Brief Answer:
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Detailed Answer:
hi
have noted all your details
your 2d echo and stress test are normal combined together their sensitivity is more then 70% to rule out cardiac ischemia or coronary artery disease
your ecg and shows premature ventricular contractions,the most common cause of PVC is myocardial ischemia decreased blood supply to heart
you have not mentioned the number of pvcs there in 24hour recordings of holter
till a particular limit pvcs are ok but after that aggressive management is done
increased intake of caffeine and nicotine (smoking) causes increase in adrenaline hormone in the body again causing pvcs ..so restrict caffeine ,alcohol and smoking if u do them
you have anxiety problem ,anxiety can mimic chest pain of cardiac origin
anxiety is one of the causes for pvcs also
both your palpitations and chest pain can be explained by anxiety
try to keep your mind busy in work donot overthink about your chest pain and palpitation,obssessive thoughts often increses the anxiety level
at least 8hours sleep to be taken daily
45minutes of regular exercises to be done daily
do you have acid peptic problem,gastritis,acid peptic disorder can mimic the cardiac pain also so please mention this

adv
stress thallium 97% sensitivity in ruling out cardiac disease
if its normal then chest pain is not because of cardiac blockage

tablet clonotril 0.5mg once daily at night(anti anxiety benzodiazepene)
tablet pexep cr 12.5mg initially for 14days dose to be incresed after 14days (stop zolfast pexep is much more safer and effective)
tab metolar xr 25mg twice daily at 9am (stop aten metolar is much superior snd is cardio selective in nature)

take them for 14days
(these medicines are not over counter medications so kindly get it prescribed by your cardiologist and follow them)

provide me detailed copies of your holter recordings reports ecg echo
thank you follow my instructions and you will be fine soon
have a safe recovery
regards

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