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Chest pain and palpitations
I am a 20 year old male, I had on and off palpitations for 1.5 years, around the same time I had a peculiar HTN which was only shown in home at doctors office it was normal, I had 20 ecg( 2 ordered by doctor, 3 in emergency rooms, rest 15 done by me just after having the episodes) all were either normal or sinus tachycardia, two echo Doppler all normal, 24 holter monitor with 5 SVE. My lipid (ldl 95,hdl 48, Tg 78, Tc 157), my cbc was normal, lft was normal my two time trop t test in normal, I went to CMC where 4 medicine doctor, 4 cardiologist, 3 endocrinologist saw me no one found anything wrong but still every day I have chest pain and palpitations randomly I am fear of death 24/7 because I don't know at this point what doctor or medical line to see.. I am 122 kg before I was 129kg, I am on 1.25mg of BISOPROLOL and 2.5mg of Amlodipine , my bp is on avg (106/65).. I don't know what to do I feel weight cause me a heart issue causing death.
Answers (19)
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Forget it.
You have had more than your fair share of Medical Consultations. Nothing abnormal has been found.
In Medical language it is known as Cardiac Neurosis.
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If your weight is 122kg and you are 5ft 7in, then your primary goal is weight reduction.
You should consider seeing bariatric team to consider options including surgical and medication options for weight loss.
Set yourself achievable activity goals- 30min walk 3 times a week would be one such goal.
All the best.
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If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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It is clear that you are going through a very distressing time. After being evaluated by multiple cardiologists and specialists with normal results (ECG, Echo, Holter, and Troponin), we can confidently say that your heart is structurally healthy.
Clinical Analysis:
Non-Cardiac Chest Pain: In many cases, chest pain in healthy hearts is related to costochondritis (inflammation of chest wall cartilage), acid reflux (GERD), or intense anxiety. Anxiety can cause "Air Hunger" and chest tightness that feels very real.
Palpitations & Medication: You are currently on Bisoprolol and Amlodipine, and your BP (106/65) and heart rate appear well-controlled. The "skipped beats" (SVEs) seen on your Holter are common and usually harmless in a structurally normal heart.
The Role of Weight: While 122 kg puts strain on your body, your lipid profile (LDL 95) is actually very good. Your weight is a long-term health factor, but it is not causing an immediate "heart issue" based on your clear tests.
Recommended Approach:
Mental Health Support: Your "fear of death 24/7" indicates severe Health Anxiety (Hypochondriasis). When the mind is in a constant state of "fight or flight," it produces physical symptoms like palpitations and chest pain. Consult a Psychiatrist or Clinical Psychologist for Cognitive Behavioral Therapy (CBT).
Gradual Activity: Since your cardiac tests are clear, start with very gentle movement, like 15 minutes of slow walking. This will help prove to your mind that your heart can handle activity.
Nutrition: Continue your weight loss journey (you've already lost 7\text{ kg}, which is excellent) with a focus on high-protein, low-sodium meals to support your BP medication.
Summary:
Your heart has been tested more than most people's in a lifetime, and it has passed every test. Your path to feeling better now involves treating the anxiety and continuing your gradual weight loss. You are medically stable.
Disclaimer: This is a clinical opinion based on the extensive test results provided. If you experience sudden, crushing chest pain radiating to the jaw or arm, seek emergency care, but otherwise, focus on the anxiety management plan.
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Kindly consult with me on 94 two six eight six 78 nine six. A little counselling will help you.
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U should take help of psychaitrist,,and continue cardiac medication as prescribed.
Next Steps
6000/steps per day help you to control weight as well as good for heart.
Health Tips
avoid heavy junk ,dairy products,sweets etc
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Thank you for posting your query here
First of all take a professional help to reduce weight
Secondly do consult a MD Psychiatrist for your anxiety issue
You will be fine
You also need a sleep study
Next Steps
Do consult a MD psychiatrist for anxiety
Respiratory med specialist for sleep study
Add weight training and Yoga in your daily routine
Health Tips
Do not change or add anything in your medication without consulting your cardiologist / physician
They know your issues as treating consultant
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Your average b.p. is o.k., rather lower side of normal. You can take propranolol 10mg and stop amlodipine. That will help you in controlling anxiety as well.
Get thyroid function tests done and share results. Get blood pressure checked after 1 week and share results.
Also try to relax by regular meditation, pranayam.
Follow a healthy life style.
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Hello , Kindly consider having a Tele-Consultation with me on PRACTO App since adequate patient history is required for proper treatment and further follow up . Thank You
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I can understand how exhausting and frightening this must have been for you, especially after undergoing so many tests.
The reassuring part is that multiple ECGs, 2 echocardiograms, Holter monitoring, troponin tests, and reviews by cardiologists / endocrinologists have all been normal. This makes a serious structural heart problem very unlikely.
What you are describing now — daily palpitations, chest discomfort, constant fear of dying, repeated checking, and difficulty feeling reassured despite normal reports — can often be seen in health anxiety / panic-spectrum symptoms. Sometimes once the mind starts associating bodily sensations with danger, even normal heartbeat changes can feel very alarming.
Weight can contribute to sinus tachycardia and BP fluctuations, but it does not appear that you are having an active heart disease based on the extensive workup done.
At this point, it would be useful to address the anxiety and fear cycle itself, as this can significantly reduce the palpitations and chest pain.
This is very treatable with therapy (especially CBT for panic / health anxiety) and medications. You may consult me for a detailed online evaluation and online therapy support directly on nine eight two six five four five six six zero
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This is anxiety u r going to stage of anxiety disorder in order to com out of this feeling do consult psychiatrist near by take course for panic attacks u will surely get normal by 3-4 weeks
Take food and water on time go for sleep without worrying u don’t have any life dangerous conditions all r normal don’t check on vitals repeatedly
After this go for mild gym activities and walk do yoga for best results
Next Steps
U can call me in practo anytime
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Hi, firstly you have already extensively evaluated life threatening conditions that could cause this and ruled them out. So please dont worry. The Holter would have picked up any life threatening arrhythmias if they occurred but none was there. That should be reassuring.
Secondly try a holistic approach to lose weight. Exercise improves mood and General stamina. Yes being overweight has cardiac risks but currently your lipids are normal, hence you have time to get into a healthier lifestyle.
Thirdly share your feelings with those close to you. You might feel annoyed when doctors ask you to consult a psychiatrist. But remember the mind is also an important organ just as the heart or the kidneys and needs special care. Counseling will help before medicines. You are not making up any of this. Its real and needs attention. So please try this
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Please consult with psychiatrist physically.
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Your 20 ECGs, 2 Echoes and blood tests prove that your heart is NOT failing or about to stop.When you have fear of death, your body releases adrenaline. This hormone makes your heart pound and your chest muscles tighten. Sometimes low Vitamin B12 or Vitamin D very common in India can cause fatigue and weird chest sensations.
Next Steps
Since the Cardiologists have cleared you, you don't need doctor. You need to focus on calming yourself . See a Psychiatrist
Health Tips
Avoid strong coffee, chai, and energy drinks, as they directly trigger palpitations
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Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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Anxiety
Panic attacks
Consult superspecialist like psychiatrist.
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
It is because of anxiety
Do regular walk and exercises
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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