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Having chest pain, palpations and shortness of breath. Underweight. Cholesterol HDL 1.11mmol/l. ECG normal. Cause?

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Looking to get a second opnion. Why Am I having chest pains?. I'm 22 Years old 5'10, just about underweight. i eat healty, however not very active.

I have no history of Family heart problems. My Blood pressure is OK, Im not anemic, thyroid is fine Blood test is Completely Normal e.g

HDL 1.11 mmol/l = 42.0000 mg/dl
LDL 2.7 mmol/l = 104.0000 mg/dl
Triglerides: 1.2 mmol/L = 106.8 mg/dL

I have had 2 ECG's Done and Holter monitor (24h) which came back normal, I think. But I'm still convinced i have something wrong with my heart like angina or blockage purely because or the pain I get, which is usually sharp but sometimes not located at different areas on chest, sometimes near heart, maybe i am wrong. It last's a few seconds, I have never had pain which has lasted longer then 5mins. i have also had other sympetoms which had led me to the ER, palpations, shortness of breath etc.

My heart also shoots up from resting Heartrate of 66-78 to 130!bpm when climbing 10-13 stairs, is this normal?

ECG Results, does it look ok?

Rate: 99
PR: 153
QRSD: 89
QT: 312
QTc: 400

P 82
QRS 66
T - 36
Posted Sun, 14 Jul 2013 in Hypertension and Heart Disease
Answered by Dr. Jorge Brenes-Salazar 1 hour later
dear XXXXX

thanks for your health concerns. So far, your blood workup including lipid panel appears within normal limits; I personally reviewed your EKG and it is also normal sinus rhythm no concerning anomalies; from my experience and the literature, sharp pain that lasts seconds, and changes location in different parts of the chest RARELY is caused by blocked arteries; if your level of concern is however so high that you may be avoiding exercise due to this, then it may be aporopiate to arrange for a treadmill test to see if ut reproduces symptoms and if we see EKG changes.

In terms of your heart rate response, the most common cause for that rapid increase is deconditioning of the cardiorespiratory system due to lack of regular exercise

yours truly

Dr Brenes Salazar MD
Mayo Clinic MN
Above answer was peer-reviewed by
Follow-up: Having chest pain, palpations and shortness of breath. Underweight. Cholesterol HDL 1.11mmol/l. ECG normal. Cause? 1 hour later
Thank you for your reply Dr.

I rarely get chest pains while doing any physical activity. I can walk normally for long periods with out any problems, maybe an occasional minor pain, but nothing severe, or experiencing any severe symptoms while walking.

Is deconditioning of the cardiorespiratory system due to lack of regular exercise, something i should be concerned about?

May i also add, i am a anxiety and panic attack sufferer which started off purely of my health concerns, so health anxiety in other words. My main worry is my heart. I fear there maybe something wrong with it or something might happen because on my symptoms, which is why i asked if it was normal to for my heart to increase so much with very little exercise, or maybe I'm just being silly.

After having done all those test, which came out normal, is it likely or possible i can still have some undiagnosed or underlying problem with my heart? or Could it just be anxiety?

Many Thanks again for your reply.

Answered by Dr. Jorge Brenes-Salazar 34 minutes later
dear XXXXX

deconditioning is benign and treatable through establishment of a regular aerobic workout plan; after a few months, the resting heart rate decreases since the heart gets used to making more efficient contractions.

You are not alone. On a regular basis I see in clinic many patients, mostly female and young, who suffer from severe anxiety and worry about their heart; although medical diagnosis is not always perfect, my job as a cardiologist is to help them understand and be reassured by the normal workup, and guide them to work with their primary care provider, psychiatrist to treat anxiety appropiately; I have found that psychologists who can conduct cognitive behavioral therapy are of great help.

best regards
Above answer was peer-reviewed by
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