HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Panic Attacks And Chest Pain?

default
Posted on Fri, 22 Apr 2016
Question: Hello,
I am 27 male, 180 poinds. 3 months back (nov 2015) i took one weed shot (banned) and then had a cigarette. My heart went racing to 178 bpm. I took aspirin thinking that it was a heart attack. I settled down for 15 min and then it went away.
10 days later, i had simple spicy food and the heart started racing again. I thought that something is really wrong with heart and went to ER after 4 hrs when when of my doctor friend suggested so (i had 2-3 episodes of heart racing since then.).

The ER took ECG which shown minor variation of QRS 121ms. The ECG had 'abnormal' written over it. Doctor did a troponin test which came negetive. I was discharged. Two years back my ECG was 'normal'.

Next day i felt discomfort in my chest (with palpitations) and went straight to ER where once again they took ECG and they told it was anxiety. I insisted that I want to get checked so they admitted me. They did all heart (ECG + xray), blood, stomach tests which came negetive. Only d3 was low for which supplement was given and i am taking it regularly. The doctor discharged me after 2 days saying that it was GERD and gave me medication. (I told about cigarette but not pot since it is banned)

2 days after this, I developed left side chest pain (which reporoduces only on some movement) for which i again went to cardiologist. Cardiologist gave some NSAIDs for pain which did nothing to pain. I resigned from job and went to my hometown. (i had 2 panic attacks in between)

2 days after reaching my homwtown i went for was admitted again after a panic attack. Doctor did treadmill test which showed good heart and later on i was diagnosed for anxiety disorder. I stayed in home for 45 days where since i was with family i had no further panic issues (i was on clomapramine and clonezepam) but had chest pain and back pain.The back pain and stiffness is more in morning. All these pains were only movement related but are present 24x7. The chest pain now is both sides and also sternum.


At hometown i went for spine specialists who ordered MRI which showed loss of cervical lordosis and little disc herniation. Doctor told it is managable and wrote NSAIDs and muscle relaxant tolpiserone. I took it religiously for 7 days but no improvement in pain. In 45 days of hometown i applied all the topical pain relief creams but there was no relief.

After 45 days, In 2nd half of january i joined a new job. My dad accompanied me for 10 days when i was at hotel. I wasnt able to do job because of chest and back pain. My dad left me for 2 days to go back to hometown. After he left, within one day i had panic attack(while i was walking my heart beat XXXXXXX to 130 and had chest discomfort). My frnd took me to hospital ER where they gave gas injections (while giving injections also heartbeat XXXXXXX to 130). They told to come in morning after telling that i had gastritis.
My RA test, Uric acid is negetive.

In morning I went to GP who ordered endoscopy which came out perfectly normal. The GP referred me to orthopedic doctor. The ortho doctor told that i had costcochondritis. He prescribed NSAID and vitamin d medication for long term and told this is known to cause palpitation. He also gave tramodol injection to reduce pain.

Since i was frustrated of pain and panic i called my dad back, took LOP from job and went back to my hometown. I went to best psychiatrist for my panic attack who wrote anti depressent and CBT. He told pain is 100% psycological.

Meanwhile i again went to one doctor who told that he doubted i have MVP since i was clearly aware of my heartbeat (which also moves tummy and fingers sometimes). He ordered 2D echo which showed Grade 1 MVP with 15%MR. This doctor added propanalol medication once a day so that i dont have racing heart. He told i have MVPS which is causing pain and panic and ruled out costo.

Today, I am now in my hometown, confused as to what really happened to me, i showed 30 doctors till now. My heart rate remains normal now but i still have the pain after loads of NSAIDs.

I have the following questions unanswered:
1. I had Normal ECG 2 years back. I smoked for 2 months only in lifetime (Pot+Cigatette, XXXXXXX 5 cigarettes per day). Did that cause 'Abnormal ECG' and changes in Mitral valve?
2. Has weed made chemical imbalance to my brain that triggered Mitral valve prolapse syndrome, causing unexpected panic attacks.
3. Why no medication has reduced my chest pain. If it is all anxiety, why only movement causes the pain in chest and back.
4. Am I crazy or missing something?????When will I be normal again???

I will upload all reports if required.
doctor
Answered by Dr. Dr. Matt Wachsman (3 hours later)
Brief Answer:
Zeveral points

Detailed Answer:
this is the longez post I have ever answered.
I hope I have found your main questions

no you are not missing anything.

panic attacks are genetically predisposed but triggered by specific triggers like pain.
Seri antidepressants are the best for prevention

you are not on them


chest pain can be from many causes. if triggered by movement it is from muscles and joints.
aspirin like drugs were good

the thoughts and worries are a problem cognitive behavioural therapy is good
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Dr. Matt Wachsman (25 minutes later)
1. can weed cause irreversible chemical imbalance that can trigger these attacks?
2. what to do for pain if NSAIDs and asprin are not working?
Should i consult a rheumatologist for muscle/joint pain?
doctor
Answered by Dr. Dr. Matt Wachsman (8 hours later)
Brief Answer:
a few options

Detailed Answer:
if the beta blocker is working, then it's working. It is a good treatment. As common as beta blockers is an SSRI for MVP. Can use both. Weed often triggers panic attacks. It is really a big set up for it because 1) illegal drug (duh) 2) mild hallucinogen 3) it actually has mild cardiac stimulant properties opposite to the effect of the beta blocker--it speeds up the heart a little bit, not dangerous amounts but some people notice the increased heart rate.

Rheumatologists can suggest some other treatments. They can even do joint injections, but, that isn't at all a common treatment for this. First, there's a LOT of NSAIDS. some, like tylenol and low dose motrin don't work on inflammation. The rest, are very different chemically and are likely to work in some people and not in others and generally 2 to 4 different ones are tried. (celebrex, indocin, and of course aspirin are three strong ones that are quite different chemically and are all possible). Surface acting drugs (methyl salycilate--ben gay) are worth a try. even surface aspirin like drugs (ketoprofen patches). There are nerve damping drugs for pain, but this doesn't sound like a nerve irritation so I cannot recommend them in general but amitryptiline has several effects on pain. Narcotics seem a really bad idea. And prednisone might be tried for a few days. If it works they you really have to see a rheumatologist because it implies an underlying disease process that the prednisone worked on.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Panic Attacks And Chest Pain?

Brief Answer: Zeveral points Detailed Answer: this is the longez post I have ever answered. I hope I have found your main questions no you are not missing anything. panic attacks are genetically predisposed but triggered by specific triggers like pain. Seri antidepressants are the best for prevention you are not on them chest pain can be from many causes. if triggered by movement it is from muscles and joints. aspirin like drugs were good the thoughts and worries are a problem cognitive behavioural therapy is good