Question 1

I've been having chest pains and I'm super worried it might be related to my heart even though all my tests like ECG, echo, TMT, and chest X-ray came back normal. The fear started after the pandemic and now I'm constantly thinking about "what if" something's wrong. I've had heart palpitations about 10-15 times and even small muscle pains make me anxious about having a heart attack. What can I do about this constant fear? Do you think there's a chance I might really have heart issues? My last echo and TMT were 10 months ago and the most recent ECG was 20 days ago, all normal. Would love any advice or insight.

Accepted Answer

It sounds like you are experiencing a lot of anxiety and fear related to your heart health, especially since the COVID-19 pandemic. Despite multiple tests showing normal results, you are still worried about having a heart attack. It is important to address your anxiety and stress levels in order to overcome these persistent fears. One approach to consider is seeking therapy or counseling to help manage your anxiety and fears related to your heart health. Additionally, practicing relaxation techniques such as deep breathing, meditation, or yoga may also be beneficial in reducing stress and anxiety. In terms of medication, you can consider taking an anxiolytic medication such as lorazepam (Ativan) as needed for acute episodes of anxiety or panic attacks. The usual dosage is 0.5-2 mg taken orally 2-3 times a day as needed. It is also important to maintain a healthy lifestyle by eating a balanced diet, engaging in regular physical activity, and getting an adequate amount of sleep. These lifestyle changes can contribute to overall well-being and may help alleviate some of your anxiety symptoms. Remember, it is essential to address your mental health concerns in addition to your physical health. If you continue to experience persistent anxiety and fear despite normal test results, consider consulting with a mental health professional for further evaluation and support.

Question 2

I'm noticing my heartbeat feels really strong and visible in my stomach and chest all the time. Sometimes when I'm just sitting, it actually makes my body move with each beat. Is that something normal? My heart rate usually sits between 70 to 80 beats per minute, and my blood pressure is around 12090. Does that sound okay?

Accepted Answer

Having a visible heartbeat in your stomach and chest, along with feeling strong pulsations, can be concerning. This may be due to a condition called aortic aneurysm or other cardiovascular issues. Your blood pressure of 12090 is slightly elevated and should be monitored. It's important to consult a cardiologist for further evaluation and management.

Question 3

I'm trying to understand the difference between the results of my echo and my CT scan regarding my heart condition. My echo shows mild concentric LVH with lvpwdd 12.2 and ivs d 12, and my LVEF is at 73. But my CT scan, which was a 128-slice MDCT of the heart, suggests normal LVH and a normal LV cavity with normal thickness, having a zero calcium score. Also, my TMT came out negative for any chest pain-related issues. I'm kind of confused here. Which result should I rely on when it comes to the left ventricular hypertrophy? Which is considered more accurate or should I be concerned about something else here?

Accepted Answer

Both CT angiography and echocardiogram are valuable tools for assessing left ventricular hypertrophy (LVH), but they provide different types of information. In your case, since the CT angiography showed normal left ventricular cavity with normal thickness and normal coronary arteries, and zero calcium score, it indicates a healthy heart without any structural abnormalities or blockages. On the other hand, the echocardiogram reported mild concentric LVH with specific measurements of left ventricular posterior wall thickness (LVPWd) and interventricular septum thickness (IVSd). Given the discrepancy between the two imaging modalities, it is important to consider the clinical context and overall picture. In this scenario, the findings from the CT angiography showing a normal heart structure and function, along with a negative TMT (treadmill test), are more indicative of a healthy heart. Therefore, the CT angiography results are more reliable in this case. To address the chest pain related problem, you can consider taking medications like Amlodipine (5mg) for blood pressure control and Metoprolol (25mg) for heart rate control. Additionally, Nitroglycerin sublingual tablets can be used for chest pain relief as needed. It is also important to follow up with your healthcare provider for further evaluation and management.

I'm really worried about this heart murmur that was detected during my TB treatment. I completed 9 months of medication, and an echo test came back normal. But the heart murmur is still being detected. Could the TB meds be causing this? It all started when I began taking them. What should I do?

Cardiologist opinion is advised to the patient.

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