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Hello, For The Past 6 Hours I’ve Had A Dull
Question: Hello, for the past 6 hours I’ve had a dull pain in my right chest with episodes of losing my breath. This has prevented me from being able to get any sleep. I took about 4 Tums antacid tablets to see if this is heartburn. The pain has not subsided.
I have a long history of panic disorder and severe panic attacks, so I’m used to dealing with seemingly life-threatening symptoms, but am often okay. I recently have had EKGs, echocardiograms, and a tilt table test, which all showed healthy heart function in the past month. These tests were ordered due to dizziness and fainting episodes that they attribute to changes in my medication.
My blood pressure prior to the changes was on the low side (80/50) and now my BP is on the high side (150/100). Should I be concerned about having a heart attack at 31 years old — or is this likely another manifestation of panic?
I’d rather not go to the hospital again if I don’t have to.
I have a long history of panic disorder and severe panic attacks, so I’m used to dealing with seemingly life-threatening symptoms, but am often okay. I recently have had EKGs, echocardiograms, and a tilt table test, which all showed healthy heart function in the past month. These tests were ordered due to dizziness and fainting episodes that they attribute to changes in my medication.
My blood pressure prior to the changes was on the low side (80/50) and now my BP is on the high side (150/100). Should I be concerned about having a heart attack at 31 years old — or is this likely another manifestation of panic?
I’d rather not go to the hospital again if I don’t have to.
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
Regarding your concern, I would explain that high blood pressure could be related to anxiety and it does not indicate any serious cardiac issues.
From the other hand, considering your performed cardiac tests and your age, I would exclude any possible cardiac issues.
Does body movements or deep breathing trigger the chest pain? This could possible indicate a musculo-skeletal issue. In such case warm local packs and ibuprofen would help relieve the pain.
Considering your past medical history, it is very likely that your symptoms could be related to anxiety, especially the fact that you can not sleep due to shortness of breath.
Anyway, before coming to this conclusion, I would recommend checking thyroid hormone levels, performing a chest X ray study and pulmonary function tests, in order to exclude a possible lung disorder.
An exercise cardiac stress test would help to definitely exclude any cardiac issues and put your mind to peace about your heart.
Another option would be to try to make some changes to your therapy (increase the dose of propranolol and clonotril, double the dose) and see if this helps improve your situation. By increasing these drugs doses, it would help improve your anxiety and thus indicate that all this situation is caused by anxiety.
It is also important checking lithium plasma levels, in order to be sure that no dose adjustments are needed.
You should discuss with your doctor on the above issues.
I remain at your disposal for any further questions whenever you need!
Wishing good health,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
Regarding your concern, I would explain that high blood pressure could be related to anxiety and it does not indicate any serious cardiac issues.
From the other hand, considering your performed cardiac tests and your age, I would exclude any possible cardiac issues.
Does body movements or deep breathing trigger the chest pain? This could possible indicate a musculo-skeletal issue. In such case warm local packs and ibuprofen would help relieve the pain.
Considering your past medical history, it is very likely that your symptoms could be related to anxiety, especially the fact that you can not sleep due to shortness of breath.
Anyway, before coming to this conclusion, I would recommend checking thyroid hormone levels, performing a chest X ray study and pulmonary function tests, in order to exclude a possible lung disorder.
An exercise cardiac stress test would help to definitely exclude any cardiac issues and put your mind to peace about your heart.
Another option would be to try to make some changes to your therapy (increase the dose of propranolol and clonotril, double the dose) and see if this helps improve your situation. By increasing these drugs doses, it would help improve your anxiety and thus indicate that all this situation is caused by anxiety.
It is also important checking lithium plasma levels, in order to be sure that no dose adjustments are needed.
You should discuss with your doctor on the above issues.
I remain at your disposal for any further questions whenever you need!
Wishing good health,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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