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What Causes Intermittent Heaviness And Pain In The Chest?
Question: Hi,
Male 26, weight 91, height 6 feet, Banker.
I've been suffering from on and off chest pains/heaviness generally left side and left arm numbness/tingling for months. I've been to ER 2-3 times. Had echo twice (Grade 1 MVP,Mild MR,EF 65-70%) and a stress test last year in October all came normal. My bp is bit high 130/85-89. I'm on medicine birsopolol which eases my heart beats which was used to be a problem 3-4 months back now I feel okay as far as my heart rates are concerned. My lipid profile is 198 total cholesterol, 50 HDL, 130LDL.
Now the problem is that for last week the episodes of chest pain left side and left arm chest pains are happening on regular basis along with a sensation of breathlessness( may be due to anxiety) and when I sneeze I feel breathless for 5-10 secs. ( I've allergic rhinitis). I went to ER yesterday only. The doctor told me the reports are normal (Trop T test 0.01, CKMB 0.89) and ECG normal ( though QT interval was 400 and QTC 435, Doctor didn't pay any heed on it, is it normal ? I've had all these interval below 400 on previous ECGs). My question is, am at the greater risk of Cardiac arrest or Heart attack ? I've been to many GPs and reports come more or less normal. I do brisk walk on treadmill and I didn't feel breathless yet I do have a mild pressure on left chest when I workout. Secondly I also have a major acidity heartburn and belching issues( is it related to heart ) Vit B-12 188, Vitamin D 20.3
Kindly help!
Male 26, weight 91, height 6 feet, Banker.
I've been suffering from on and off chest pains/heaviness generally left side and left arm numbness/tingling for months. I've been to ER 2-3 times. Had echo twice (Grade 1 MVP,Mild MR,EF 65-70%) and a stress test last year in October all came normal. My bp is bit high 130/85-89. I'm on medicine birsopolol which eases my heart beats which was used to be a problem 3-4 months back now I feel okay as far as my heart rates are concerned. My lipid profile is 198 total cholesterol, 50 HDL, 130LDL.
Now the problem is that for last week the episodes of chest pain left side and left arm chest pains are happening on regular basis along with a sensation of breathlessness( may be due to anxiety) and when I sneeze I feel breathless for 5-10 secs. ( I've allergic rhinitis). I went to ER yesterday only. The doctor told me the reports are normal (Trop T test 0.01, CKMB 0.89) and ECG normal ( though QT interval was 400 and QTC 435, Doctor didn't pay any heed on it, is it normal ? I've had all these interval below 400 on previous ECGs). My question is, am at the greater risk of Cardiac arrest or Heart attack ? I've been to many GPs and reports come more or less normal. I do brisk walk on treadmill and I didn't feel breathless yet I do have a mild pressure on left chest when I workout. Secondly I also have a major acidity heartburn and belching issues( is it related to heart ) Vit B-12 188, Vitamin D 20.3
Kindly help!
Brief Answer:
All the reports and the blood pressure reading are withen normal
Detailed Answer:
Hello XXXXXXX
I went through the information you have provided and even tour past medical history .
As I start I would reassure you that nothing is wrong with you and you are NOT at any risk of carisac arrest more than tour friend or your neighbour of the same age . so Stop being frightful as anxiety is adding to your symptoms
Your troponin , lipid profile , Qtc and even the blood pressure reading are in normal range .
Now all the symptoms you have been having and the chest pain and panic attack like situation s are common in MVP , It just mild laxity on one of your valve as is seen in 2-3 out of every 100 people on heart , however in some it may cause symptoms out of proportion to the severity . anxiety during such a time adds to the symptoms and will make you feel worse , As you have done so many test s and have effectively ruled out Cardiac as cause I would wish that you stop here . unnecessary testing will add to anxiety.
bisoprolol is a good drug to control those extra beats and your blood pressure both . again this can be explained by MVP.
Of all the reports Vitamin d is slightly low and should be maintained more than 40 .
D rise XXXXXXX 60 k once a week in warm glass of milk for 8 weeks would be enough.
Lastly reflux gastritis may cause the symptoms you describe , so a gastro work up will effectively rule out the same .
Alternatively would consider pain esomeprazole 40 mg once before breakfast for 3 weeks .
Let me know if any clarification is needed and I would be happy to help .
Regards Dr. Mody
All the reports and the blood pressure reading are withen normal
Detailed Answer:
Hello XXXXXXX
I went through the information you have provided and even tour past medical history .
As I start I would reassure you that nothing is wrong with you and you are NOT at any risk of carisac arrest more than tour friend or your neighbour of the same age . so Stop being frightful as anxiety is adding to your symptoms
Your troponin , lipid profile , Qtc and even the blood pressure reading are in normal range .
Now all the symptoms you have been having and the chest pain and panic attack like situation s are common in MVP , It just mild laxity on one of your valve as is seen in 2-3 out of every 100 people on heart , however in some it may cause symptoms out of proportion to the severity . anxiety during such a time adds to the symptoms and will make you feel worse , As you have done so many test s and have effectively ruled out Cardiac as cause I would wish that you stop here . unnecessary testing will add to anxiety.
bisoprolol is a good drug to control those extra beats and your blood pressure both . again this can be explained by MVP.
Of all the reports Vitamin d is slightly low and should be maintained more than 40 .
D rise XXXXXXX 60 k once a week in warm glass of milk for 8 weeks would be enough.
Lastly reflux gastritis may cause the symptoms you describe , so a gastro work up will effectively rule out the same .
Alternatively would consider pain esomeprazole 40 mg once before breakfast for 3 weeks .
Let me know if any clarification is needed and I would be happy to help .
Regards Dr. Mody
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you doctor, Your answer does my nerves.
These constant on and off persistent left chest pains and left arm pains are taking a toll on my quality of life and mental peace. I do try to take attention away from it but always end thinking about it when the pain starts and it intensifies even more. With so many doctors I've met and with no diagnosis, it frustrates me a lot. No doctor has ever advised me for an angio as well. Is all this due to MVP ? I've almost never experienced pain on my sternum. But yes chest pain heaviness/pain and left arm tingling has become too much to bear along with excessive burping and heartburn as well. All this due to MVP ?
Majority of all these chest pain on left side and left arm tingling start when I end up in a heated argument ( Stressed) and then these atypical pains carry on for hours with a dull pain with low intensity. I hope this is not related to Angina ?
These constant on and off persistent left chest pains and left arm pains are taking a toll on my quality of life and mental peace. I do try to take attention away from it but always end thinking about it when the pain starts and it intensifies even more. With so many doctors I've met and with no diagnosis, it frustrates me a lot. No doctor has ever advised me for an angio as well. Is all this due to MVP ? I've almost never experienced pain on my sternum. But yes chest pain heaviness/pain and left arm tingling has become too much to bear along with excessive burping and heartburn as well. All this due to MVP ?
Majority of all these chest pain on left side and left arm tingling start when I end up in a heated argument ( Stressed) and then these atypical pains carry on for hours with a dull pain with low intensity. I hope this is not related to Angina ?
Brief Answer:
Angina would not be among my top three differential
Detailed Answer:
Hello ,
I really under stand the anxiety that built if you don't have an answer .
For angina , You are a young , healthy guy . The TMT has been negative , which effectively rules out any significant heart disease . For a young person we generally end cardiac evaluation at this point.
Also angina pain would increase with exertion, would be associated with breathlessness.
Your symptoms are not typical of angina pain.
Also MVP fits all the symptoms you have .
For burping and heartburn , consider reflux gastritis as a possibility. Bankers sitting job and the stress can cause dyspepsia. aye our previous Dr. Teli has suggested that you rule out gastrointestinal cause . I would second his opinion.
Lastly if you were in weight lifting an all and ever any injury or sprain to the neck , get a cervical X- ray just to rule out spondylosis.
For information visit
www.mitralvalve prolapse.com , Go through the problems people face . Don't buy anything just read the information.
MVP is not going to cause any major problems in future , so don't worry in that context. It just causes a lot of symptoms. Once you know about them , you would be able to deal with them better .
Even if you still worry about angina or heart attack ,A CT coronary angiogram would be more than enough . You don't require an invasive angiogram
Regards Dr. Mody
Angina would not be among my top three differential
Detailed Answer:
Hello ,
I really under stand the anxiety that built if you don't have an answer .
For angina , You are a young , healthy guy . The TMT has been negative , which effectively rules out any significant heart disease . For a young person we generally end cardiac evaluation at this point.
Also angina pain would increase with exertion, would be associated with breathlessness.
Your symptoms are not typical of angina pain.
Also MVP fits all the symptoms you have .
For burping and heartburn , consider reflux gastritis as a possibility. Bankers sitting job and the stress can cause dyspepsia. aye our previous Dr. Teli has suggested that you rule out gastrointestinal cause . I would second his opinion.
Lastly if you were in weight lifting an all and ever any injury or sprain to the neck , get a cervical X- ray just to rule out spondylosis.
For information visit
www.mitralvalve prolapse.com , Go through the problems people face . Don't buy anything just read the information.
MVP is not going to cause any major problems in future , so don't worry in that context. It just causes a lot of symptoms. Once you know about them , you would be able to deal with them better .
Even if you still worry about angina or heart attack ,A CT coronary angiogram would be more than enough . You don't require an invasive angiogram
Regards Dr. Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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