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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chest pain while breathing

lately i been experiencing some chest pain and a little shortness of breath. i feel like i cant take deep breathes and my chest feels like its caving in. I been to a caridologist and and internal doctor many times. Did Ekgs, did a stress test with the holtor hooked up during workout , had 2 holtor monitors. All these test came back normal with nothing wrong what so ever. i have a slow heartbeat. resting at 60 but thats it. all my doctors and cardiologist said its normal and all my test are fine. well i go running i feel some shortness and caving of my chest. what can this be. Im 23yr olds male, good shape , workout everyday. no family heart problems. I have developed a lot of anxiety and stress over the past year and its been on going. my doctor thinks a psychiarist should help me out bc i been through a lot. what do u think this can be i dont want to keep going back to doctors since they all run all these test and they always come back negative. any ideas?
Fri, 11 Dec 2009
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It is good that you have seen a cardiologist and gotten a clean bill of health. Twice I had what I was sure were heart attacks, same symptoms as you described and in both cases I felt that I was dying, once I called ems to the side of the interstate, and once my terrified wife drove me to the ER, both times I had clean EKG's, People told me they sounded like panic attacks, to which I was sure they were full of shit because how could something that had such strong physical symptoms be just in my head, right?? Since then, about 5 months ago, I have accepted that I have anxiety/panic disorder, and I have seen a behavioral therapist and am now taking Lexapro 20mg everyday, I have gone from having about one level 10 (heart attack-like) panic attack/day to zero bad panic attacks and about 1-2 level 3 anxiety spells/week The good news is that the success rate for treatment of anxiety disorder is about the highest of any mental health disorder.--I am down to one session a week with the behavioral therapist, but there is no way I'm quitting the Lexapro anytime soon. Drugs: SSRI's like Lexapro are now the gold standard, they used to give people benzodiazapenes like Xanax, now these are reserved for severe cases that don't respond to the SSRI's because they can cause dependance and they mellow you out almost too much to where they alter your personality. However SSRI's take a while to start working all the way, the smart thing is to start at 5mg, then 10, 15 up to 20, spending at least a couple days or more at each step, also they will fool with your serotonin levels and you feel "something" happening, some people report feeling a little worse the first day or two when they first start or tritate up to the next dose. I'd ask your GP or a psychiatrist to see if maybe he'd give you just a few Xanax as a stop gap, and start an SSRI, combine this with some behavioral therapy and you are going to start feeling a lot better really soon. Good luck!!! Also any good bookstores will have books on anxiety disorder, just make sure it is one written from a psychiatric/behavioral psychology perspective and not "heal yourself with herbs, Jesus, Scientology, etc. Also, Google: "Panic + Breathing Exercises" ----This is something you can do to start feeling better right away!!!
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