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Light smoker. Paranoid about getting heart attack. Feel pain and tightness in chest. ECG normal. Have low vitamin D. Suggestions?

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General & Family Physician
Practicing since : 2001
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I am a light smoker who is always stressed with my work. Over the last couple of years, I have always been paranoid that I am going to have a heart attack. I sometimes get a tight chest but not pain - more discomfort and I get little twinges in my arms sometimes and sometimes tingly fingers. the more I think about it the worse it gets. The discomfort in my chest tends to be light but noticeable and I start to worry it is my heart. I used to do recreational drugs a while back and am worried I caused myself damage. I did have an ECG about 19 months ago which came back fine. I get a bit lightheaded too at times and tired. I have got very low Vitamin D which I have been taking tablets for. The chest discomfort is often around my collar bone - just under and there is no pain in my arms but just little twinges sometimes.
Posted Tue, 23 Jul 2013 in Hypertension and Heart Disease
Answered by Dr. Michelle Gibson James 1 hour later
HI, thanks for using healthcare magic

It is understandable to be concerned about chest pain.
Chest pain can be caused by any structure in the chest from the skin inwards but obviously the possibility of the pain originating from the heart is usually the main concern.

Heart related pain would usually start on activity because this is the time the heart is the most active. It occurs because there is decreased blood supply to some parts of the heart, the reduced supply results in the pain.
Initially the pain is relieved when the person stops the activity, if the heart disease progresses then it can remain even when resting.
It would be associated with shortness of breath, palpitations and sometimes profuse sweating.

It is not usually worsened by anxiety about the pain. It is usually a central or slightly to the left pain, tight or heavy feeling.
The ECG would have not just looked at the heart rate and the rhythm but would have also been able to show if there are any parts with a reduced blood supply. This is because when there is reduced supply it causes changes in the way the ' 'current' of the heart flows.
If your ECG was normal this means that there were no areas with reduced blood suppy, the rate and rhythm were normal and no areas of enlarged heart.

This makes it unlikely that the pain is heart related. If you wish you can repeat the ECG to see if there are any changes since the last one.

Smoking cigarettes ,even a small number, can affect the heart so it would be best, if possible to eliminate this risk factor. This is because the components of the cigarette narrow the blood vessels and reduce the blood supply.

Chest pain can also be related to any condition affecting the muscles and bones in the chest cavity, the esophagus, lungs, skin rashes such as zoster, anxiety.

You may want to consider visiting your doctor for an evaluation regarding the other possible causes of chest pain.

I hope this helps, feel free to ask any other questions
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