Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

137 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Feeling anxiety and stress. Started shivering and chest pain. Chest x-ray normal. Any solution?

Answered by
Dr.
Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

default
Posted on Fri, 15 Feb 2013 in Hypertension and Heart Disease
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.
doctor
Answered by Dr. Anantharamakrishnan 6 hours later
Hi friend,
Welcome to Health Care Magic

You are young / maintaining your weight in normal range / doing regular exercise / no tobacco or alcohol / no junk food / good family history...Great indeed! It is rare to see one like you, nowadays! Your parents were blessed...

Your only problem seems to be Anxiety.

Chest pain lasting nearly a decade means it is unlikely to be related to the heart / it can not be serious at all. A normal stress test practically excludes it.

If vitamin D is low, you should take vitamin D! (not calcium only, as you state.../ there are preparations once a week initially and later once a month.

If one doctor excludes heart disease, the possibility of heart disease is rare / if two exclude, then it is remote / 4 or 5 cardiologists as in your case means – you have NO DISEASE OF TE HEART!

It is Cardiac Neurosis – Anxiety focussed on heart.
A Psychiatric consultation and counselling will help.
Develop hobbies.
Learn to relax – go to park, beach...
Strengthen family bonds – wife in particular.
Get good friends...

A thallium stress ECG and CT-Angio (non-invasive) may be done – they are most unlikely to show any positive clues but all the same better to do - to rule out the disease and create confidence.

Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Anantharamakrishnan 11 hours later
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.
doctor
Answered by Dr. Anantharamakrishnan 9 hours later
Hi Mr XXXXXXX

Nexito Plus is an anti-depressant (contains Escitalopram).
At times, an anxiolytic like clonazepam is combined (Nexito Plus Forte).
You have already seen several cardiologists and got clearance!
You need to see a Psychiatrist – you are already on drugs / further assessment and counselling will help.

The cost of the tests varies with the city and the Institution.. CT-Angio may cost approximately ₹10,000 / Thallium stress at half the cost.
The tests need not be done immediately.
You can go for it later – if you are still worried – after Psychiatric assistance.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Anantharamakrishnan 7 hours later
Thanks a lot Doctor, it was a great help.
doctor
Answered by Dr. Anantharamakrishnan 18 minutes later
Thank you Mr XXXXXXX
No cause for concern.
You will be well - no doubt about it - it is question of patience and perseverance.
Wishing you a speedy recovery
God bless you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,  
Drug/Medication ,  
Treatment/Therapy
Lab Tests ,  

Recent questions on  Clonazepam

doctor1 MD

onths and i would like to know how to correctly switch over to klonopin all my prescriptions are from mexico and i lost the...onths and i would like to know how to correctly switch over to klonopin all my prescriptions are from mexico and i lost the...

doctor1 MD

Hello.doctor my name is Rikta Das. I'm from kolkata. I'm a housewife. Age 52. Height 5feet 6 inch.my problem is dizziness. Yeaster day when i broke from my sleep i felt my dizziness in my head. After this whenever i go to the bed for rest or get up from sleep i feel d same. I called a local doctor he told me this is a case of acute seton vertigo.and he gave me some medicine-prochlorperazine maleate i.p 5 mg twice daily and clonazepam i.p 0.25 . And my bp is 150/90. But i feel same today. Nothing improve in my health. Is there anything serious? How do i get rid off this problem?

doctor1 MD

My daughter has been having problems for a year now. Her symptoms started as fits, lack of emotion, almost seizure like, sweating, whimpering, shaking, screaming, kicking, spots in her eyes, slurred speech, loss of memory. After a long time of visits with her ped she recommended an eeg. We went to the hospital and had this done along with an MRI. It all came back normal. Actually they told us she needed mental help and to go home and figure that out. They didn't do a panel on her or check her with a meter to see if at any time her glucose could be related. At the time they also had her on clonazepam thinking she was having seizures then requested that I wean her off them. I did that. Her symptoms remained the same but she added headaches and vomiting and anxiety to this. So she was put on Amitriptilin 5mg. After a while her stomach pain and headaches eased to few times a week instead of every day. She still has the whimpering, with nightmares, shaking, sweating, pasty face. She is hungry all the time. She eats but its not a lot and multiple times a day. One of those headaches was bad enough because she was not urinating that I took her to the ER they did a glucose and it was 62. I just had a blood draw done on her but the nurse didn't give me any numbers. She said it was all ok. So I have a meter and I've been keeping an eye on her glucose. It's the only thing that I have to go on. She gets close to lows and close to highs but they said she is still not out of range. She also has highs before she eats like 113 and then 88 two hours after she eats. Or she had one that was 122 before she ate and 78 after she ate. The doctor told me not to focus on her numbers but when she has weird symptoms of hypoglycemia with these episodes I am completely thrown off. Plus it is driving me crazy she has been poked and pushed and moved and its taking a toll on all of us. I know her list of numbers is not way out of the ordinary but I am wondering what I should be looking at here? I know I am not crazy and my gut tells me that her glucose is the key but just how I am not sure.I should also mention during these episodes she is tight her muscles are contracted and she is strong, really strong. She curls her hands and arms up and it's hard to get any juice or candy in her mouth. Her jaw is tight and she is not willing to let me in. When I do get the juice into her mouth it takes a couple minutes but then she slowly starts to come out of it. The whole time I was giving her clonazepam I was giving her juice so I never associated the juice possibly bringing her out of whatever she is doing. These episodes are not occurring out of range, like one at 78, one at 112, one at 124. Its not bad numbers at all. She shouldn't be having episodes because her numbers do not meet the minimum or max. So I am confused, what am I missing here?

doctor1 MD

Hi there. I have recently stopped using Citalopram . I was on it for 9 months and tapered off slowly over a period of 5 months. I am getting the usual withdrawal symptoms ....dizzy, brain zaps, low mood and low motivation. The most troubling is...

doctor1 MD

About 5 weeks ago my husband came home and started scratching all over his body. Then about a week later I started to have the same problem. We started using Eucerin skin calming itch relief cream and it seemed to help but then we both would start...

doctor1 MD

I'm interested in trying a benzo medication called clonazolam. I suffer from severe anxiety/panic attacks. Xanax works ok. Do you have any suggestions Doctor?