Even after ER, worried about heart disease

[TJE123]

I went to the ER the other day with a squeezing arm sensation, which usually happens when I eat badly, especially lately. At the ER, they ran an EKG test and took blood work, and blood pressure and said it's all fine. I'm in my late 20s and overweight (BMI of 41), so I am very worried about it. Furthermore, got a slight jaw dullness a couple times.

Could be anything, but together I am frightened it's angina.

 I don't know why they didn't do a test to find out about my arteries having atherosclerosis. It's like the people at the ER don't think I'm serious and just doing a quick test to see if I'm dying. As for the arm pain, I can stretch my arm out and the squeezing discomfort seems to go away but it comes back after stretching.

[MOchp]

If your EKG and blood works was normal then it is safe to say you don't have heart disease. Chest pain, tightness and an assortment of other complaints are common with anxiety. I had chest symptoms during my first occurence of health anxiety and ended up having tests done that were normal. I would of sworn to you at the time that something was wrong with my hear though.

[TJE123]

How about heart blockage though? They said online that EKG's/blood work/blood pressure doesn't show that. 

[MOchp]

I found the following quote online.

"An ECG/EKG can demonstrate changes suggesting a blockage. These include changes of ST elevation - certain patterns are highly suggestive/diagnostic of an acute myocardial infarction (a "heart attack"). Another pattern (ST depression) suggests ischemia - or a lack of blood supply to part of the heart again is suggestive a partial blockage."

It does say though that for it to detect changes it is usually required for it to be a cardiac stress test which is just an EKG while you are exercising to increase your heart rate and not a resting EKG. A heart blockage at your age even being overweight isn't a high probability though. If it worries you it might be worth talking to your doctor about a stress test for peace of mind. Still remember what I said though. Anxiety causes a long list of symptoms and some of the most common are ones that mimic cardiac problems. You can search through the forums here and find a long list of posts by people who think/thought they had cardiac problems, but what they were feeling is from anxiety.

[marc]

At your age a blockage is extremely unlikely. My wife went to the hospital last year with chest discomfort.
She is 54. They ran an EKG, blood work and did a cat scan of her chest. They said all appeared OK and it was
likely that she had a virus (which she also had)which caused the discomfort. The ER doctor (along with my friend who is
an internist/cardiologist) said that the best non-invasive test to detect blockages is a thallium stress test. They said that
they typically only pick up blockages if they are 70% or greater and that small blockages can also cause heart issues
(as low as 20%) as they are more unstable and can break off. They explained to me that when you have a larger blockage,
your body has time to try to make collateral ways to get blood through. When you have a small blockage, your body
does not have the time to do this. They also said that typically, heart blockages take decades to develop and don't
happen overnight.

[sixpack]

hello tje

I'm sorry you are so worried.  it is no fun living in our anxieties.  all it does is rob us of joy.

now my two suggestions:

1.  You are, from your own admission, overweight.  You know this is a risk factor for heart disease, diabetes and other health issues.  One thing that you can do STARTING today is committing to a healthier lifestyle.  Don't waste not only your time and money on ER visits but the ER's time especially when it takes away from people who are indeed in emergency situations..   I want you to call your GP and get a good physical.  I want you to ask your GP for a referral or rec to a nutritionist.  From there you can get on a sensible diet.  You can get involved in a healthy exercise regimen.  THIS will help not only your TRUE physical well-being but your emotional one as well.

2.  Start taking proactive steps to dealing with your anxiety disorder.  There are many posts around here that give suggestions.  There are self-help modules listed at the top of this page and in the med/therapy folder.  gcalex posted one in a thread recently. 

by doing these two things------LONG TERM------- things will start getting better for you.  The wonderful thing about adopting proactive habits is that it gives us confidence and power and pride.  When we take responsiblity for getting better damned if we don't start getting better.     We take our lives back.  We are in better control (not complete as life just doesn't work that way). 

good luck and be well.

[marc]

Sixpack is correct in her assessment. My information is only strictly from what physician's
have told me.