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Author Topic: Cardiac Fears - What's Next  (Read 373 times)

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Offline NickT76

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Cardiac Fears - What's Next
« on: August 27, 2014, 03:20:00 PM »
Hi everybody,

I'm not sure but I think my anxiety has gotten the best of me, or, I think my doctors missed something.  About 2 years ago I started with really bad Anxiety and had my first panic attack.  I did end up in the ER thinking I was having an heart attack... I wasn't.  I do see a cardiologist, one of the best in the country.

2 years ago he did a complete cardiac workup (EKG, Nuclear Stress Test, Echocardiogram and even a CT Angiogram... Yes a CT Angiogram on a 36 year old).  The results were all normal.

Fast forward to this year.  ALS fears I think put me over the edge and now my chest pains started up again.  Crushing, tightening pain... Plus I started getting cramping and pain the back of my legs.  My cardiologist said I should go to the ER just to be sure its not a blood clot.

I went.....while there they asked if I had chest pains and I said yes... I became a cardiac patient... everything was normal except cardiac enzymes were slightly high... not Heart attack levels but just a bit elevated... I ended up staying.

Hospital did Venous doppler which showed no blood clots in my legs and even did something called a D-Dimer test which looks for clots elsewhere in the body.  I guess they wanted to make sure there wasn't a pulmonary embolism.  D-Dimer all clear.

I had my follow up with my Cardiologist last Friday who pretty much told me my blood work is outstanding... full blood workup including cholesterol and triclicerydes.  He was quite impressed about my cholesterol.  Based on the numbers it is very unlikely that I would even get plaque buildup in my arteries based on the numbers.  I do have a bit of high blood pressure - I think pre-hypertension levels but try to stay on low sodium diet.

Before I left he told me the CT Angiograms are good for 5 years meaning chances of any cardiac events are practically 0 for 5 years.

Anyway........

Chest pains have been pretty unbearable for the past few days.  They start in the middle of my chest, then move to the top of my chest, move to the bottom of my left breast area, are tightening, sometimes piercing and my neck and arms even hurt. 

Please someone tell me why I think my cardiologist missed something... or I've formed a blood clot in my lungs or i have one of those rare Aortic bulging issues.... 

Is this classic Anxiety guys or should I continue this medical train?




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Offline rap_Talon

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Re: Cardiac Fears - What's Next
« Reply #1 on: August 27, 2014, 04:54:19 PM »
Your doctor/Cardiologist may have missed something, but those tests they have run are pretty much as conclusive a bill of health as you can get - there's no problem there. It's in your head.

What you are describing sounds very anxiety related, and is something I have experienced myself; I ended up in ER as well, where they found no issue.
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Offline NickT76

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Re: Cardiac Fears - What's Next
« Reply #2 on: August 29, 2014, 10:45:35 AM »
Thanks rap.

I probably should have stayed off of Dr. Google because I read about something called Aortic dissection or bulging Aorta on several "medical" sites.  All are pretty serious things.  Now I"m thinking in my head that might be what's going on with me because of the constant chest pain going into my back.  I've read one of the top risk factors is high blood pressure.  My blood pressure has been borderline for a few months now; upper 130s over high 80's.

I guess a coronary CTA 2 years would have seen something brewing up back then with my Aorta.

Again according to my Cardio heart disease does take years to develop with risk factors.  I'm hoping something like Aortic Dissection doesn't happen that quickly.  I have great cholesterol.

Why am I so hung up on this now?
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Offline rap_Talon

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Re: Cardiac Fears - What's Next
« Reply #3 on: August 29, 2014, 11:53:21 AM »
Your Cardio is right; heart attacks don't just happen out of the blue like that. There's underlying causes, damage that happens over time. Without these, and with clear testing, it'spretty darn certain you aren't going to be having a heart related issue. You BP is no worse than my own, and the doctor has said, at my age and with my risk factors, there's no chance that a borderline high BP is going to be causing any real issues - we're going to work on it as part of eating healthier and exercising more.

Constant chest pain usually has one of two causes; anxiety, or musculoskeletal. With issues like heart problems, the 'pain' typically comes and goes and intensifies on certain situations, such as exercise or strenuous activity. Or at least that was the case in those I cared for that had heart conditions :)
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Online fishmanpa

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Re: Cardiac Fears - What's Next
« Reply #4 on: August 29, 2014, 12:09:43 PM »
That train stopped at the station when the test results came in. I've had two heart attacks, triple bypass and stents (not to mention cancer). I'd be jumping for joy with results like yours. I also know chest pain as you describe is a symptom of stress, anxiety as well as acid reflux (it put me in the ER several months ago).

I can tell you with all certainty that if indeed your were having serious heart issues, you wouldn't be here typing about it.

Hope you feel better soon!

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"Eat. Drink. Enjoy the work you do. Be thankful for the blessings in your life. Live. Love and seek out the things that bring your heart joy. The rest doesn't matter!."  King Solomon.

Offline patmob

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Re: Cardiac Fears - What's Next
« Reply #5 on: August 29, 2014, 12:30:02 PM »
Fishmanpa - when you had your heart attacks, was it clear that what you were feeling was different than anything you had felt before?

A lot of us worry that we "might" be having a heart attack but we're not sure so I guess my question is, when it happened to you was there any room for doubt that something had was happening?

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Online fishmanpa

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Re: Cardiac Fears - What's Next
« Reply #6 on: August 29, 2014, 12:52:16 PM »
I can assure you it's a totally different feeling but I don't suffer with HA. HA tends to skew your perception and what you think is sinister quite frankly isn't. Your anxiety kicks in, you hyperventilate, your muscles tighten and hurt etc. etc. My left arm hurt so bad I couldn't use it and the pain was a 8-10 out of 10 both times. Even with large doses of morphine, it hurt like hell!

Now, when I went to the ER a few months ago, I was having chest pain and I had my doubts it was my heart. I have some "scanxiety" and I had my follow-up appointments coming (I always get really stressed as I had cancer). But, based on my history, it was prudent to go. As it turned out, it was stress related along with some reflux. I was given a chill pill and a PPI and I haven't had it happen since. That being said, it did hurt like the dickens!.

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"Eat. Drink. Enjoy the work you do. Be thankful for the blessings in your life. Live. Love and seek out the things that bring your heart joy. The rest doesn't matter!."  King Solomon.

Offline NickT76

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Re: Cardiac Fears - What's Next
« Reply #7 on: August 29, 2014, 01:40:11 PM »
Wow guys very insightful.  I do take Omeprazol 40MG 2 x daily so I guess that's why I keep fearing this cardiac stuff because I"m treating the reflux.  2 months ago I did have an endoscope which actually wasn't all that bad..minor inflammation.

I guess your comment the train stopped with the testing should be comforting enough. Having Health anxiety however I always feel as though I'm going to end up being that statistic where something was there that testing missed.

The pain does definitely come and go as you describe but lasts all day.  I was just on a 2 hour conference call and I didn't feel anything....strange.  Now that I'm done and started walking around again... here we go... center chest pain... throbbing, tightness, stabbing, aching. 

See my endless cycle?  Maybe I should go for a walk and test myself
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Online fishmanpa

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Re: Cardiac Fears - What's Next
« Reply #8 on: August 29, 2014, 02:02:04 PM »
Here's the thing Nick, what you describe is indicative of reflux and stress. Both my heart attacks were different but equally painful and there was no if's and's or but's about it! I was in distress! The first was a pain deep inside, like behind my heart if that makes sense (turns out the main blockage was on the inferior wall thus the pain). I had a bit of pain and dizziness in the morning and it went away. That night it hit and hard. Within 20 minutes I was having pain from my armpit down my arm. I drove myself to the hospital (alone in a rural area). By the time I got there I was in bad shape. I actually went out on the ER...afib... they used the paddles to bring me back on-line. 4 days later I was under the knife. That was 2007

The second felt different. It was more like indigestion. In fact, I took some antacids and the pain went away so I thought that was it. The next day it came back hard and there was no doubt. I went to the ER and actually had the heart attack there! Damn... that one was worse than the first! The next day I was getting stents. That was Oct. 2012... then came stage IV head and neck cancer... yeah, I've been through some poo for sure.

You got good results from your tests and while there's a one in a million something is missed, it is what it is. You could be in a car accident tomorrow, or some other nonsense can happen. The best thing you can do for yourself is to take care of yourself physically and mentally. Don't smoke, refrain from drinking (it's really bad for anxiety and reflux) and work on taming the HA. Stress isn't good for you!

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"Eat. Drink. Enjoy the work you do. Be thankful for the blessings in your life. Live. Love and seek out the things that bring your heart joy. The rest doesn't matter!."  King Solomon.

Offline Raaawr

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Re: Cardiac Fears - What's Next
« Reply #9 on: August 29, 2014, 05:52:12 PM »
Wow fish, really crappy story and I'm sorry to have read it but im also glad you shared it. Puts a lot of my heart worries in perspective. In fact just reading your post seems to have dulled my latest out of anxiety.

Nick just to reiterate what a lot of people are saying; pain in the middle of the chest is most likely acid reflux. Heart pains don't tend to be so localised that you can pinpoint it's location.  Also the pain you describe coming from the left side could well get your stomach. Also the pains could simply just be musculature or a combination of the lot which is what I experience.

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Since July 23rd 2014 I have had;
Brain Tumor, 5x Heart Attacks, 2x Blood clots in leg, 1 blood clot in Arm, 2x Appendicitis, Pulmonary Embolism, Brain Tumor, Internal Bleeding, Ebola.

Offline NickT76

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Re: Cardiac Fears - What's Next
« Reply #10 on: September 03, 2014, 11:49:16 AM »
Hi guys chest pain seemed to go away for a couple of days and then out of the clear blue sky it gradually started up again last night.  Right after dinner while watching TV I started feeling what I thought was acid reflux.. hadn't taken my omeprazole in about a week or so.  Over the course of about an hour the burning got more intense.  I took omeprazole and a couple of tums to no avail.

Along with the burning I started getting center chest pain that felt like squeezing and stabbling all at once.  I ended up going into a full blown panic attack and crying.  My wife talked me down and I eventually went to sleep.

This morning from the minute I opened my eyes up the chest pains have started all over again... and it's been about 5 hours since I've been up... I'm getting burning across the center of my chest that comes and goes along with varying levels of pain in my chest; tightness, stabbing, pressure, etc.  They have been here all morning; might go away for a minute or 2 but come back again.

I'm inclined to just say F*** it and go to the ER but I was just there.  It hasn't even been 2 weeks. I still have some bruises in my arms from where the IV lines and blood was drawn last time.

Can anxiety really get this bad guys or am I goinig to be this 1 in a million lottery winner that was given a clean bill of health? 

I've had perfect blood work up to date and every cardiac evaluation done 2 years ago.  I do apologize if I sound like a broken record here but just really scared.
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Offline richm66

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Re: Cardiac Fears - What's Next
« Reply #11 on: September 05, 2014, 03:21:35 PM »
Nick,

I am in my early 40's now.   In 2006, one day sitting at my office at work, I began having skipped heartbeats.  Scared the crap out of me.  I went to ER and was cleared after a nuclear stress stress.  For the next several months, I was a nervous wreck with chronic chest pain.  Probably went to the ER 4-5 times in several months.  Always normal.   I eventually went to the Cleveland Clinic for an executive physical and had a complete workup by a preventative cardiologist that included a 64 Slice CT Coronary Angiogram (very new technolgoy at the time that showed 3-D images of the heart).

All of my tests were normal, except to the surprise of the cardiologist (because all my labs were good, BP was good, EKG and echos and stress test were good). - the CT Coronary Angiogram showed that I had "mild" mostly calcified plaque in two distinct spots in my LAD.  All other arteries were clear.   Needless to say this freaked me out.   I thought I was a ticking time bomb.

However, the cardiologist assured me that no such minor plaque would cause chest pain.  Also, it was later explained to me that calcified plaque is "preferable" as it is less prone to rupture than uncalcified plaque (more prone to rupture).

Needless to say, because of the results of the test and even though my cholesterol levels were fine, I was informed to eat better, begin to exercise and to take Lipitor.

I did all 3.  I became an avid runner and I have been on Lipitor for 8 years.   My HDL cholesterol is now higher than my LDL cholesterol.  The goal is to slow any progression of any plaque formation over my lifetime to whereby it may never be of any clinical nature. 

Believe me, I stress about it.   I take anti-anxiety medications daily as a result and I have been back to the ER on a number of occassions and always normal.

My regualr doctor is convinced that I am extremely healthy and that nearly "everyone has some plaque".   In fact, based on studies of autopsies of veterans of Vietnam War, it has been determined that plaque formation begins early in life and is a progressive disease of aging (although some may never get it).

Basically, I was told that if every 35 year old in the country had a CT coronary angiogram, that likely half of Americans would have some plaque.

Am I better off knowing or not knowing ?   I am better off knowing, because now I can be preventative before something happens.  (medication, eating healthy, exercise).

What I need to to work on is my mental health.  Which I am beginning therapy this week to help me deal with everday pains of getting older and realizing everything is NOT a heart attack.   To live in fear is no way to live and I am done living that way as of this week beginning with my therapy.

Enough about me.    You need to work on "accepting the diagnosis".   Your test results were outstanding.   Their is no way to guarantee against what tommorow may bring.   However, in your case, it is not a heart attack.

Even my cardiologist now says that my risk of a heart attack over the next 10 years is less than 1 percent.  (basically as low as they can say).    You have Health Anxiety like most of us here.   And I know what that feels like.

Look into speaking with your personal doctor about helping with that.   I think that is more of a concern than your heart at this time.   Plus, the posters before me (fishpa, etc.) should have provided you with some additional reassurance.   They certainly have done so for me indirectly just reading their posts.

Cheers to your continued good health!
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Offline richm66

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Re: Cardiac Fears - What's Next
« Reply #12 on: September 05, 2014, 04:09:53 PM »
Also - You cannot take PPI's on an as-needed basis for GERD/Acid Reflux.   These are maintenance medications meant to be be taken every day for 24 hour sustained relief.

And if you do decide to come off of them, you need to wean yourself off, so as not to possibly cause "rebound acid secretion", which causes excess acid secretion as your proton pumps in your stomach are suddenly turned on again.

You could try Gaviscon or Rolaids for immediate relief or over the counter Zantax 75 or Zantac 150 that are less strong than a PPI.

If you really feel that bad, you can go always go to the ER (better safe than sorry).   But agaim, it appears that you have obsessive worry and anxiety that are likely making each "panic attack" worse than it really may be.  You need to treat this as well, just like any other symptom you would have checked out by a doctor.

Hope you feel better soon.
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