ZocdocAnswersWhy am I having unexplained chest pain?

Question

Why am I having unexplained chest pain?

I've been having anxiety problems stemming around my heart. I have close relatives with heart problems on both sides of my family. I'm 18,I began having sharp chest pain that would come and go, in both the right and left sides, but left more often. I also have achy feelings in both arms, but again left more often than right. They are in both lower and upper arm, sometimes they are sharp instead of achy. My family doctor did an ekg and she said it was how a perfect normal ekg should look. She thinks I may have a gallbladder problem but we haven't tested yet, I'm waiting to schedule an ultrasound. This chest and arm pain are persisting though and I keep worrying I'm having a heart attack. I don't feel particularly anxious until AFTER it starts, what could be going on? I've been close to going to the ER a few times since last seeing my doctor but I hold off telling myself it's just anxiety. Also been having fluttery feeling in chest

Answer

Sorry to hear that you have been struggling with issues relating to anxiety, and chest pains. It sounds like there is a lot going on, and you definitely will need to talk to a physician to help sort through your symptoms (you are correct in first starting with your primary care physician which I think is appropriate in this case). You yourself seem to suggest a couple times in describing your symptoms that anxiety may be playing a role in your problems. This could very well be true. In fact, there are definitely situations in which anxiety can be the root cause of ALL of a patient's symptoms, and can mimic the symptoms of a myocardial infarction (aka 'heart attack'). The problem is that many of the symptoms that you describe are non-specific, meaning that they could be the manifestation of a heart problem, but could be from numerous other things, including anxiety, or reflux. You mention that you have a family history of heart problems, but you are also very young still which typically puts you at a much lower risk of serious heart problems. Part of what your physician will do, is take a more detailed cardiac history which will help better determine cardiac risk factors. For instance, it is important to determine if you had any childhood heart problems, heart surgeries, arrhythmias, etc. Also how old were your family members when they had heart problems? These are all things that a primary care physician can usually work up. It is not unreasonable however to ask your primary care physician to refer you to a cardiologist to be evaluated. Even if they evaluate you and tell you your heart is fine, they can give you lifestyle modifications that will decrease your cardiovascular risk factors over your lifetime. Book an appointment today!

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