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    Mild chest pain. ECHO, TMT normal. What could be the cause?

Posted on Tue, 28 May 2013 in General Health
Question: Hii, I am 27+ year male, about 4 months ago I had very mild chest pain which was sometimes on the right and sometimes on the left. From that time I started researching on the reasons of chest pain on google one night while again reading about heart attacks all of a sudden I started feeling uneasiness and I rushed to hospital, where initial ECG was sinus tachycardia and the next ECG was normal. I went to see a cardiologist where he asked me to undergo a ECHO and a TMT all of those were absolutely fine, I achieved 100% in TMT. Cardiologists says no heat disease.

But still back of the mind I always keep thinking that I will get a heart attack. The pain has not gone yet, its location is different all time, sometimes it is shoulder and sometimes in left hand, I feel like pain in some muscle or nerve. I get up in the night and start thinking about the pain.

what is the actual cause of the pain, 2 cardiologists says no heart problem.

my BP went high for few days ranging 130/80 to 150/80 (may be because I think too much about it)

I even got blood work done, serum (tychlirides?) is 300 it was 200 before 3 months (did it go up because of tension)

may I please gtet a clear answer....
Answered by Dr. Omer 58 minutes later

Thanks a lot for your input.

I am really sorry to hear about your problem. First of all your age is 28 years and you have completed a set of heart tests that are ECHO and TMT. Echo shows valve problems and hypertrophic cardiomyopathy which are common causes of chest pain in your age but your echo and TMT are normal. Its a very good news for you. Your blood pressure also fluctuates that is 150/80 again the upper part of your blood pressure is high which shows stress or anxiety in your case with normal lower part. Triglycerides fluctuates, but should be less than 200. Your triglycerides were 300 must be because of wrong timing and less than 10 hrs between your dinner and your test. So you shouldn't worry about it.

Hypochondriac is a disease common in your age with anxiety and depression and feeling of imminent heart problems and feeling of going to die.

Different location of pain in your chest indicates somatization, meaning actually your body is fine but your brain is generating the pain.

On TMT, you achieved maximum heart rate again a very good news.

If you can get psychiatric counselling with SSRi Tablets, most of your problems will be solved like 98%.

You are young and healthy as a 28 years old should be. Its the internet making your life miserable, do study things from internet but do not apply them on your self. A very long life ahead is waiting for you.

I have tried my best to give you a practical answer but there might be questions in your mind. So please feel free to ask, because our discussion always remains open. So you can always ask more and I will be glad to assist you. Your excellent feedback is requested and will be appreciated.


Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Omer 1 hour later
I am not sure if the brain is generating the pain or not, also I have developed a habit of checking my pulse again and again, and whenever it is high I again get tensed. If brain generates the pain, do we feel uneasy because of brain generated pain?

Also doctor gave me medicine for cholesterol and trigyclyrides (one medicine for both of them) some (astrovastetin?) not sure about the name as I dont have that now.

Also sometimes I am unable to sleep and feel heart is beating fast, why is that?

I get burbs when I have pain in the chest and burbs make me comfortable, do I get burbs because of anxiety or what?
Answered by Dr. Omer 49 minutes later
Hi again,

As I have told you, you do not have heart or heart valve problems.

Somatization is actually anxiety, meaning the pain generated by your brain also cause high anxiety and anxiety causes high heart rate and checking your pulses again and again. Anxiety is a vicious cycle meaning, the more you get worried about yourself, the more pain, fast heart rate, difficulty to go to sleep, high intestinal motility with burps. All are features of young onset anxiety, which leads to somatization and hypochondrism(already explained). That anxiety and somatization is generated by your brain, but you yourself wont be aware of it.

Atorvastatin is cholesterol lowering drug whose side effects is myalgias. Meaning, muscle pain that can occur in any muscle group. I won't recommend you this medicine, as your age is 28 and you are not a patient of hypercholesterimia(high cholesterol). Get a repeat lipid profile test with proper timing of fasting before test. Only then, it can be confirmed.

I just want to advice you that, treat your anxiety and all your problems will go away and you will start to live a happy life. You need to go to psychiatrist for counselling. Anxiety relieving breathing exercises and SSRI will help you tremendously.

I wish you good luck that you get well soon.

If you have any question, please ask because our discussion always remains open so you can always ask more till you are satisfied> You can click the smiley to rate the answer. You can come back here to ask anything even after you have rated the answer. I will be glad to assist you always.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Omer 31 minutes later
I am still not sure of the pain, but 1 last question.

I had 5 ECG out of which 3 normal and 2 were sinus tachycardia (due to fast heart rate, may be around 100-108)

TMT and ECHO normal
Lipid shows serum trigleycrides as 300 and other stuff in lipid are a little bit up or down (cardiologists says them yo be ok)

is there anything to worry about or should I just stop thinking about it?
Answered by Dr. Omer 30 minutes later
Hi again,

Your ecgs are normal as you said. And fast heart rate >100 again due to anxiety.
Still get a complete lipid profile test, with proper timings of fasting, as your cardiologist said you are okay. I say the same. And this time probably your lipid profile will come normal.

There is only one advice for you. Stop thinking and get yourself busy in what you like or want to do.
Stay happy, life is long and tensed. Don't make it more tensed by your thoughts. Cheers.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
Answered by
Dr. Omer

Internal Medicine Specialist

Practicing since :2005

Answered : 508 Questions


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