Ongoing centre chest pains, breathleness, upper back pain, been to A&E 3 times in 1 month

[Bighugs88]

Hi 👋
I have spoken to my gp for medical advice. I am just hoping for reassurance, support and if anyone else has or is going through the same thing. I will try to keep this short but a lot has been going on.

Background: 33 yrs female, no high bp, normal cholesterol levels, never smoked, never taken recreational drugs, bmi of 20, active and work part-time as a Midday Assistant. No previous or known heart conditions. Both parents are in their 60s and high high bp, high cholesterol and are on medication (blood thinners). My mum recently has been suffering from breathlessness and chest pain so is under going tests through the NHS relating to Angina.

So from Feb to April I had random pain in my upper left arm which went after a week, then randomly I had a sharp pain right in the centre where my heart is and this pain travelled across my right chest to my shoulder. I couldn't move and had to sit down then after 4 mins the pain went and I was completely fine. This then happened again numerous times after 3 weeks gap. I only started to take this as a serious health concern when on 30/5/2022 in the evening the pain happened again, terrified in quickly went to local A&E they did an ecg which was normal and then said I could go home and a doctor will call u tomorrow. I didn't ask for further testing as I felt fine, but on the same day at night when I was sleeping 10:45pm I wanted to turn and then then pain started again but this time my right shoulder up to my elbow was hurting. Went back to A&E in the car as the ambulance didn't come. They kept me in and did ecg, chest x ray & blood test for inflammation, viruses & tropnin, the results all came back fine. The doctor was surprised I was having these pains since Feb, said it might be costochondritis eventhough my ribs and sternum were not tender or sore. Since 31/5/2022 I have been having continuous dull ache in the centre of my chest (feels like my heart is injured or bruised 😞) I get random sharp chest pains for a few seconds on my left and right side. Having fluttering of the heart which feels like in my throat, breathlessness & upper back pain. When breathing in or laughing my chest hurts at the centre. I was back in A&E 2 days ago and again chest x ray is clear (no inflammation & no swelling of heart), blood tests normal, ecg fine. The doctor tested for blood clotting, haemoglobin & d dimer for clotting all the results are fine so ruled out anaemia & doesn't think clot in lungs.

My anxiety levels have been really high, thinking the worse that I am having an impending heart attack, swelling of heart, blood clot in lungs . I have a 5 years old daughter who has autism and she is my world. Due to hig levels of anxiety I have loss my appetite and have now a sensation that there is a lump in my food pipe and finding it hard to swallow.

My gp finally has referred me to a cardiologist as the rapid access chest clinic do not take female patients under 40 yrs if there is any abnormal result (high bp, abnormal test results from A&E). She has referred me for 24 has ecg and also an ultrasound scan of my abdomen to rule out problems with gall bladder. This might take weeks, but the doctor said if I feel very unwell or unable to keep down liquids then I need to go back to A&E.
I am just so worried that I am going to drop dead, that there is something seriously wrong with my heart. Even typing this now I am getting weird palpitations. Seriously I am not disregarding pain, but if the pain was somewhere else I wouldn't be so worried but as it is my chest area right in the centre I am thinking the worst is going to happen even though 2 different doctors at A&E have reassured me there is no instant danger. Please anyone there for support

It could just be that your mattress needs replacing and you need to do some strength and mobility exercises.

I assume you've been told whether you have an elevated ESR and CRP? They show whether there's inflammation in the body (ie, possible autoimmune arthritis). And can definitely make people feel anxious or low outside of any MH condition.

If you've got weak core muscles, this can also throw your posture out so that you're putting strain on your thoracic spine, causing pain in your back, ribs and chest.

Watching this thread with interest as I have these extact same symptoms - pain in left shoulder, pain in the right shoulder which travels down my right arm intermittently, plus I can't lie on my right side in bed as it feels as though there is a large tender lump inside my rib cage behind my right breast which is being squashed when I roll over to that side.

I am also exhausted and spent most of yesterday asleep on the sofa - most unlike me.

I am 45, not overweight and am very active. Just wondering if I can be arsed doing battle with the NHS and reading the OP is making me think it's not worth it.

Good luck OP and let us know what it turns out to be.

@NeverDropYourMooncup
I swapped the mattress as the one previously was very soft. Lying flat on my back rather on the sides eases the stiffness and pain. To be honest with you anxitey and pain most probably has caused my muscles to become quite rigid and stiff. I don't always have the best posture with my upper back tend to sit with my back bent rather than straight. I have started to do simple back exercises looking at YouTube.

@ToastofLandon
As problems initially started of as heart related I have hopefully been referred to cardiologist via gp for further testing. The chest x ray and ecg were all normal on both occasions at A&E. Once I have had the ultrasound scan then I will request for CT or MRI with gp especially if pain is continuing

@NeverDropYourMooncup
Also yes my inflammatory markers were low on both blood tests at A&E

I have taken lansoprazole in the morning before breakfast. I have had breakfast and a banana. I am feeling quite nauseous, for some reason my heart feels like it's fluttering a lot this morning. I think it's the sensation of feeling nauseous which is probably heightening my awareness to my heart beat (mostly being anxious).
Will try and go out for fresh air and take my daughter to the park to keep myself distracted. It's like I have become so aware of every pain, movement & heart beat waiting for the pain or palpitations to occur

It is impossible and unprofessional to attempt to diagnose anyone over the internet and I would always advise anyone with chest pain to get assessed urgently and am pleased you have been.

What I will say - carefully - is that from the tests you listed and the way you have described your symptoms, it doesn't seem like typical cardiac pain. Obviously, if you have any further episodes of very severe chest pain, do please seek urgent help from 111 or return to A&E to be assessed by a medical professional.

That said, I agree with the posters suggesting that you are assessed for gastric disorders including reflux and gallstones. The lansoprazole should help reflux and I would speak to a pharmacist about perhaps taking gaviscon when you have acute symptoms. You need to leave an hour before taking your lansporazole and do check with your pharmacist about any other meds.

Something else you might want to consider is whether you could modify your diet to see if it improves your symptoms. Have a look at GERD on reputable sites for more info. Here is the NHS page. www.nhs.uk/conditions/heartburn-and-acid-reflux/

@MissWired
Thanks for your message, what has the doctors said about your symptoms? Have you had any tests done?
For me it's taken so long to even get referred as 2 gp's refused to refer me in the first place. Then the rapid access chest clinic refuses my referral and the gp surgery didn't contact me I only found out by calling the rapid access clinic myself. Only on 24th June I have been referred to a cardiologist and for ultrasound scan and 24 hr ecg. It just seemed to me as my initial results from A&E are fine, not in terrible pain in terms of collapsing, being young and healthy (bp, cholesterol, weight) the doctors don't really seem to bother.
But believe me my energy levels are so down just want to lie in bed, plus my daughter who is 5 has autism so she is full of energy all the time. However, keeping myself busy does allow me to spend my day efficiently otherwise I would be constantly worrying about my heart, lungs thinking of the worse. Do let me know how things are going with u x

@Cuck00soup

I completely agree with terms of medical advice. The first time I went to A&E and they said your heart is fine. I was still told my the doctor that if the chest pain comes again with different symptoms or is different to what you are experiencing now then do come back for urgent assessment. So when I stated getting palpitations, feeling dizzy, sharp centre chest pains and feeling tight in the chest I went back to A&E on 8th June and most recently on 22nd June.
I am aware if the pain changes to sudden chest pain which is not going away I will definitely go back to A&E rather than staying at home, the hospital is very close by to where I live. Also the lansoprazole tablet I do take 60 mins before breakfast. So far I do feel sometimes nauseous and full but have not been vomiting since 3 days. As the vomiting was making my heart rate really fast and the palpitations worse.
Let's see what the cardiologist say and the ultrasound scan of the abdomen

It's just that I still think something is going on with my heart eventhougj I have been to A&E twice. I think once I have seen the cardiologist and had further tests done hopefully this will put my mind at ease. I think anxiety is playing a major part here. 😕

Of course! You are bound to worry. I think the thing to hold on to is that they have tested you twice now for coronary artery disease and not found anything.

Whilst that's obviously good news it doesn't mean that there isn't another cause for your symptoms. I hope you get to the bottom of it soon.

Thank you for all your support guys, will keep u updated. I have an appointment on 21st July for blood cholesterol check at gp.
When the appointments come through for the tests I will let u guys know. Look after yourself and big hugs x

I have an ongoing back problem and paracetamol wasn't really helping so I started taking ibuprofen as well. It reacted somehow with the HRT I'm on and left me with pains as you describe. I called 111, I genuinely believed I was having a heart attack. They triaged me and suggested Gaviscon on the basis we would very quickly know whether it was helping or not. I stopped the ibuprofen immediately and started on Gaviscon. It took a while for the ibuprofen to get out of my system but it was definitely heartburn brought on by the medication. It's definitely worth a try.

@TheFeistyFeminist
I am no longer taking nurofen as it can irritate the stomach lining I am just taking paracetamol when needed. I do have gavison liquid at home. The A&E doctors didn't give strong painkillers for me to take at home such as codeine as I am already getting dizzy spells so suggested to take other painkillers which I am fine with don't want to start feeling really faint with strong medication.
I have been given lansoprazole 1 tablet before 60 mins breakfast time.
I already have reflux and gastritis which can flair up when I am very anxious.

Hi everyone
The nausea has come down a lot, feeling better was able to have my meals today and the chest pain has to a certain degree calmed down a bit. Still get the centre chest pain now and then but not like how it was previously. For me I notice Gavison liquid really helps and putting the pillow up when sleeping helps as well.

However, what hasn't really gone away is the palpitations, I am trying to ignore them because the more I think about them they happen more frequently.
They have been constant though, my anixtey levels are much lower hence I have my appetite back. However, after every 1 or 2 hours during the day I get a fluttering sensation in my centre chest and I can feel this in my lower throat it's frightening and annoying like my heart is all over the place. Yesterday I felt a fluttering palpitation near my left lower rib beneath my breast.

I have already mentioned this to the gp last week, she has referred me for 24 hr ecg. I have never had palpitations in the past when I have been really anxious.
Hopefully, when I see the cardiologist they can rule out any problems with tests.
Just wish they would stop as they are really scary. They have been happening since 2 weeks now, I was in A&E (mentioned before on 22/6/2022) the blood tests where normal.
I have cut out caffeine and high carbon foods, making no difference. Just have to wait for the 24 hr ecg monitor.

A&e doctor said you are not anaemic and blood tests are fine.
She said don't worry.
But they feel absolutely awful and make you think your heart is going to stop. At night I have 1 or 2 and they seem the worst as it is really quiet

Any suggestions?
I don't know if my thyroid was checked.

OP you really need anxiety medication.

You have had so many checks and none of them have shown anything physically wrong with you.

With anxiety you feel the urge to keep checking to 'make sure' but the checking just reinforces the fear.

You are utterly terrified right now that your heart is about to stop. That is causing physical sensations which makes your brain believe your body is ill.

You need to see your gp and ask for help treating your anxiety. Meds and CBT would really help right now.

@Minimalme
Thank you for replying, j think I really need to relax and stop worrying about palpitations. You are right about "checking to make sure," that has been happening for the past 3 weeks.
Will speak to gp do have an appointment this Friday afternoon so will mention about medication to hep ease anxitey and cbt. Thank u

Can you ask the gp to send a stool sample to test for h pylori which is a bacteria that can sometimes develop into gastritis type pain. Symptoms sound very similar and can be treated with strong antibiotics and lanzoprozole to protect the stomach lining. Hope you get it sorted soon

OP, a good friend of mine had all of the same symptoms as you, went for many of the same tests, was back and forth to A&E - she was incredibly ill and we had all got to the point we thought we may lose her.

However her GP then put her on Sertraline and suddenly everything vanished. Within 3 months she was healthy, fit and well - two years on she now has a baby and has had no health symptoms since.

Maybe consider anxiety medication? It revolutionised her life.

@bookwormbeagle
The gp has asked me to drop off a stool sample to the surgery for testing since Friday, will hopefully pick this up tomorrow

I have something called nutcracker oesophagus, which means that it often goes into spasm and can cause a lot of pain, and often referred pain which is usually my back or top of my shoulder.

The nurse who did a lot of my tests said that anxiety can make it worse.

I went to a and e recently with chest pain - couldn't breathe deeply, incredibly painful and it also turned out to be a digestive issue.

I hope you manage to get some answers soon.

@SellingStevenage
Anxitey can be very exhausting and cause a range of symptoms, have been through this a couple of years. When I have been anxious during this time around concerning my heart and chest pains my husband has seen me going though this and he actually said he was terrified that something would happen to me and has been very worried and will often call me during the night when he is doing a night shift at work.

I will speak to the gp on Friday about medication to help with anxitey I have had serialise in the past.
I am very happy for your friend, bless her & my well wishes.

I mean sertraline