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Suggest Treatment For Chest Pain, Severe Anxiety And Sporadic Heart Palpitations

Posted on Thu, 4 Jun 2015

Question: I have been taking Seroquel and Clonidine, and Librium(only in extreme cases) for pretty severe anxiety, which I started having after I stopped drinking about 8 months ago. Over the last 24 hours I have had some chest pains along with some sporadic heart palpitations, and I think maybe that might be happening because of me missing a couple of dosages of both the Seroquel and the Clonidine in the last two days. I went to the local Urgent Care center earlier today, and they checked my BP and they also administered an EKG-both results were good. I would like your take on this situation. You can review my previous questions to your neurologist for additionally background information. I will await your response. Thanks in advance.

Answered by Dr. Benard Shehu (28 minutes later)

Brief Answer:
Severe anxiety episode due to missing dose...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concerns.

1. It is great that your BP and EKG were normal. That means that your current health problems are not life threatening.

2. Based on your description, what might have triggered your anxiety attack was the missing dosage of medications. That's why the anxiety reaction was more severe than others. I highly recommend to try to take your medications as prescribed without missing dose.

3. I also advise to run further cardiac tests :
- holter monitoring
- stress test

to definitely exclude heart problems and determine the real cause and solution to your anxiety problems.

Hope it was of help! I'll welcome any other query you might have!
Dr.Benard

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

Follow up: Dr. Benard Shehu (22 minutes later)

Thanks for your quick response. I am looking to follow up with an appointment with my cardiologist next week. I had a stress test in August of last year, and everything was normal. I am going to get back on schedule with the meds, and I am hoping that should reduce or eliminate the heart palpitations. Again, so I understand, you do believe that the missed dosages of the two meds-Clonidine and the Seroquel may be responsible for the sporadic palpitations that I am currently having.

Answered by Dr. Benard Shehu (11 minutes later)

Brief Answer:
Explained below...

Detailed Answer:
Hi back,

1. When you meet your cardiologist, please refer my suggestions for other cardiac tests (holter monitoring). If the last stress test you did was normal, no need to repeat it for now. Go ahead with Holter monitoring only.

2. I really believe that when you'll be more accurate on taking the right dosage of medications, your palpitations issues will be over too.

3. You are more susceptible to stress/anxiety than other people. Everything that might cause stress/anxiety to you (including thoughts) will trigger heart palpitation. That's perfectly normal. However, in your case, these palpitations are altering your daily quality of life.

The aim is to exclude other organic problems that might cause palpitations. If no organic issue is found, then, you should work more on your psychological part including psychotherapy or others.

Hope it was of help!
Dr.Benard

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

Follow up: Dr. Benard Shehu (3 days later)

I went to the cardiologist, and as a precaution, he is going to put me on the holster heart monitor this Thursday, and then we are going to do a nuclear stress test on Monday. I will keep you posted on the results. Also, my primary physician is suggesting that I do a sleep apnea test, and the cardiologist agreed with that suggestion. My heart palpitations have been less frequent since I started back on the Clonidine(I have not started taking the Seroquel again as of yet). one quick thing-I have had a bit of a facial twitch between my upper lip and my nose-could that be anxiety related, medication related, neurological related, or perhaps something else.

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Following answer to your query.

Detailed Answer:
Hi back,

What you are reporting is more likely to be associated with medication side effects. If it's supportable you should continue with clonidine, otherwise or if the things are getting worse you should stop taking it.

I'm waiting for more good news from you!
Wish you health!
Dr. Shehu

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

Follow up: Dr. Benard Shehu (2 days later)

I woke up this morning with an upper left eyelid twitch-I am curious as the probable cause of this, and it is possibly related to my current health situation. BTW-I am wearing the heart monitor, and I should get the results of that Friday or Monday.

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer:
Stress/neurological/side effect of clonidine to rule out...

Detailed Answer:
Hi back,

The twitching of your left eyelid might be related to:
- being stressed due to situation you are going through
- possible central side effects of clonidine
- neurological problems with facial nerve

In all cases, I do not see anything worrisome. I advise to wait for the result of Holter monitoring and then, we can discuss for further evaluations.

All the best!
Dr.Benard

Note: For further queries related to coronary artery disease and prevention, click here.

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