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Back pain, burning in stomach, anxiety, panic attacks, GERD, EKG, ECHO, event monitor test normal, high cholesterol. Chances of heart attacks ?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
hello i wrote to u many times, i have been having back pain, especially on the left side, burning in stomach and throat, short of breath,feeling like u want to burp but cant. i do suffer from anxiety and panick ansd i do have gerd. i allways have a fear of heart attack. now my history. i did ekg and echo in may it was normal. i had event monitor last year it was normal, i had stree test last year i did two stages out of tree because i started having panick attack they told me even thogh they wanted me to get my heart rate to 138 i did 122 what i did finish was good. i had complete blood work done 3 weeks ago my cholesterol was 210 ldl 147 hdl 49 try 69 glucose 84. my guestion what can i have is it possible for me to have heart attack and how long does it take for atheroslerosis to develop need help and advices
Posted Mon, 30 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 2 minutes later
Thank you for your query.

From the description of your symptoms, you have GERD (gastro-esophageal Reflux Disorder) and an anxiety disorder. The symptoms do not appear typical of any cardiac pathology. This seems to be borne out by the results of the ECG, echo and stress test.

In order to identify the level of cardiovascular risk, I would like to know your age, gender, ethnicity, family history of heart attack, diabetes, hypertension and stroke, your blood pressure, weight and height, smoking status, presence of rheumatoid arthritis, presence of atrial fibrillation and presence of chronic kidney disease.

Your total cholesterol and LDL cholesterol levels are marginally high. You need to pay attention to your diet. Take care to consume a low fat diet, avoid red meat, fried foodstuff, avoid yolk, avoid butter/ghee/excess oil/curds/cheese, reduce the salt in your diet and take plenty of fruits and vegetables.

Atherosclerosis is a slowly progressive disease. It starts in your adolescence (some do say even from the time you were in your mother's womb) and progresses slowly. The rate of progression depends on your genetic make-up, and the influence of risk factors. While there is nothing that you can do about increasing age, gender, and your family history, the most important risk factors like smoking, abnormal cholesterol, diabetes, blood pressure and sedentary lifestyle can be tackled effectively to reduce the risk.

I hope this answers your query. Feel free to contact me for any further clarifications.
With regards,
Dr RS Varma
Above answer was peer-reviewed by
Follow-up: Back pain, burning in stomach, anxiety, panic attacks, GERD, EKG, ECHO, event monitor test normal, high cholesterol. Chances of heart attacks ? 15 minutes later
ok i am 32 years ols woman, white, no arthritis, last blood work was done about a month ago so my organs including kidney seems to be ok. my usual blood presure is 110/70, i never smoked i never drank. my family history my grandma passed away last year from heart attack due to diabetes and parkinsons. my dad had one stent put in lastb year he was 55 my mom is ekg echo stress test were fine i also had last year holter and event monitor they only found palpitations . they told me my heart is good. my height is 5.5 my weight is 176 i am on a diet. my anxiety is very scary.
Answered by Dr. Raja Sekhar Varma 18 hours later

Thank you for your clarifications.

With the data that you have given, it can be estimated statistically that the risk of a heart attack in the next 10 years is less than 1%. This is a statistical estimate that has been computed through validated algorithms based on epidemiological studies. Overall, it is likely to be accurate though individual variations can always be there.

Hence, you can rest assured that you are comparatively at low risk for a heart attack.

However, I would strongly advise you to consider lifestyle changes in terms of diet and exercise. A low fat and low calorie diet is advised, as detailed in the previous post. Your Body Mass Index is 29.34, which indicates that you are overweight. A BMI value less than 25 is optimal. You could consult your dietician and plan on a healthy diet which will enable you to reach your target. Exercise in the form of walking, jogging, swimming, etc is also useful to maintain fitness. You may even find that your anxiety symptoms and GERD improving with a good diet and exercise combination.

You can take a combination of Pantoprazole and Domperidone for your GERD. In addition, sucralfate suspension taken before meals can also help. Please avoid lying down immediately after food. Kindly consider evaluation also for hiatus hernia, gall stones and esophagitis, since these conditions can produce the symptoms of GERD.

I would also advise you to consider a good stress management program. Yoga and other relaxation techniques can be useful. In addition, your anxiolytic medications can be optimized.

I urge you to develop a positive outlook and stop worrying about your heart. With a reduction in weight and cholesterol levels, the risks of a heart attack will be lowered even further. Please do a repeat fasting lipid profile after 3 months of diet and exercise. If the lipid values are still above normal, I would advise you to start on a statin, after confirmation from your physician.

I hope this answers all your doubts. You can always contact me for any further clarifications.

With regards,
DR RS Varma
Above answer was peer-reviewed by
Follow-up: Back pain, burning in stomach, anxiety, panic attacks, GERD, EKG, ECHO, event monitor test normal, high cholesterol. Chances of heart attacks ? 1 hour later
please i have one more worry that i am concerned. i have been having headaches for more than a year. the feeling is like my head especially in the back is very heavy and myu neck hurts or it starts pulsating with my panick and anxiety i think its aneurism. i went to er last month they did neuro test and ct scan and told me i have migraines and tension headaches my scan was clean. they prescribed pheurocet . i dont have anybody in my family with aneurisms, i dont smoke, n o kidney desease.
Answered by Dr. Raja Sekhar Varma 4 hours later
Hi ,

Thanks for writing back.

The description you have given about the headache make me think of tension headaches as they present often that way.

I do not suspect it to be due to aneurisms , though aneurisms cause headache they will be so severe that you will not be able to locate the site .They may or may not be pulsatile.

Also you mentioned that the scan shows no signs of aneurism , I would suggest you not to worry on the same and go for stress relieving techniques like meditation .

Wish you good health.
Above answer was peer-reviewed by
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