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Non-drinker, Non Smoker, Mild Chest Pain, High BP, Sleeplessness, Poor Diet

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Posted on Mon, 21 May 2012
Question: Hi
35 year old male, non-drinker, never smoked., pretty unfit in athlete terms but can cope with a moderate jog or a game of touch rugby. Carry my bag round the golf course. 15 kg overweight. (185cm - 115kg - muscular build)
Been under a very hard work schedule (global) for 3 months and am lacking sleep and had a poor diet at the same time.
I have had a mild constant chest pain for 3 weeks+ (new thing). It does not hurt to breath, but the discomfort is always there. It is located top /middle / right of the sternum. It has felt a more like mild heart burn than anything else. There is no other pain anywhere else, no headaches, not thirsty.

Yesterday I had a whoozy/ dizzy spell and seeing I was near a clinic I decided to get my BP checked.
First reading was 144/100 - 10 minutes later it was 144/82. The nurse told me to go a rest and come back today for a recheck.
Today went after work, but now without coffee or sugar for the last 24 hours. The reading was 158/82

I am not on any medication (never have been)
What should I do?
What could it be?
doctor
Answered by Dr. Robert Galamaga (25 minutes later)
Hello and thanks for the query.

You are quite young to consider the symptoms which you have as suspicious for cardiac disease, especially if you have no previous history of this and if there is no history of premature cardiovascular disease in your family.

What I really think is the most likely contributing factor to your symptoms is a degree of reflux esophagitis or "acid reflux." This is sometimes referred to also as gastroesophageal reflux disease or GERD. This is a very common thing which can occur in young patients such as yourself. Certain things may contribute to the development of the symptoms including: stress, anxiety, being overweight, diets high in greasy foods, alcohol or coffee.

As for the blood pressure - I would tend to think that is more an effect of your body being stressed from the chest discomfort. This can raise the blood pressure as well. I would not ignore the blood pressure readings - we need to keep an eye on them - but I don't think it's worrisome right now.

In order to get this under control, I suggest you purchase an over the counter equivalent of prilosec or omeprazole which is a medication which lowers the acid content of the stomach and promotes healing in the stomach and the esophagus.

I would suggest you take this medication twice daily - with morning and evening meal for 10 days and then take it just once daily with breakfast for an additional 30 days. This would likely be adequate to promote healing and will likely lead to a gradual resolution of your symptoms.

If beyond this course of medication you continue to have symptoms, you may need to see a gastro doc who might consider taking a look inside your esophagus and stomach with a tiny camera (endoscopy) to investigate further.

I hope you have found some reassurance in my answer and that the information is otherwise adequate for you.

Thank you again for the query. I am available for your followups.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Robert Galamaga (20 minutes later)
Hi Doc,

Thanks for your answer, it is obviously a big concern that it is a heart issue. Everything that I have read suggests that a heart issue would be more left and far more severe for short bursts, with pain elsewhere.
I am not against going to a physician for a check up as I have not been to a doc for possibly 5 years.

The pain alone does not bother me, but the blood pressure numbers frighten me more.

I am not burping, but a slice of bread or starch (not fruit or veg) does seem disagree with me slightly.

I am not familiar with the drugs you mention, but would a standard anti-acid work or are these more powerful?
doctor
Answered by Dr. Robert Galamaga (16 hours later)
Hi,

Good to hear from you again.

Standard antacids may work but if you are having symptoms as significant as you have reported, I would recommend Tab. Omeprazole which is a over the counter medicine and as it is more potent while at the same time being quite safe.

Please continue to monitor your blood pressure over a period of time as well and share the numbers with your physician. You might have to consider decreasing the amount of salt in your diet which might help in reducing your Blood Pressure. Finally, regular exercise will be a certain benefit to your blood pressure and overall well being.

Hope this answers your query.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Non-drinker, Non Smoker, Mild Chest Pain, High BP, Sleeplessness, Poor Diet

Hello and thanks for the query.

You are quite young to consider the symptoms which you have as suspicious for cardiac disease, especially if you have no previous history of this and if there is no history of premature cardiovascular disease in your family.

What I really think is the most likely contributing factor to your symptoms is a degree of reflux esophagitis or "acid reflux." This is sometimes referred to also as gastroesophageal reflux disease or GERD. This is a very common thing which can occur in young patients such as yourself. Certain things may contribute to the development of the symptoms including: stress, anxiety, being overweight, diets high in greasy foods, alcohol or coffee.

As for the blood pressure - I would tend to think that is more an effect of your body being stressed from the chest discomfort. This can raise the blood pressure as well. I would not ignore the blood pressure readings - we need to keep an eye on them - but I don't think it's worrisome right now.

In order to get this under control, I suggest you purchase an over the counter equivalent of prilosec or omeprazole which is a medication which lowers the acid content of the stomach and promotes healing in the stomach and the esophagus.

I would suggest you take this medication twice daily - with morning and evening meal for 10 days and then take it just once daily with breakfast for an additional 30 days. This would likely be adequate to promote healing and will likely lead to a gradual resolution of your symptoms.

If beyond this course of medication you continue to have symptoms, you may need to see a gastro doc who might consider taking a look inside your esophagus and stomach with a tiny camera (endoscopy) to investigate further.

I hope you have found some reassurance in my answer and that the information is otherwise adequate for you.

Thank you again for the query. I am available for your followups.