Question: Hi,
My profile: Age 26, Male, Non smoker, Non Drinker, Banker, Height 182 cm, Weight 90Kgs

This is gonna be a long post. I have been under physical and mental trauma for last 7-8 months. It all started as episodes of breathlessness in the night. 2-3 nights continuously in April. I had consulted a MD Chest (Pulmonologist )and my reports came normal except my IgE level was inflated to 637+ I was put on Allegra. Then After 15-20 days I developed the problem of rapid heartbeats and palpitations along with episodes of breathlessness and chest discomfort and I got it checked by MD Cardiologist. ECG and Echo 2D was done and all came back normal. Only diagnosis was MVP Grade 1Â in Echo 2D. These palpitations and chest congestion problem was occurring on and off for 2-3 months.


In September, Again there has been episodes of breathlessness, a feeling of shallow breathing when I go to deep sleep and I usually got up as a jolt in the chest because of Shallow breathing and then followed by rapid heartbeats for 2-3 mins after that I came back to normal. This happened to continuously 2-3 days. I again went to GP this time another MD chest and he denied the possibility of Sleep Apnea. I went to see another Cardiologist and he recommended holter monitoring . The tests were normal according to him ( Though the slowest heartbeat was 48 and the highest was 157 and ventricles and SVT couplets )


Then that doctor put me on Inderal 40 mg ( My BP comes usually normal, sometimes it comes 130/85) and advised me to check my lipid profile, sugar and thyroid. My sugar and thyroid came normal. But My lipid profile came high ( Total Cholesterol 240 , LDL-136 , HDL-50 and triglyceride 106) along with an inflated level of homosysetine of 45 and Lipoprotein(A) was around 55. I was told LP(A) is hereditary and it cannot reduced substantially. I was told to reduce my cholesterol level. Treadmill test was also done and it was normal as well.

Right Now I'm taking Betcap 40 mg ( My rapid heartbeats are normal, usually occurs when I exert a bit ) and Homocheck tablets. I was put on rosuvstatin till my cholesterol comes back normal ( Total 153, LDL 90 and HDL 39). Now I don't take it.


The problem is now it has started occurring again, the chest discomfort usually, a fisting pain on my chest ( I've heard of unstable angina though I'm finding it hard to believe in my case my almost all reports came normal ) and a feeling of nausea and chest stiffness when I usually exert ( brisk walk on treadmill but I still manage to brisk walk for 20 mins daily on it but meanwhile I feel thirsty nauseatic and feel a discomfort on chest ). I have also been suffering from heartburn ( acidity ) and feeling of being full after meal.
Symptoms Now:-
1. Irregular Heart beats ( reaches to 110-120 at the time of episodes) causing chest pain that moment, after sometime heart beats come normal and pain radiates to left arm and left leg ( occasionally both legs ) and a headache.( This episodes happen in nigh as well)
2. Extertional Chest discomfort ( I would not say like a angina but its always displeasing to walk to an elevating area like ladders, though I don't feel it while brisk walking)
3.Acidity, frequent burps and heartburn ( I don't have any idea that this heartburn may be a sign of heart disease)
4.Chest squeezing at center when I talk continuously for sometime. I have to stop talking and wait till my breath becomes normal.
(All these symptoms and signs were never there 7-8 months back but for last 7-8 months I have been suffering from all mentioned above.

You can very well judge my frustration by the length of my post. I have been to 6-7 cardiac specialists ( Cardiac Electro physiologist as well and I came back as nothing serious but these episodes of frequent discomfort in daytime and episodic nights are making so sick and physically and mentally distressed.

I want to know all these symptoms show any heart attack or any cardio vascular diseases in waiting ( Coronary Arteries Disease, Tachardiya, angina or anything) ? I feel scared to death. Help me out.

Thank you for the response doctor.

1. Why coronary Angiography has not been recommended by any doctor till now keep in my mind that my symptoms are persistent ?

2. What can be a possible case of a clot in my artery specially when my Cholesterol is almost normal and my BP is ok as well and also the my age doesn't make me an obvious candidate of a heart disease ?

3. My TMT went perfectly normal. May this be a possibility that a TMT can go without detecting anything ?

4. If I go for Coronary Angiography What can be possible side effects associated with it ?

Thank you.

Thank You Doctor,

I have taken appointment for Gastro. will provide you the details day after tomorrow.

1 thing I would like to tell you that after asking 1st follow up question I did brisk walking on treadmill yesterday and today for 21-22 mins at the speed of 5.5 kmph. I did feel a discomfort in upper chest and nausea feel. But it was not like a classic angina such as squeezing. It was coming and going in that time span. I didn't made me to stop it on treadmill. Is this something good ?>

The main concern is rapid heartbeats occurs at least once a day or two and after my heartbeats comes normal it is followed by a bad numbing pain in me left arm and both the legs and that really bothers me.

I talked to my cardiologist in CIMS about the possibility of angiography as well and he wasn't in support exactly to go for Angiography. I feel pretty confused here.

Thank you for your support.

Thank you Doctor,

I will get my gastro done as soon as possible and will give you details.

The Doctor I am consulting is Dr XXXXXXX Naik at CIMS

Regards,
Anshul