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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for persistent vertigo and severe chest pain

Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Mon, 6 Jun 2016 in Mental Health
Question: Hello ive been expirencing bad panic attacks and its always constant. my panic disorder developed 6 months after my dad and paw died my mom also tried to kill her self. lately my symptoms have been horriable I get shakey vertigo feeling detached from my body pain over my heart vision problems, feeling weak and disoriented. today I felt horriable pain over my heart and panic when looking in a camera or mirror I also feel like I will past out in the last month ive had a chest ct and a calcium ct ekg several times all came out good. also had brain ct which came back normal. in janurary I had echocardiogram came back normal. my calcium score came back 0 so my questions are....

1. could this be heart attack?
3. are all these symptoms connon in anxiety and panic disorder?

3 is there any other medical or nureological conditions that can be causeing this for last four months I also have exersicise intolerance I get panicky same with masturbation and sex. ive been tested for thyroidand diabeaties and cealic im all good there.when I walk I will feel weak and off balance as well my limbs feel like they are lighter than they are andim hypersensitive to screen light for some reason makes me panicky also have been nauseated
on and off last couple of days with gas and some abdominal pain but none today
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 41 minutes later
Brief Answer:
Panic Disorder

Detailed Answer:
Hello XXXXXXX

I am so sorry for your losses. I lost my father when I was 20, so I have some understanding of what that is like. It sounds, too, like there is a lot of tumult happening in your family's life.

Given all of the cardiac and other medical evaluation you have had, I do not think your symptoms are from a heart attack. And yes, all of the symptoms you described can occur with panic attacks.

Given that your symptoms came on after losing your father and grandfather, I think it is safe to say that they are related to your reaction to that. Have you talked with a grief counselor or a psychologist? Also, have any doctors talked with you about the benefit you might get from medications for panic disorder?

Since your symptoms are ongoing, rather than just being occasional, I'd recommend an antidepressant medication for panic disorder, such as the SSRI medication escitalopram (Lexapro). This medication has an earlier onset of action and fewer side effects compared with some of the other antidepressants. But it may take a few weeks before you really start to see the benefits of taking it. And it can cause some mild nausea in the first couple of weeks but that should go away.

If you decide to take an antidepressant for the panic disorder, hile you are waiting for the antidepressant to kick in, it may be helpful to take an anti anxiety medicine such as lorazepam. This works immediately but has a shorter duration of action, so you have to take doses 2-3 times a day. Or it can be used just at times when panic or symptoms are most severe. The problem with this type of medication is that it can be sedating.

I strongly advise seeing a psychologist or grief counselor to talk about the feelings you have, and your primary doctor or a psychiatrist to talk about medications to help the symptoms.

Please let me know if I can provide further information. And best wishes to you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 24 minutes later
I took lexapro 10mg and had a horriable panick attack hours afterwards is this common when starting this drug? I have a counsler and psychologist and have started cbt threaphy. Also is this disorder forever? Or in time is it cureable eventually ?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 19 minutes later
Brief Answer:
You will feel better in time

Detailed Answer:
For people who are sensitive to some mental health medications, it may be best to start with a lower dose, such as taking 5 mg instead. In fact, some people even start with 2.5 mg. It takes longer to get up to a dose that is helpful this way, but it can be worth it going up on the medication gradually helps you to tolerate it.

I can't say that it is impossible that the Lexapro caused the severe panic attack, but initially sometimes symptoms can get worse before the medication starts to help. That's why a low dose of lorazepam might help too.

And are your symptoms forever? The predisposition to having anxiety will be there, yes, but you can heal, and I believe with time and help you will. You have very recently had a big loss in your life, and further upheaval given your mom's trouble too. The meds and cbt can help that too. The loss leaves a bit of a scar, but you'll find that you will be able to gradually feel emotionally better and happy and well again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 19 minutes later
Is there any neurological disorders that can mimic my symptoms also I lay in bed I feel shakey and weak and have heart pain it feels like a heart attack and symptoms been on and off all day am I in danger? I feel very disconnected from my body shooting pains over my heart and gassy EKG echocardiogram and calicm ct score of zero
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 37 minutes later
Brief Answer:
I don't think it's a neurological disorder.

Detailed Answer:
I don't think there is a neurological disorder that would give all of the symptoms you are having, and these symptoms can all happen with panic disorder. I know the heart symptoms especially must be scary, but you've had a good cardiac evaluation. Also, it was wise of your doctor to check for diabetes, thyroid disease, and celiac disease.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 11 minutes later
So should I just try to ignor the pain and go to bed? I'm healthy body weight as well I am vitimin d defficent though 15.6 mg
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 20 minutes later
Brief Answer:
Treat the anxiety and the chest pain should go away.

Detailed Answer:
Do you have some anti anxiety medication such as lorazepam or Xanax (alprazolam) that you can take? I think this would calm all of your symptoms down. If you have none, can you call the doctor who is on call for your own doctor to get 1 or 2 lorazepam or alprazolam to get you thru the night? If not, is there an urgent care you can go to to get some to get you by?

Your Vit. D level is low, but wouldn't be causing these symptoms.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 5 minutes later
So I should not worry about heart attack or anything life threating?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 6 minutes later
Brief Answer:
Nothing life threatening

Detailed Answer:
Given your healthy cardiac test results (and other tests), I do not think you need to worry about a heart attack or anything life threatening.

Anxiety disorder with panic can make a person feel like there is impending doom, but you have evidence that no real physical crisis is impending for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 4 minutes later
Only condition I do have is a 90 degree kyphosis curvature, can that cause the pain in heart or more likely gas?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 11 minutes later
Brief Answer:
Kyphosis

Detailed Answer:
That is a pretty sever kyphosis, but it shouldn't be causing heart pain given that your heart checked out ok.

If you think you might be having "heart burn", you can try Zantac 150 mg and see if that helps you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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