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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes chest pain and shortness of breath?

In the last 6 weeks or so I ve been developing chest pain and shortness of breath. Prior to that I had suddenly become very fatigued. I had trouble staying asleep and just generally felt like something was off. I asked my PCP to run some lab tests, I was worried that maybe my hypothyroidism had gotten worse and perhaps I needed a medication adjustment. I also asked for a test to check for Diabetes. There is a strong history of DM in my family. My thyroid was slightly low so he increased it. My HgbA1C was borderline. Then suddenly one morning about 6 weeks ago I developed a tightness in my chest and jaw and I became very short of breath and diaphoretic. This woke me from my sleep at about 430AM. I went to the ED and a stress test was negative so I was sent home. We did discover that my BP was elevated so I was started on Lopressor. When I followed up with my PCP he prescribed Nitro and ordered a stress echo. That test showed some abnormality at the LAD so an angio was done. The major vessels were clear. So during my follow up with Cards I was told I have Angina although the cardiologist couldn t tell me why I was having Angina with clear vessels. His response was if you have chest pain take Nitro. I followed up with my PCP and in a nutshell he said it wasn t my heart. When I explained that I continue to have the chest tightness with jaw pain and shortness of breath he actually yelled at me. He said it couldn t possibly be my heart and I was an hysterical female so I should take Xanax when I get the chest tightness. I am 54 years old. I developed hyperthyroidism after my first son was born in 1992. I also had pre-eclampsia during that pregnancy. After my second son was born in 1999 I experienced what the OB/GYN said was I had developed Premature Ovarian Failure and my cycles stopped at the age of 36. I have a strong family history of diabetes and heart problems. I have researched this and I found something called Microvascular Disease and it said that women are more prone to this than men. My question is is it a possibilty that that might be the problem?? The chest tightness is coming more frequently and is getting more severe. I get very short of breath walking even short distances and the pain in my jaw is also getting worse. Nitroglycerin SL improves the symptoms but after a bad episode of the chest tightness I feel exhausted. I m an ED nurse and have never really had any problems handling stress and don t feel anxious and there is no way I can take Xanax and work. I would be very interested in hearing any thoughts on this subject.
Thu, 3 Jan 2019
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General & Family Physician 's  Response

If symptoms persist, it is better to consult a physician and get evaluated.

We have to rule out possible cardiac and chest related problems.

Hope I have answered your query. Let me know if I can assist you further.

Dr. Shinas Hussain,
General & Family Physician
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