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Breast Pain, Dizziness, Induced By Stress, Echocardiogram At 6 Weeks Ok

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Posted on Mon, 28 May 2012
Question: Intense sharp stabbing pains under left breast. Generally last for at most one hour. Had 4 episodes in three days. None for last 5-6 days. Also had the same issues Feb 2010. Occassional dizziness, feeling that I may collapse. Induced by stress/upset. Age 45. female. 170cm high. weight 72.6kg. failed ecg when in pain, not when not in pain. Echocardiogram at 6 weeks ok. Treadmill and tilt test ok.
doctor
Answered by Dr. Gopi A (11 hours later)
Hi,
Thanks for the query.

The dizziness and pain in chest you experience looks more like an anxiety attack.

The pain you are experiencing is definitely noncardiac. Probably a lot of anxiety overlay is there.

The physiological symptoms also include palpitations of the heart, ranging from severe to moderate. Shortness of breath ,chest pain , feeling of dizziness and trembling of the body. In some cases, these symptoms are also accompanied by nausea and a tingling sensation through the body.

There are women that suffer from ‘derealization’. This is when the women feel no attachment to the world and may be totally detached.
Some woman also suffer from abdominal distress when they have anxiety attacks.

Some doctors recommend breathing into a paper bag as an effective short-term treatment of an acute panic attack.

Meditation needs tο bе mastered іf іt’s tο bе effective. Thе objective іѕ tο gеt rid οf уουr fears аnd anxieties bу using special techniques tο саlm yourself down, relieve stress аnd relax tight muscles, etc., ѕο thаt уου саn turn negative feelings іntο positive ones.

I would recomend you see a good physician/psychiatrist who will prescribe you medication and cognitive behavioural therapy.

Hope i have answered your query.I will be available for follow up.
Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Gopi A (9 hours later)
Is it possible that I have stress-induced cardiomyopathy?
doctor
Answered by Dr. Gopi A (24 hours later)
Hi and thanks again,

No, your echo is normal. This means there is no cardiomyopathy.

Hope I have answered your query.

Wish you good health

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Gopi A (14 hours later)
WWW.WWWW.WW I had been trying to research stress-induced cardiomyopathy on the above site, amongst others. Difficult to take in if you are not a Doctor, however I took it to mean that your abnormalities would clear within days as they were caused by stress enzymes and not any long term damage. I didn't have my echo until 6 weeks after the event (I wasn't sure whether you appreciated this in your last response). -----Could it be possible that as a result of the delay the symptoms had cleared? The image was the brightest the operator had ever seen but pressures etc were within tolerance. She said that she didn't have a previous result to compare it with and so she couldn't tell whether it was enlarged or not as it was within tolerance now. If it is possible, then I will get my doctor to do blood tests during my next attack.
Until then they were concentrating on a possible blood clot.
I also omitted, and have just realised, that they believed my initial attack was Pericarditis as I was very ill for many months. Although the results were inconclusive, it was not ruled out.
The reason that I believe that something must be physically wrong is that I have had stress prior to my illness last year and had no more than a headache with it. Since my illness last year, I now get severe stabbing chest pains, dizziness, a feeling that I will collapse, occasional loss of balance and tiredness during attacks. A stressful situation triggers it, but I am a happy, fun person. I am not a worrier by any means. Even now, I would like to get to the bottom of this as I am fed up of being ill, but I don't overly worry about it. At work, I am laughing and smiling all the while.
My recent attack, I had had some stress for a few days which triggered the attack. However, I kept having attacks for several days after even though the upset had been totally resolved and I was going around laughing and joking with my work colleagues. I had one attack while I was chatting and laughing with my boss. It just came without warning. He thought that I was having a heart attack, the pains were that immense.
Sorry, to keep asking but I really need to understand what's happening, why it's happening now when I have always been alright before and how I can stop it.
doctor
Answered by Dr. Gopi A (7 hours later)
Hi ,

Thanks for writing back.

I can assure you you did not have Stress induced cardiomyopathy because it is not something which would go unnoticed. I will not be able to throw more light towards your diagnosis with out actually having a physical consultation.

Also if it was pericarditis with the severity in the pain you experiencing , you would be more sick and present with signs of inflammation like high fever , continuous chest pain etc.

Heart induced pains will progress in severity and intensity every episode .Its very atypical for one to get heart induced chest pains so frequent and of moderate severity without affecting other activities.There will be impairment in the heart rate , BP and also in respiration if it was due to any pathology in the heart.

I would suggest you to get the tredmill test and Echo repeated in another Cardio center and compare the results. Do take your old reports for the test.

Wish you good health.

Take care.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Gopi A (27 hours later)
Thank you so much for the above information relating to my current illness. I think you have answered, pretty much, as much as you probably can.
You mentioned heart rate, BP and respiration. I can confirm my heart rate was increased to 114bpm and even after rest and an ecg it was still high at 98bpm. Normally this would be around 70. My systolic BP was ok, at 123, but my Diastolic BP had fallen to 65. Not a major drop but normally my BP is around 75. My respiration during and after an attack is impaired. I am in the Army and can normally run 1.5miles in 13mins56secs. When I try to breathe after an attack it feels like I am struggling and very unfit. When I try to walk I am breathing heavily. By a week or so after the attack it seems to have improved a fair amount.
I am not sure whether this helps you any further, but I thought that it was worth mentioning as you have been so helpful so far.
doctor
Answered by Dr. Gopi A (31 hours later)
Hello again,

The additional information reinforces that during your episodes all parameters are within normal limits and that your problem is not organic in nature.

I suggest you to be reassured again.

Regards,
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Gopi A

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Breast Pain, Dizziness, Induced By Stress, Echocardiogram At 6 Weeks Ok

Hi,
Thanks for the query.

The dizziness and pain in chest you experience looks more like an anxiety attack.

The pain you are experiencing is definitely noncardiac. Probably a lot of anxiety overlay is there.

The physiological symptoms also include palpitations of the heart, ranging from severe to moderate. Shortness of breath ,chest pain , feeling of dizziness and trembling of the body. In some cases, these symptoms are also accompanied by nausea and a tingling sensation through the body.

There are women that suffer from ‘derealization’. This is when the women feel no attachment to the world and may be totally detached.
Some woman also suffer from abdominal distress when they have anxiety attacks.

Some doctors recommend breathing into a paper bag as an effective short-term treatment of an acute panic attack.

Meditation needs tο bе mastered іf іt’s tο bе effective. Thе objective іѕ tο gеt rid οf уουr fears аnd anxieties bу using special techniques tο саlm yourself down, relieve stress аnd relax tight muscles, etc., ѕο thаt уου саn turn negative feelings іntο positive ones.

I would recomend you see a good physician/psychiatrist who will prescribe you medication and cognitive behavioural therapy.

Hope i have answered your query.I will be available for follow up.