairs gradually.

If your pain within the 6 months is intolerable, then, go to ER immediately.

Thank you.
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Having Pain In Chest, Breathlessness, Sweating And Fatigue. Suggestions?

Hi, You are not mentioning if you checked your blood sugar level, and what were the results to exclude diabetes. It is also important to lose weight, The mediterranean diet is one of choices I recommend to my patients. At the end, you should go for coronary ct, if everything is ok, then, you should repeat cardiac ultrasound and TMT after 6 months. You can use pain-killers (orally and locally), depending on the intensity of your pain. It is advised to go for physical activity step by step by increasing its intensity. For example, 1 day walk for 5 minutes, then add more minutes other days. Try to climb the stairs gradually. If your pain within the 6 months is intolerable, then, go to ER immediately. Thank you.