Hello
Thank you for your query at DoctorSpring.com.
I understand your concern.
You are suffering from atypical chest pain and palpitations. Also you feel you are pale and cyanosed. Although you are extremely low risk to have a coronary artery disease on account of your age and history you still could get a 2D ECHO and stress test done to rule out any cardiac cause of the pain.
For palpitations I would suggest you get a 24 hour Holter done to rule out any serious arrhythmia. If you could get an EKG during the palpitations that would be as good as a Holter examination.
As far as pallor and cyanosis is concerned if your examining physician too feels that you have pallor then you could get a simple test like Hemoglobin level done. Measuring blood Oxygen saturation with a pulse oximeter would be a simple test to rule out cyanosis. I am not aware of the health care system of your country and if you can demand these tests. However, they are advisable to allay your fears and rule out a cardiac cause of these symptoms. It may be anxiety after all.
Feel free to discuss further.
Regards,
Dr Vivek Mahajan,
MD Medicine, DM Cardiology.
Patient replied :
Thank you for your reply, Doctor.
I will ask my GP about gettin a holter fitted and having an echo done. Although I did have a 2D echo and treadmill test 6 months ago for the same problem, both were satisfactory at the time. Should the tests be repeated?
I do get a little anxious when the pain presents so perhaps some of my symptoms are anxiety related as you said.
I was just wondering if you think the problem may be something neurological due to the pain and tingling in my arms?
I have also noticed that I become short of breath when lying on my left side. My chest feels quite tight then. Would there be an obvious cause for this?
Thank you
?
Hello. Thank you for writing to us again.
Since you had an echo and tmt in the last 6 months you need not do it again. If these were within normal limits you probably do not have a cardiac etiology for your symptoms. Of course the holter will give some information whether the palpitations are due to amy arrhythmia. It could be a neurological disease if tingling and pain in limbs occur. However other symptoms cannot be explained. The chest tightness also doesnt seem cardiac. You may see a neurologist to allay your concerns. But the chest tightness and breathlessness cannot be explained by neurological etiology.
Feel free to discuss further,
Regards
Dr Vivek Mahajan