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Dr. Andrew Rynne

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Are chest pain with palpitations and breathlessness symptoms of anxiety?

Answered by
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Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 5241 Questions

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Posted on Mon, 11 Aug 2014 in Hypertension and Heart Disease
Question: Can all my daily severe symptoms including severe central chest pain that radiates to my left arm back of my shoulder and up info my neck and jaw, the profuse sweating, the palpatations and the breathlessness are all anxiety even when I'm not having a panic attack? I am constantly thinking about my heart and having a heart attack 24/7 I'm that scared
Can anxiety create these intense exact cardiac symptoms? X

I have had a ct scan of my heart and an echocardiogram both came back normal

Would the ct scan of my heart rule out everything? Including small arteries? I know it came back saying everything was normal but I don't know what was normal like valves and arteries

I constantly feel like this and I'm so exhausted and I feel genuinely unwell which frightens me more I'm convinced it's my heart
doctor
Answered by Dr. Albana Sejdini 1 hour later
Brief Answer:
It's due to medications you use...

Detailed Answer:
Hi there,

I am sorry for the situation you are in. I am also happy that your both your cardiac tests (ct-scan and echo) resulted normal. If it was from your heart, these examinations should had reported.

This makes me think that there is something else triggering your symptoms. I was looking into the medications you are taking and found out that the use of some of them might trigger the symptoms you are experiencing:
- mirtazapine
- amytriptyline
- oramorph Sr
- tramadol

So, I advise to consult with your doctor (who prescribed such medications to you) about their side effects in order to adjust their dose or switch to other meds.

Discuss this further with your doctor and let me know!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 11 hours later
At the moment I am only taking tramadol and diazapam all my other meds I haven't took for months

Diazapam is the only thing that remotely helps with these symptoms but I'm not allowed to be on it any longer as it is for short term use only

Do you think it is my anxiety disorder? Can you recommend another medication I can recommend to my gp that is similar and could help me
doctor
Answered by Dr. Albana Sejdini 3 hours later
Brief Answer:
Buspar&psychotherapy....

Detailed Answer:
Hi back,

Thank you for following up.

First, must rule out other organic problems before confirming it is due to anxiety disorder.

You can discuss with your doctor about having a full check up (not only examination of cardiovascular system) to rule out other pathologies:
- hormonal balance (rule out thyroid problems)
- measure electrolytes in blood
- chest X-ray and pulmonary function tests to rule out lungs issues
- control your blood sugar level to detect spikes or very low levels

Buspar is one alternative medicine. I also highly recommend to my patients to schedule psychotherapy seances as they have helped many of my patients who tried. They succeeded to get out the anxiety status and continue a normal and anxiety-free life.

You can discuss this with your doctor too.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 1 hour later
I have had a chest x ray and a cpta scan on my lungs and both were clear I've also had my thyroid checked it was normal

If I take diazapam 5 mg during the day can I take herbal rescue remedy at night? I've been told I can but I wanted to check with a professional first
doctor
Answered by Dr. Albana Sejdini 23 minutes later
Brief Answer:
Yes,Excellent choice...

Detailed Answer:
Hi back,

Yes, you can safely use rescue remedy at night. Preferably, I advise my patients to take diazepam 5 mg at night, while the herbal remedies (pills or tea) during the day for better results.

Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 34 minutes later
Thank you. :)

About four weeks ago I had a massive anxiety attack in a packed out cinema and felt a lightning blog pain from my chest down my left arm which was different to the usual pain and aches
At the hospital my troponin was 44 but six hours later it was normal less than 10 I was told I had no damage and sent home and then I had my heart ct scan which was normal

Two gps have said it is my anxiety that caused it but one gp said there was no way my troponin would be that high without damage and anxiety cannot cause it so I'm frightened I've had a heart attack and I'm not getting help or that I'm heading to having a heart attack
I have had three troponin in the last two weeks that were all normal
I guess I'm just looking for closure especially with all my cardiac symptoms even though I know my gp said I'm creating the symptoms in my head

Can you give me your opinion?
doctor
Answered by Dr. Albana Sejdini 23 hours later
Brief Answer:
Not related to your heart...

Detailed Answer:
Hi back my dear,

Troponin level might be increased in various circumstances where striatal muscle is being damaged (whether skeletal or of the heart).

As there are 3 main units of troponin complex, only 2 of them are specific for the heart muscle, also called "cardiac troponins". Therefore, when your troponins are measured, you can asked about the level of cardiac troponins to evaluate if it has to do with your heart damages.

Usually, when cardiac troponins are elevated, they will take time (few days) to get down as the reparation of the heart muscle from the damage is not happening within few hours (takes longer).

As your troponin levels were down to normal level after 6 hours, this makes me think that nothing bad happened to your heart. This was also confirmed by other measurements of troponin and other cardiac test.

Definitely, it had to do with the panic attack you had.

All the best!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 2 days later
Thank you for all your advice

When they originally suspected I had angina they have me a gtn spray and it actually works it takes away most my symptoms so that's why I think it's something cardiac and I'm getting worse and worse everyday the pain I'm in today is unbearable
Diazapam also helps so I cannot understand what is wrong with me I'm quite frightened about my heart especially with the gtn spray working but diazapam also helps a great deal so it's confusing

I'm frightened that something has been missed on my tests which happened to my mothers sister she had every test done possible and told she had anxiety she died from a 95% blockage in her arteries

doctor
Answered by Dr. Albana Sejdini 3 hours later
Brief Answer:
Try to control anxiety&you'll be fine...

Detailed Answer:
Hi back my dear,

I understand your worries. You have done all the necessary consultations and lab tests and nothing was found fortunately. This should be taken as a good sign from you.

So, try to relax and control anxiety. That will make your pain and problems worse. If you cannot succeed alone, then, ask to get helped from your family or friends. If still cannot control anxiety, psychotherapy can help.

You are too young to think of death. Enjoy life with its beauties.

The fact that your mother's sister had a heart blockage increases the chances to have heart problems. However, if you follow a healthy lifestyle and diet regimen, that risk is probably reduced. So, think it this way and you will see improvement.

All the best! Enjoy life!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Albana Sejdini 3 hours later
So despite not having a stress test and the heart attack symptoms the resting tests were enough? I am truly terrorfied the fact I'm constantly sweating, crushing central chest pain left arm pain jaw pain and pain between my shoulder blades everyday is so frightening I can't eat or sleep

Can anxiety truly produce these symptoms to exactly mimic a heart attack?
doctor
Answered by Dr. Albana Sejdini 26 hours later
Brief Answer:
Yes,anxiety can mimic exactly heart attack...

Detailed Answer:
Hi back my dear,

Yes, stress and anxiety can mimic exactly heart attack. However, to confirm, should run the above-mentioned tests. If they are ok, then, it is due to anxiety.

The characteristic of anxiety attack is that the pain gets more intense if you think over it or if you get more worried.

All the best!
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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