Heart & Cardiology/chest pain and dizzines

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Question
Hello,
   I will start off by giving you my age, weight, and height.   I am 29 years old, I am 5'5"  and the last time I was weighed it was 175 lbs I think.    I have been experiencing chest pain over the past year.  First I started having it every now and then, but it seems to be getting more frequent and now is followed by dizziness.   The pains occur right over my heart, on the left side of my chest and sometimes in my back right behind my chest.  It starts off feeling like my heart has stopped or is not beating right, it pounds really hard and I feel really sharp pains sometimes pressure in my chest.  after it stops it feels as though blood is rushing to my head and I feel a tingling sensation in my body.  I have to lay down after words because it feels like I just got done spinning in circles or running really fast and then stopping suddenly.  
The frustrating part about this whole thing is that I have been to the emergency room once for it, they didn't find anything unusual except for that my potassium and magnesium was a little low.  I have also been to my family doctor about it.  She had an echocardiogram done on me, and I was also sent home hooked up to a device (I can't remember the name of)  that records your heart rhythm.  after all the testing, they found nothing unusual.  Is there anything else that could be causing this that might be overlooked?  Any information you can give will be appreciated. Thank you for your time.

Answer
Hello Amanda,

The sensation that your heart stops is a skipped beat.    Skipped beats are normal heart activity, easy to understand as normal from knowledge of the heart's electrical system and occurring in about half of us.  They don't mean you have heart disease or will in the future develop heart disease or any cardiac catastrophe.   Chest pain in a young person is usually cramping of muscles in the chest wall.  If pushing on the painful area modifies the pain (makes it better or worse), or if the pain is relieved by bending the body away from the painful area, that proves the pain is from chest  wall.  Even if these maneuvers donít affect the pain, itís still probably chest wall.  Pain caused by narrowing of the coronary arteries that supply blood to the heart is extremely rare below age 40. Chest wall pain is no threat to life or health, just a big nuisance.  Safest management is just to ignore the pain, though Tylenol, aspirin or ibuprofren usually help.  Dizziness may be over breathing from anxiety.  Pay attention to your breathing and breathe slowly and shallowly.  Dizziness can be caused by low blood pressure too, if it occurs only when you're standing.  Measure your BP sitting and then standing for 1,3 and 5 minutes.  If it gets below 90, that's the cause of your dizziness.  Eat lots of salt and drink lots of water.

Please write back if this note doesnít answer all your questions.

David Richardson

Heart & Cardiology

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David 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.

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