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What Causes Tightness Of Chest Upon Walking, Soreness In Throat And Fatigue?
Question: I would be grateful for some advise as to what to do next. Over past 18 months I have had 4/5 episodes of similar symptoms and have been seen at hospital 3 times, last seen 2 weeks ago. Each time I have had blood tests, ecg, chest xray and they are all fine. Had an ecg on tues this week ready for pre gynae op and this also fine. My symptoms at present however are: tightness of chest on walking,exertion, sometimes just when sitting at computer/watching tv, not breathless but get very sore irritated feeling in throat. Fatigue/lethargy, am always constantly tired despite sleeping lots. Wake during the night suddenly with upper abdo and upper chest pain, have very disturbed nights once or twice a week. Jaw ache, seems to be muscular as happens when sitting in certain positions and doesn't seem to occur when walking but not sure. Nausea, often. Missed and irregular heartbeats on occasion, racing heart on one occasion when chest pain was bad (prompted my last admission to hospital). Frequent burning pain in shoulders, more left sided, upper back, upper chest, comes and goes, sometimes very severe, lasts varying lengths. Feel generally very unwell. Burning leg pain, when sitting, not related to exercise. Feel often like going to collapse. Other complications include hiatus hernia, left shoulder muscle problem longstanding and age, am 50 and presumably perimenopausal with irregular periods but no hot flushes as yet! Any advice on whether I should have my heart looked into further gratefully received, no one seems to suggest follow up or further investigation after hospital tests. My blood pressure is normal, cholesterol around 6 I believe, I am 5ft 9ins and weigh 13.5 stone. Thank you for reading!
Brief Answer:
Need answers to some questions
Detailed Answer:
Hi,
Thanks for writing,
Welcome to Health Care Magic,I am Dr.Muhammad Ahmad, I have read your question closely and will try to answer you in best possible way,
I would like you to provide me with some more info regarding the issue.
1) You said pain starts when you exert, does it settle down when you rest after exertion?
2) What is the exact location of pain(compression) can you pin point?
3) Any stomach burn or acidity issues lately?
4) Any constipation?
5) Any weight changes?
5) Any mood changes?
6) Was your thyroid profile checked? how was it?
7) Was your fasting sugar etc checked? (were you checked for diabetes?)
8) How is your HB?
9) Does jaw ache happen alone or it accompanies the chest compression on extertion?
10) Which speciality doctors did you visit?
11) Did you undergo any stress testing for heart?
12) Any anxiety lately?
13) Any meds you are on ?
I am waiting for your input.
Dr.Muhammad Ahmad
Resident Cardiologist.
Need answers to some questions
Detailed Answer:
Hi,
Thanks for writing,
Welcome to Health Care Magic,I am Dr.Muhammad Ahmad, I have read your question closely and will try to answer you in best possible way,
I would like you to provide me with some more info regarding the issue.
1) You said pain starts when you exert, does it settle down when you rest after exertion?
2) What is the exact location of pain(compression) can you pin point?
3) Any stomach burn or acidity issues lately?
4) Any constipation?
5) Any weight changes?
5) Any mood changes?
6) Was your thyroid profile checked? how was it?
7) Was your fasting sugar etc checked? (were you checked for diabetes?)
8) How is your HB?
9) Does jaw ache happen alone or it accompanies the chest compression on extertion?
10) Which speciality doctors did you visit?
11) Did you undergo any stress testing for heart?
12) Any anxiety lately?
13) Any meds you are on ?
I am waiting for your input.
Dr.Muhammad Ahmad
Resident Cardiologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry reply went to my junk email just found it!
Yes pain does generally settle after exertion.
The pain I am most concerned about comes on in my upper central chest maybe a bit to the left and I get a burning sensation at the sametime in my central upper back. Feels almost cramp like, makes me feel nauseous and drained.
I do appear to have some stomach gerd issues at the moment which have come on much worse in last few days as I have been taking aspirin/paracetamol to try and relieve other pains.
No weight changes. Trying to lose weight but not doing very well.
Not constipated but hard dark stools due to iron tablets.
No new mood changes just generally fed up with life! Wouldn't say depressed though. Tearful at times due to feeling so ill.
Thyroid not checked recently, about 6 months ago but no action suggested so presume ok.
Checked for diabetes. Ok.
HB fine ferritin was down to 3 now upto around 18
Jaw ache happens alone, appears to come on when sitting at different angles, ie. Now when looking down typing! doesn't seem to happen on exertion.
Haven't seen any specialists but I believe it was a cardio dr who saw me in a&e.
Not had stress testing for heart.
Seem to get hormonal anxiety, but never had panic attack or anxiety attack. Usually very calm person but do worry about health when unwell.
Taking iron tablets and painkillers. Started omeprazole today as oesophagus seems very irritated.
Yes pain does generally settle after exertion.
The pain I am most concerned about comes on in my upper central chest maybe a bit to the left and I get a burning sensation at the sametime in my central upper back. Feels almost cramp like, makes me feel nauseous and drained.
I do appear to have some stomach gerd issues at the moment which have come on much worse in last few days as I have been taking aspirin/paracetamol to try and relieve other pains.
No weight changes. Trying to lose weight but not doing very well.
Not constipated but hard dark stools due to iron tablets.
No new mood changes just generally fed up with life! Wouldn't say depressed though. Tearful at times due to feeling so ill.
Thyroid not checked recently, about 6 months ago but no action suggested so presume ok.
Checked for diabetes. Ok.
HB fine ferritin was down to 3 now upto around 18
Jaw ache happens alone, appears to come on when sitting at different angles, ie. Now when looking down typing! doesn't seem to happen on exertion.
Haven't seen any specialists but I believe it was a cardio dr who saw me in a&e.
Not had stress testing for heart.
Seem to get hormonal anxiety, but never had panic attack or anxiety attack. Usually very calm person but do worry about health when unwell.
Taking iron tablets and painkillers. Started omeprazole today as oesophagus seems very irritated.
Brief Answer:
You need workup in my opinion.
Detailed Answer:
Hi,
Thanks for writing back,
Chest Pain:
It can be due to your stomach issues, that is easily treatable, but "chest compression on exertion", settling with rest is very typical presentation in angina, I believe you should be evaluated for cardiac issues, considering your age and built. You should at least be passed through chemical of physical stress testing so that changes in ECG during exertion can be seen, if it comes out negative, well and good otherwise you can manage the things easily before something bad takes place.
Stomach and gut:
Your stomach and gut do seem to have issues but these are really manageable with prokinetics and PPI , you can discuss this with your doctor.
You have already started Omerprazole, you can continue with it for a couple of weeks,
Here i also wana mention that aspirin worsens stomach issues you can use tylenol instead.
Jaw pain:
It doesn't feel like a serious issue, looks like a muscle or TMJ, do exercises of jaw with the help of physiotherapist and apply voltral gel over it , it might be TMJ.
Lethargy:
It can be general low mood you are having due to health issues, it can also be hormonal or it can be due to heart (less likely), More weight also causes lethargy.
SUGGESTIONS:
1) Keep calm.
2) Try to arrange a meeting with a cardiologist or at least a GP, and discuss with him about Stress testing , Holter monitoring for irregular beats and other options, plus a cardio referral if he deems indicated.
3) Keep taking omerpazole for stomach.
4) Take iron pills DURING a meal it is expected to reduce side effects, or use iron pills with reduced GIT effects like sangobion.
5) Do read about nature and presentation of angina pain and see if it fits.
6) As your stomach issues resolve , things will get clearer , if chest compression resolves with stomach issues it means culprit was stomach.
7) But still I gotta say that your history is quite typical of angina it's betyer if you are tested, stress testing is just an EKG done after making you walk briskly on a treadmill there shouldn't be any harm in doing this easy test.
8) As your health gets better and anxiety goes away your mood will start to elevate with time.
9) I would also like such patient in my clinic to take medium dose vitamin D calcium tablet it helps in making muscles bones strong and reduce aches.
10) If you can have angisid, just place one under tongue when chest compression starts after exertion if pain gets relieved it means it's cardiac.
Just expect and hope good, with time things will get way better with proper follow up and treatment.
If you have any question to ask feel free to ask.
Dr.Muhammad Ahmad
Resident M.D. (Cardiology)
You need workup in my opinion.
Detailed Answer:
Hi,
Thanks for writing back,
Chest Pain:
It can be due to your stomach issues, that is easily treatable, but "chest compression on exertion", settling with rest is very typical presentation in angina, I believe you should be evaluated for cardiac issues, considering your age and built. You should at least be passed through chemical of physical stress testing so that changes in ECG during exertion can be seen, if it comes out negative, well and good otherwise you can manage the things easily before something bad takes place.
Stomach and gut:
Your stomach and gut do seem to have issues but these are really manageable with prokinetics and PPI , you can discuss this with your doctor.
You have already started Omerprazole, you can continue with it for a couple of weeks,
Here i also wana mention that aspirin worsens stomach issues you can use tylenol instead.
Jaw pain:
It doesn't feel like a serious issue, looks like a muscle or TMJ, do exercises of jaw with the help of physiotherapist and apply voltral gel over it , it might be TMJ.
Lethargy:
It can be general low mood you are having due to health issues, it can also be hormonal or it can be due to heart (less likely), More weight also causes lethargy.
SUGGESTIONS:
1) Keep calm.
2) Try to arrange a meeting with a cardiologist or at least a GP, and discuss with him about Stress testing , Holter monitoring for irregular beats and other options, plus a cardio referral if he deems indicated.
3) Keep taking omerpazole for stomach.
4) Take iron pills DURING a meal it is expected to reduce side effects, or use iron pills with reduced GIT effects like sangobion.
5) Do read about nature and presentation of angina pain and see if it fits.
6) As your stomach issues resolve , things will get clearer , if chest compression resolves with stomach issues it means culprit was stomach.
7) But still I gotta say that your history is quite typical of angina it's betyer if you are tested, stress testing is just an EKG done after making you walk briskly on a treadmill there shouldn't be any harm in doing this easy test.
8) As your health gets better and anxiety goes away your mood will start to elevate with time.
9) I would also like such patient in my clinic to take medium dose vitamin D calcium tablet it helps in making muscles bones strong and reduce aches.
10) If you can have angisid, just place one under tongue when chest compression starts after exertion if pain gets relieved it means it's cardiac.
Just expect and hope good, with time things will get way better with proper follow up and treatment.
If you have any question to ask feel free to ask.
Dr.Muhammad Ahmad
Resident M.D. (Cardiology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your advice it all seems to make sense.
Brief Answer:
Things should work out fine.
Detailed Answer:
Hi,
You are always welcome ,
Take no alcohol, no smoking, less spice, less oil, and no fizzy drinks, coffeir or any caffeinated product..(what ever applies).
I will be eager to know how things work out after you follow the suggested approach.
You can contact me for any assistance regarding health issues specially Heart issues, directly at:
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Wish you best of health..!!
Dr.Muhammad Ahmad
Resident M.D. Cardiology
Things should work out fine.
Detailed Answer:
Hi,
You are always welcome ,
Take no alcohol, no smoking, less spice, less oil, and no fizzy drinks, coffeir or any caffeinated product..(what ever applies).
I will be eager to know how things work out after you follow the suggested approach.
You can contact me for any assistance regarding health issues specially Heart issues, directly at:
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
Wish you best of health..!!
Dr.Muhammad Ahmad
Resident M.D. Cardiology
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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