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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Panic Attacks And Pain In The Left Arm?

I have chronic panic anxiety. Severe panic attack (I believe) last weekend. For the past week have had intermittent pain in shoulder blades and left arm. Funny feeling in chest-like pressure but not exactly. EKG at doctors office showed left axis deviation, normal sinus rhythm. No high blood pressure. PCP said he was not concerned. Of course I am. What does this mean? Should I see a cardiologist?
Fri, 16 Sep 2016
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General & Family Physician 's  Response
Hello,
Thank you for asking at HCM.

I carefully read you question and understand your concern.
I would say that anxiety might cause chest pain and chest pain might cause anxiety. It is not strange if they contribute to one another.
In the ECG you had a left axis deviation and I am suggesting doctors did not see a direct sign of heart being the cause of the chest pain but on the other side ECG is not the only test that can be done. What I would suggest is:
1. Have a stress test- this is a test that checks your heart while you exercise and if this is normal than it is less likely that your chest pain is due to heart.
2. A heart ultrasound would be good as you have a left axis deviation it would be good to make sure how are the rooms of the left side of the heart.
3. If you have the acute pain you might do the blood test of the heart enzymes like troponine and if this is normal it gives a higher assurance that no damage of the heart muscle is happening.
4. If all those tests come out normal, than other causes of chest pain should be considered from the most simple one like muscular pain to lungs or stomach acid reflux being the cause.
5. I am not surprised that after all the other causes are ruled out, anxiety might be considered as the cause of the chest pain and than to speak with the right doctor on that is important.
So I would recommend you to see your cardiologist and consider all those examinations to make sure the heart is doing well and than if all is well than other diagnosis should be considered.

Hope this is helpful and answers to your questions

Best regards
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What Causes Severe Panic Attacks And Pain In The Left Arm?

Hello, Thank you for asking at HCM. I carefully read you question and understand your concern. I would say that anxiety might cause chest pain and chest pain might cause anxiety. It is not strange if they contribute to one another. In the ECG you had a left axis deviation and I am suggesting doctors did not see a direct sign of heart being the cause of the chest pain but on the other side ECG is not the only test that can be done. What I would suggest is: 1. Have a stress test- this is a test that checks your heart while you exercise and if this is normal than it is less likely that your chest pain is due to heart. 2. A heart ultrasound would be good as you have a left axis deviation it would be good to make sure how are the rooms of the left side of the heart. 3. If you have the acute pain you might do the blood test of the heart enzymes like troponine and if this is normal it gives a higher assurance that no damage of the heart muscle is happening. 4. If all those tests come out normal, than other causes of chest pain should be considered from the most simple one like muscular pain to lungs or stomach acid reflux being the cause. 5. I am not surprised that after all the other causes are ruled out, anxiety might be considered as the cause of the chest pain and than to speak with the right doctor on that is important. So I would recommend you to see your cardiologist and consider all those examinations to make sure the heart is doing well and than if all is well than other diagnosis should be considered. Hope this is helpful and answers to your questions Best regards