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    What do my echo test results indicate?

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Posted on Tue, 31 May 2016 in General Health
Question: I am a 35 year old female who is relatively healthy.  For about the past 9 months or so I have been having chest pain ranging from mild to bad.  It can happen on either side of my chest, not necessarily where my heart is and mostly near my left armpit.  It is sometimes a dull, aching pain.  Other times it's more of a sharp, stabbing pain. Occasionally one or both arms will also have a throbbing pain as well.  It seems to happen after a large meal and mostly happen before a week or two of my period. I tend to have a lot of anxiety about things like this so a lot of times I can work myself up into a frenzy and make the pain that much worse.  I went to see the physician that i am thinking I was having a heart problem, only to be told the first time that it was anxiety/stress and the next time that it is GERD.  I am currently taking (prescription) Esomeprazole for 2 months but it did not help the chest pain at all.  I went back to my doctor and she gave me Xanax for the anxiety and decided it might be fibromyalgia. The Xanax is helpful when I am having episodes that are exceptionally bad.  It does calm me down and thus relieve some of the discomfort. I have had an echocardiogram and the result is below and my doctor said it is no need to worry for heart problem.
Echo report is
1. Trivial MR
2. Mild to moderate TR
3. Normal LV systolic function (EF=66%)
4. No regional wall motion abnormality
5. No pulmonary hypertension
6. No ASD, No VSD, No PDA
In addition, I've had all other blood tests, ECGs, my blood pressure is fine (but slightly low), etc. and things are fine. Now, the last couple weeks I have been experiencing a throbbing pain in my left leg especially when I am having pain on my left chest side or aches other parts of the body. Sometimes also right leg. Now, could the leg and chest pain be related?  And if so is it indicative of any kind of cardiovascular problem?  I have incredible anxiety about it and no one seems to know what my chest pain means.
It would be thankful, if i can get a full advice on my condition.
doctor
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer:
Here is a list of suggestions you need to follow religiously ma'am

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms do point toward GERD (gastroesophageal reflux disease), but as you complain about your pain getting worse after a large meal, I do also recommend an upper GI endoscopy to rule out conditions such as peptic ulcer disease (PUD).

Let me now go ahead and list some do's and don'ts for an individual with GERD, which I am afraid your doctor has not done for you, so please do take my suggestions seriously:

+Do not eat spicy food
+Do not smoke
+Do not have carbonated drinks
+Do not have oily food
+Do not drink tea
+Do not have fried food
+Do not drink coffee
+Do not have fatty food
+Drink plenty of water
+Avoid acidic food and drinks (e.g. citrus fruits and drinks)
+Avoid stress and anxiety
+Avoid alcohol
+Have 5-6 smaller meals instead of 2-3 larger ones
+Avoid overeating
+Lose weight if you are overweight or obese
+Avoid long gaps between meals
+Use 1 tablet of either raniditine or omeprazole 15 minutes before each meal, only when you have your symptoms or an episode of GERD
+Have 1 tablet of lansoprazole 30 mg once daily for the rest of your life
+Avoid vigorous forms of exercise
+Make sure you finish the last meal of your day at least 2 hours before bedtime
+Do not eat and sleep immediately, make sure there is at least a 2 hour gap between your meal and sleep
+Try to get at least 7 hours sleep everyday

As for your chest pains, they are related to GERD, and just for your reference I shall go ahead and list all the symptoms of GERD:

+Heartburn
+Dry cough
+Sensation of a lump at the back of the throat
+Hoarseness of voice
+Sore throat
+Regurgitation of food or sour/bitter liquid into your mouth
+Chest pain
+Difficulty swallowing
+Bitter taste in your mouth especially after or during the regurgitation

As you can see from the above list of symptoms, your chest pain is also related to GERD ma'am. Most gastric conditions can mimic cardiac events ma'am, which is why you always felt this was something to do with your heart. Do not worry, and just follow my suggestions.

I am sure that if you follow my suggestions religiously, you should be able to avoid all your symptoms. Please feel free to write back to me for any further clarifications, I would be more than happy to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan 13 minutes later
Dear Doctor
Thank you for your reply with details infomation.
In that case, does this mean the pain used to have across the body, especially near left side armpit and the legs are also due to GERD?
And that echo report which i mentioned in my previous query is no need to worry??
Sorry for asking you back because the situation which i mentioned previously is really disturb my daily life whenever i have that feelings. And whenever I go and see the doctors, they seems I am overacting and over worried but I am the one who is suffering and I only know how it makes me get worried.
Thank you in advance for your reply.
doctor
Answered by Dr. Shoaib Khan 2 hours later
Brief Answer:
Yes; yes; echo is fine; I completely understand for sure, don't worry

Detailed Answer:
Hello once again ma'am.

Yes the pain described by you could either be a cardiac issue (which has been ruled out adequately) or related to GERD or other such gastric issues.

The pain in the legs could be due to a reflex triggered by abdominal bloating or irritation which results in pain spread towards the lower abdomen and very rarely to the legs as well.

No ma'am, the echo report shows mild deviation from norm, but these are things that can be well controlled with lifestyle and blood pressure maintenance. Many individuals can live a normal healthy life without even knowing they have such changes in their heart.

I completely understand how you feel ma'am, and your condition can also aggravate your anxiety and stress; and vice verse (i.e. your anxiety and stress can aggravate your condition). So in my opinion, controlling both of them is important.

Your Xanax will help control anxiety, and in turn provide some amount of relief to the GERD, but the other suggestions provided by me will also provide relief to the GERD, and in turn the anxiety and stress.

I wish you a speedy and complete recovery. Please follow my instructions religiously, and anytime in the future should you need my assistance, please do not think twice to write to me here.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan 4 minutes later
Thank you doctor. I will surely follow your instruction. It is glad to hear that the echo is fine :)
doctor
Answered by Dr. Shoaib Khan 19 minutes later
Brief Answer:
Always here to help, keep in touch ma'am :)

Detailed Answer:
Hi.

Please do, and keep in touch with me. Keep me well informed about the progress you are making; make a note of all the food items that you consume that result in an aggravation of your symptoms (and avoid them), and write to me about them so I can explain how and why they are causing you those symptoms.

Any other doubts, small or big, you know where to find me. :)

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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