AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Question I am a 24-year old female, overweight (165lbs, height is 5 feet 1 inch), non-smoker, on omeprazole for reflux. I also take a multivitamin when I remember. I don't know my blood pressure but anytime it has been taken the nurse tells me that it is good. The reflux is under control to the best of my knowledge. Last week I experienced a strange episode out of nowhere- it felt hard to breathe, my vision "shrunk", I was shaking, very afraid, slightly nauseated. There was no sweating. I had bouts of diarrhea for the rest of the day, and slight chest pain. I should mention that I had been sleep deprived, stressed and had twice my normal caffeine intake that day. The next day the rest of the symptoms were gone but the chest pain remained. It doesn't spread to arms but I occasionally feel slightly nauseated and dizzy. My chest feels tender to touch in some spots. When I rub my chest, it makes the pain worse, but I am not sure if it is the exact same pain or if I am just aggravating my chest area by poking at it.
6 days later I finally went to the doctor. My EKG was normal, and they blamed it on stress, saying I may have had a panic attack. But I am not stressed now (I think) and still in pain. Exertion normally doesn't play any role, but I did take a long walk on the treadmill tonight and felt the pain in the last 5 minutes of the 40-minute walk, but it doesn't get better with rest.
I had a similar incident happen 6 months ago- I got very upset, and had been very stressed, and then had a sudden bout of chest pain and anxiety. I had a normal EKG then too. But this time the chest pain is more severe and has lasted longer.
Should I pursue this further with my physician? Or wait and see what happens? Is stress truly a probably cause?
Answer Dear Erin,
Pain from clogging of the coronary arteries that supply blood to the heart is unheard of in a 24-year-old woman, so it's not threat of heart attack. The most common cause of chest pain in a young woman is cramping of muscle in the chest wall, and you have already shown that you probably have chest wall pain, since pressure on your chest wall modifies the pain. Chest wall pain is a big nuisance but no threat to life or health at all. The episode last week of breathlessness and shrinking vision and shaking was a panic attack, and maybe that episode caused enough change in the chemistry of your body, by blowing off too much carbon dioxide from breathing hard, triggered the chest pain. Should such an episode occur again, pay close attention to your breathing and breathe slowly and shallowly. If necessary, breathe through a 15-inch 1 inch diameter tube. Breathing too fast and hard blows off too much carbon dioxide and causes shrinking vision, tingling in lips and fingers, etc. I think the chest pain will subside in a few more days. Aspirin Tylenol or ibuprofen may help.
Please write back if this note doesn't answer all your questions.
