Question: Hello Doctor,

I am 33 years old male, height-5.11, weight-71 generally good in shape.

Lifestyle- I was not very active earlier due to my job profile, but I have been doing exercise 4-5 times a week for the past 4-5 years and lost 12-14 Kgs. Dont smoke

or alcohal, and dont have junk food, excess fat or sweet. There is no family history of heart disease.
Psychological/Behavioural condition - I have general anxiety and stress for so many years. When I feel relaxed this pain reduces/goes off. I feel very anxious and

worried due to this pain and think all the time about this.

I have had chest pain for the last 8-9 years primarily on left side, sometimes feel shivering under left side of chest area and left hand. The pain aggravates in

winter and I feel strong heartbeats in winter. I started using I consulted General Phyician 8 months back and many tests were performed - ECG, Stress Echo, Lipid

Profile, BP, Vit B12, Vit D3, CPK serum, Thyroid Profile, Glucose (Fast, PP), Chest X-ray etc. Everything was fine except Vit D3 so I was suggested calcium tab. I

consulted a cardiologist and he said it is a muscle spasm and given me Benalgis Tab, I took it for 2 months I was relieved to some extent. I consulted 4-5

cardiologists with reports and they all say it is not related to heart, it could be other reasons - muscle spasm, bone, gas, anxiety and suggest to ignore and relax.

Few days back I had a strenous exercise session, next morning my heart was pounding and I was feeling dizziness, fatigue and restless. This episode has happened couple

of times after that as well, when I have good amount of physical activity, I feel some disturbance/mild pain in middle of chest, feels heartbeats, become exerted and

breathless. I am really scared, anxious and always think about this only and it is affecting other areas of life. Please help me and advice.

Thanks very much Doctor, I am bit relaxed after your reply. I was just worried with new things (dizziness, breathlessness and extreme fatigue) started few days ago and affecting my professional and normal day to day life. I think these things emerged after a great panic attack I had gone through (I forgot to mention earlier). These things starts on the day after I had done too much physical exercise and when this episode goes on, it is difficult to even walk for half or one kilometer. When I take Nexito Plus (Which is adviced by a Cardio) these signs reduces and I feel better after couple of days. Please suggest me what should be the line of investigation further - Cardiology or Psychiatry, if Cardio, which of the test you mentioned is more important or both necessary. Please tell me approx cost of the test(s) as well.

Thanks a lot Doctor, it was a great help.