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Pain in the chest, difficulty in breathing, palpitations, high cholesterol levels, history of heart problems

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Cardiologist, Interventional
Practicing since : 1996
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Hi! My name is XXXXXXX I am 35 years old, female, 5'5", 147lbs. Unsure if this matters, but I have five children, carried all of them to full term. Health history includes high cholesterol, ldl came back at 167 two weeks ago, unsure of total number, but the rest of the blood work panal (full work up) came back normal. Also was told about 4 years ago I have a "leaky" heart valve, unsure of which one. My bp is normaly low 100s / 60s. I have had palpatations for last 15 years, randomly. Recently, for about the past month and a half, the palpatations have increased and I now experience them daily, several times a day. In addition, I keep experiencing pain in my chest, again several times a day. It is not extreme, it's not sharp at all...more like just a squished feeling if that makes sense? Uncomfortable but not horrible. I have difficulty breathing when I feel the pain--not in drawing breath in but rather it feels like I can't get enough, again if that makes sense. I also have times when my heart races, for no reason--yesterday was at 132bpm for about 20 minutes; normal at rest rate is around 70. All of these things I have experienced randomly over the past few years, but they are consistent here lately, daily and several times a day. I am exhausted constantly, perhaps not sleeping well because I wake at night frequently from getting overheated--sweating, which is a new thing for me. I have been dealing with dizzyness and daily headaches for the past few weeks also, again something that is new. I saw my dr on Friday, and she said because of my age she is not concerned, just eat a low-fat diet for the cholesterol. I only thought of it all being heart related because my dentist said something last week about my poor oral health combined with the pains in my chest-saying that the two could be linked? There is a vague family history of heart trouble. My Father has high bp and irregular heartbeat. His mother had high bp and died after having a stroke. All three of his sisters died of heart attack. No known history on my mothers side, and my own sister has no problems. With our insurance I am able to see a cardiologist without referral from my doctor, but I hate to take such a drastic step if it is not really necessary. I was hoping you could help me determine if I should look further into what I'm experiencing or trust my dr in her assessment that my age and my blood work all say I'm fine? Thank you so much for your time!!!
Posted Tue, 1 May 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 3 hours later
Thank you for your query.

Firstly, the fact that you are getting palpitations on a daily basis but randomly would suggest that there could be some arrhythmia of the heart. An ECG recording during the palpitation, or if the duration of the symptom is too short, a Holter recording (24 hour continuous recording of the ECG) will help you in achieving a diagnosis. Further treatment would depend on the cause that is found out.

If it is just an acceleration of the normal rhythm of the heart, causes like anemia, stress, anxiety, infection, unaccustomed exercise, sleep deprivation, etc will have to be considered. If it is an abnormal rhythm, treatment will have to be directed against the specific condition.

Since there is a strong family history of cardiac disease (on your father's side), and since the value of LDL cholesterol (the "bad" cholesterol) is rather high, it would be better to start on a statin, in addition to diet control and regular exercise. Your cardiologist will guide you as to the correct dose and exact drug that you will need. In view of these risk factors, he may even recommend doing a stress test (treadmill test) to look at the possibility of coronary artery disease.

Your chest pain, as you describe it, is atypical. However, since you think that there is a "leaky valve" too, it is better to do an echocardiography also to identify the exact extent of the leak (probably mitral valve prolapse with mitral regurgitation). Usually, annual echo tests are recommended for mild valve leaks.

Thus, I think you should XXXXXXX your cardiologist and get these tests done. You can even upload the ECG/holter report/echo report/TMT report on this website so that I can review them and give you a more specific answer.

I hope this answer has been helpful to you. I will be available for any follow-up questions that you may wish to ask.

With regards,
Dr RS Varma
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