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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having chest and arm pain. Normal EKG and chest X-ray. Any idea?

Answered by
Dr. Geoffrey Ward


Practicing since :2011

Answered : 183 Questions

Posted on Sat, 19 Jan 2013 in Hypertension and Heart Disease
Question: hearti am 29 years old.....dnt smoke....dnt blood pressure is almost normal averages 135/85 ....i do have severe anxiety ....and i am about 10 lbs heavier then perfect weight. i have been having chest pain in left arm and pressure in center of chest for about a week. i have been to the er twice dr once...and have had seen a emt. so far i have had 3 troponin blood test....chest xray....and an ultraound of stomach and abdomin.....all test came back negative. Dr told me that i had notjing to worry about and that my test results were gorgeous. with that being said still have some chest and arm pain...should i be concerned? i have a history of anxiety and this is really getting to me. havr the test that they have done rule out a heart problem? the dr says at my age that amount of testing would have shown somthing if i had any heart that correct?
Answered by Dr. Geoffrey Ward 2 hours later
Hello and thank you for your question.
Your doctor is correct. If you were having heart damage or an irregularity, it would show up in your ekg or as an enzyme irregularity on your blood test. Since you've had three consecutive ekgs negative, negative blood tests and examinations by multiple doctors, it is safe to say you are perfectly normal.

The description of the symptoms you are giving is most likely due to anxiety.

Heart attack has been described as a crushing sensation in your chest like an elephant is sitting on you, with pain radiating down your arm, up your neck and through your jaw on the left side of your body.

Other reason for this sensation can be heart burn or GERD. You can get referred sensations from this in your chest and arm.

Best regards. If you have any more questions feel free to write back. I am hear to help.

Dr. Ward
Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Geoffrey Ward 1 hour later
i have been diagnosed in the military of gerd and have been diagnosed with extreme anxiety or generalized anxiety disorder. maybe this is the cause of my fear. like i said er dr told me she had done a complete cardiac workup including blood...xray....ekg...and ultrasound of kidney..liver...and gallbladder. she said results werr gorgeous. that is two er drs and a pcp. all that concerns me is that the gerd dosent react to. gerd medication. it eases it but pressure still present. she told me that as far as cardiac goes there was no nees to do major test and that major test are only ordered if one of the other test had shown an irregularity. was told i was ok not to worry but witj the pressure and occasional left arm pain is it possible after allll thosr test i could still have a heart issue? sorry to sound crazy but maybe thats why i have anxiety and most likely my major problem
Answered by Dr. Geoffrey Ward 34 hours later
It is safe to say that you are fine. Anxiety is very complex and can produce many different symptoms that may be mistaken for different conditions and diseases. Most of the time people go to the ER over and over again with different emergencies and only after several negative tests do they determine that it's anxiety.

Since the tests are negative the chances of it being a heart condition undiagnosed is very unlikely.

GERD can produce referred pain and pressure, it can be exacerbated by anxiety. GERD can also cause anxiety, so you have a vicious cycle that you are experiencing.

Try Yoga, eat a diet low in spices and high in fiber, sit in a quiet space, lay on your back, put one hand on your chest and one hand on your stomach. Try to breath in only raising your hand on your stomach. Count to three and breath in slowly, let your body naturally exhale for 7-9 seconds. Do this for 20 minutes three times a day. Your body will feel like you are not breathing but really you'll be controlling your body and changing your system from running on sympathetic to parasympathetic and may reduce some of these symptoms.

I hope this helps. Let me know if there is anything else I can do to help.

Best Regards

Dr. Ward

Above answer was peer-reviewed by : Dr. Shanthi.E
Follow up: Dr. Geoffrey Ward 31 minutes later
dr ward...

i have also been getting really bad headaches in the back of my head as well. have been to dr with these as well feels like heat and pressure in lower right side of head and back of head. it comes and goes as well. have seen dr and was also told headaces were anxiety as well. i find myself being concerned and worried that somthing is badly wrong. maybe this anxiety or just hypochondria idk. these headaches feel like an insane amount of pressure in back of head and makes head feel likebits going to explode. i have no nausea.....double vision...pupils are fine...none of ur classic brain tumor or brain anureysum so why the reoccuring headaches? have had a xray on my upper spine and the c1 and c2 are out of line and i am recieving accupuncture and massage therapy at this time. could the upper spine be the cause or could my anxiety be right and there be a real problem in head such as tumor or anureysum? like i said have seen two drs and chiropractor and all three said no need for mri or cat cat scan my symptoms dont warrant one but they do say anxiety and an alignment issue is 99.9% the cause....does this sound right?
Answered by Dr. Geoffrey Ward 2 days later
Hello and thank you for your response.
I have dealt with this before. The anxiety causes tension, we tend to tense our shoulders and breath with our shoulders rather than our diaphragm. When you do this, you cause muscle contractions and knots in the muscles located in your upper back and neck that attach to the base of your skull. When you have these knots and tightness it produces a sensation of a headache with burning, pressure, heat, dizziness or a combination of the said mentioned symptoms. C1 and C2 are surrounded by many nerves and are the two bones that allow our head to turn and move up and down. They are the axis and the atlas. When these bones become malposed, this can cause discomfort as well. Most of this is an anxiety issue. An aneurysm would feel like the most excruciating headache you have ever felt in your life. Like you are getting an ax put into your skull. Most concerns would be in your temporal region.

Your symptoms indicate chronic anxiety and tension, not a brain tumor or an aneurysm.

I agree with the other doctors that have examined you.

I recommend looking into the anxiety relief program called The Linden Method. It has helped many people with their anxiety issues. You show clear signs of anxiety disorder. Fear of death from different ailments and diseases, going to several doctors asking for tests and getting the same answers, there really isn't anything wrong with you. The next step is to address the anxiety, realize these symptoms that you are experiencing, although very real, are not going to kill you and will eventually leave over time when the anxiety has been brought under control. The only way to get rid of anxiety is through training and constant fighting against the urges through breathing, visualizations and repetition. Medications only mask the symptoms and not actually take them away.

I hope this gives you the answers you were seeking and the comfort knowing that you are fine. Any other questions I'll gladly answer.


Dr. Ward

Above answer was peer-reviewed by : Dr. Shanthi.E

The User accepted the expert's answer

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