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What causes persistent chest discomfort and heart palpitations?

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Posted on Tue, 27 Dec 2016
Question: I have passed an echocardiogram, stress test, and iodine ct scan within the past month. Still having chest discomfort and palpitations sometimes they go away other times they persist. Started atenolol and have been on Zoloft a week the to help anxiety. If I passed these tests and still have the pains, what else can I suggest to my doctor? Passed ecgs as well showing pvcs, wore a holter, and it showed the pvcs. Had blood tests several times came back normal, stress is an issue but can it cause these pains?

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Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
Please read in detail

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

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What causes persistent chest discomfort and heart palpitations?

Brief Answer: Please read in detail 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