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

Spoke to gp she said need to wait for abdominal ultrasound scan this Saturday. The 24hr ecg results will take a week or 2 to come. I have booked a private echocardiogram for tomorrow at harley street. Called ambulatory care to get back vitamin b12, d and ferrtin result. Was told if results are out of range doctor will call u. If they are within normal range u will not receive phonecall, receptionist not allowed to give results on the phone or call the doctor. Have been prescribed citroplam (20mg) & proponlol by gp for 1 month as symptoms are being excavated by anxitey. She said physical symptoms are being investigated in the meantime. She said muscle twitching is sign of anxiety. Hardly ate much for now. My mum is coming over to stay with me tonight as husband has a night shift.i told gptgat I have suffered with health anxitey before (on the system) and been very stressed but I never have continuous vomiting, palpitations and chest pain or muscle twitching which has stated recently. Having said that I am super aware of any sensations in my body.

If it's a central nervous system issue how will this be checked. Gp will need to refer? At the moment she is not doing any referrals for me until she gets results. Trying to ignore and not look at the muscles twitching.

Hope all goes well today.

I had a diagnosis of myocarditis after MRNA (also know it can follow Covid). Main symptoms were strong heartburn-like pains which resolved in a few days and then palpitations with occasional chest pain. It was diagnosed after a few days in hospital, but after a few weeks the bloodwork and ECG were normal. MRI was crucial for diagnosis and it has required ongoing treatment.

I had my private echocardiogram today, the sonographer was very polite and the procedure took about 25 minutes. He told me during and after the procedure that my heart is fine and I have received the report today via email and it was fine. Size of all chmabers are normal, the cables look healthy. The aorta and inferior vena caba are normal.and there is no swelling or presence fluid in the pericardium.

So he said the palpitations in your case are not caused by structural defects as your heart structure looks normal. I have requested from the gp my 24 hr ecg report which has arrived at the gp surgery. I do have an appointment booked on 1st September to discuss vitamin d results, PTH results (not sure what the levels are as not showing on nhs app) & ecg report. Having said that the organisation who analysed my ecg said if there was a dangerous rhythm then we would call you directly and your surgery. So let's see what gp says. Having said that my palpitations are not a fast heart rate there more like forceful beats out of sync like extra and skipped beats with thuds and fluttering most common at rest or relaxing.
Just more reassured that my heart structure is fine as my nhs appointment for cardiology was late September, so the echo was reassuring.

I mean the valves are healthy not cables lol

The surgery will get back to me by 25th August regarding a copy request for 24hr ecg for my reference

Great to hear that, Bighugs88! :) Hope you feel better soon and get some CBT maybe for the health anxiety.

@Granforjam
Thank you 😊 I have already had an initial assessment with talking therapies, I have their number will contact them to start my sessions.

Glad to hear you're being taken seriously OP. A bit of a long shot, but do you think it's something you eat that's leading to this? I often get palpitations if I eat a large amount of carbs in one go

My PTH levels have come back normal, my reading was 3.9 and the ref range was 1.6-6.9 and.

@BorisJohnsonsHair
Thanks for your message, I am awaiting to see the doctor on 1st September to discuss ecg report as the reception said you need to speak to go first at appointment and then we can give u a copy of your report.
I had 2 palpitations today:
Around 4.30pm when I was relaxing in bed
And one just now at 10pm came out of the bathroom. Both occasions I was relaxed and my heart was fluttering in my chest up to my throat. I know I have had the echocardiogram done privately and my heart structure is fine but these palpitations are so worrying, I have been very relaxes following my echo but the palpitations are still there.

You asked me about food and any pattern, I have cut out all caffeine and they still occur. Having said that before my health troubles started I use to eat whatever I fancied and never had palpitations.

I did have 2 episodes of the fluttering in my heart when I had the monitor on, so hoping the report will specify what type of rhytm I am having and me being tired and dizzy is linked with this.

I have notice that I am getting a spam in my lower neck laryngospasm but I think these are my palpitations arising right from the centre of my chest up to my throat.
But I have noticed my lower throat does feel funny and quite tense.

I pray 🙏 that palpitations would stop they are nasty

Just out of curiosity has anyone else experienced a weird feeling or sensation in their lower throat when they are having palpitations. Like I said mine are still there everyday but when I have them for a few seconds my heart rate is not fast but the way the heart is beating is out of sync like a flutter like it's not contracting properly🤔

I have palpitations a lot @B@Bighugs88 and I’ve also had a number of heart investigations due to a separate medical issue, and honestly the palpitations are due to anxiety. Just because you don’t feel anxious in that exact moment, doesn’t mean your body isn’t still on high alert and dealing with the huge amounts of adrenaline and cortisol it’s being flooded with every time you feel anxious. Things like lump in throat, strange aches and pains etc are also very common symptoms of anxiety. You’d be amazed at the physical ailments it can cause.

Please try not to dwell on the physical aspects and concentrate on your mental health. I had health anxiety for years and the best thing I ever did was take SSRIs, just a very low dose, I would go so far as to say that my health anxiety is 90% gone as a result. Talking therapy will help a bit but sometimes the anxiety is due to an imbalance that only SSRIs can fix. I put it off for years thinking I could cope alone, now I wonder why I put myself through that for so long when SSRIs have pretty much cured me!

best of luck x

Hi everyone,

I have a copy of my 24hr ecg report and had an appointment with the gp today. I wore the monitor on 15th July for 24hrs. Gp saI'd report states normal rhythm and HR variability is within normal limits. The times I experienced chest pain and dizziness (made a note in diary sheet) the heart rhythm was normal. Report states max HR was 124bpm (walking around) and mini HR was 58bpm. There were no episodes of bradycardia, no AF, No VT, no SVT, but there were 3 episodes of SVE which in 24 hrs is less than 1%, I felt 2 of these episodes. Gp said these are ectopic beats (skipped and extra beats). She said are normal but need to be investigated so wait for cardiology appointment now they might put u on a 7 day monitor. She said at the present situation no need to take propanolol as your heart rate is fine, the irregular rhytm is not fast but hard hence the thud feeling I feel in my chest and throat. She said all blood tests are fine and she cannot do much now. Said wait until 26th September for appointment with cardiology at hospital where they will do more tests in the mean time if irregular beats are happening a lot every few minutes and chest pain is not going away then go to A&E. I did mention to her that for fhe past 1.5 weeks I been getting the irregular beats every day sitting down, waking up in the morning and doing house chores my heart feels like it stopped and then I get a prominent out of sync beat which is a hard thud like my heart is contracting under pressure to push blood and I can feel this rhytm in my throat. I did have episodes of dizziness today and felt quite weak and been having chest and upper back pain. However, she checked my bp which is fine and said heart related chest pain would stay continuously and be very painful like crushing. Mine is sharp short stabs of pain and stiffness. I told gp about private echocardiogram scan of heart and she said to send the surgery a copy as well. She said she does feel for me that the irregular beats are scary as it's the heart but after doing all the investigations if everything is normal with the heart then there can be no explanation and people at any age can get irregular beats but they need to be monitored and anxiety can make it worse. I asked her will they ever stop as I get really scared with them she said there is no definite answer, may just have to cope with them and ignore them once all tests come back clear and just keep an eye on the frequency.

That's good news. Perhaps knowing that there's no concerning results after all those tests will help you accept that, whilst they are different, you don't need to panic?

I've had them a couple of times after nasty chest infections, including Covid - they lessened in frequency and then just stopped. The most uncomfortable ones were when I had a sore back from the infection as well, but as I knew it's something my body does, I'm not anxious, I think 'Oh, that one was strong'.

@NeverDropYourMooncup
Thank you for your message, I will try to look at ways to reduce my anxiety trigger which was and still is health anxiety (cardiophobia), will contact talking therapies again as after initial assessment still waiting for sessions to begin. Hope you are well and I hope for me these weird beats do lessen.

Morning everyone,

I had the most terrifying pain experience yesterday evening and ended up calling 111. I am getting dizzy spells throughout the day. Did check blood pressure which was around 101/69 which is normal. The dizzy spells last for a couple of seconds when walking about like I am swaying on a boat it's not a spinning sensation.
I was standing talking to my husband and I just turned my body to the right as I moved slightly I had a very sharp pain at the centre of my chest I screamed between my breasts and my husband witnessed this but after a few seconds it went. I pressed around my sternum but it wasn't hurting. I went to the kitchen to drink something I opened the fridge door and then I had the sharp pain again exactly the same location within 5 mins, the pain takes my breath away but what is this pain? It comes on suddenly and is very sharp pain like a stabbing pain where my heart is. I have already mentioned that I am suffering from irregular hearbeat which for now have been ectopic beats I am getting them daily. I did call 111 straight away and they said to call gp tomorrow morning. However, the last appointment I had with hp said she is unable to do anything more relating to this condition as it could be cardiac related so wait for appointments with cardiologist via nhs. Before this terrifying episode I did call the cardiology department and informed them about the daily extra/,skipped beats that are happening continuously she said we don't have emergency appointments available and if you are having problems in between your tests then we advise to go to A&E we cannot give u earlier appointments.i was able to sleep last night but now am terrified about this pain should I go to A&E, I have calmdd down a lot in the last 1 week since I have been told about ectopic beats, but I am having random sharp pain episodes abd couple of days back 7 days ago I only had a ache in my left upper arm to my elbow which hurt when pressed but it went away after 2 days.
The gp did twice press on my joints around my sternum but it didn't hurt. I am really worried about the sharp pains the last occurrence happened 1 week ago at my mums house applying ibuprofen gel makes no difference. Should I go back to A&E? I know gp will say the same thing.

Overall what I noticed is that:
I never had the upper left arm pain and sharp chest pain together. For the past 3.5 months I have had 3 episodes of my left upper arm aching (dull pain when pressed) up to elbow which comes on suddenly and lasts for a few days still able to do all activities then went the arm pain goes away after a couple of days start getting sharp centre chest pain for a few seconds when I am standing, bending to pick something up it is very sharp.
When I call triple 111 they ask if pain radiates to my arms, at that point of time it doesn't but I have had left arm pain on 3 occasions now exactly the same location abd type of pain which after 2 days it disappears and then I get sharp centre chest pains.
Only thing recently is that I have been diagnosed with ectopic heartbeats which have increased in frequency in the last 1.5 weeks with near constant dizzy spells when walking and standing . Did have a private echocardiogram which was normal in late August which just stated trivial MR (normal finding) but vavles are thin and healthy and EF is 60%.

Have you had a ct scan? I had very similar symptoms and was dismissed for ages until presenting at a and e with severe chest pain. (Not heart related) - i was originally seen and discharged but went back on GP advice and they finally did a scan. I have an arterial aneurysm. Related to a rare autoimmune disease.

I dont want to be mean but I really think this is all likely to be a GI issue and anxiety. I had gallstones and it sound very much like what you are describing it was agony and stretched along.my back and across my chest. when I went to AandE I had elevated bp and hr due to the pain and was extremely dehydrated from being sick, my urine was practically black and I got paracetamol and sent home because they would only admit me if blood tests showed my liver was deranged.

Then because i was so stressed and anxious I was getting palpitations. If you've had so many chest xrays and ecgs and 24 hours monitoring and bloods taken so often I doubt it's anything physical to do with your heart. I'm not saying to ignore it but i dont know how much more they can do for you in a and e, they wont just give you a ct' scan because you keep going up theres has to be more an indication for it.

How long do you wait after the pain starts before going to a and e? And how long have you been taking the ssri for?

@MiltonRoad
Thanks for your message, A&E won't do CT scan as the pain is very sharp but last for a couple of seconds to 1 minute at rest or standing not on exertion and has been happening every 2 weeks since may 2022 but when I reach to A&E the observations are fine as the pain only last many seconds to 1 minute, even the ectopic beats happen throughout the day but at A&E the ecg is normal. I seriously don't know what to do as my appointment for cardiology is 26sept.

@Cats4life
Thanks for your message, I did have an ultrasound scan of the abdomen and pelvis in July 2022 and was told everything is fine liver, kidney, gall bladder (they didn't see any stones), ovaries etc. So gp excluded gallstones, I am able to eat fine, haven't seen any drastic changes in my stools either and no abdominal pain.

I want to think it's all anxiety, but I do think there is something going on, I know anxiety symptoms can range to many physical symptoms. When I am very health anxious I do loose weight, lose my appetite and vomit everyday, but I have never experienced random upper arm aches, sharp chest pain and irregular heartbeats. Recently, in the past 2 weeks the ectopic beats are happening every day on and off all day (heart sinking feeling and then 1 or 2 thuds and back to normal rhythm & the sharp chest pain happens out of nowhere and will catch me off guard. Yesterday I talking to my husband about a cricket match and the pain came from middle of my chest between my breasts and the pain was very sharp and within 5 mins it happened again. The left upper arm pain happens randomly as well. The pain will last 2 to 5 days painkillers make no difference and the pain occurs exactly the same location which is from shoulder to elbow the back and side region of my arm. I don't think anxitey is accounting for all my symptoms, it's very scary and not in my control have started talking therapies but they said need to get my tests done via cardiology to make sure there is no underlying condition and then can start sessions. The tablet for anxiety I haven't started taking yet

Would you not just consider taking the anti anxiety medication then and sure in 6-8 weeks if your symptoms get better you will know they worked?

Maybe you are just suffering different symptoms this time, with any condition that are multiple different symptoms.

I'm not saying all your symptoms are anxiety related but many of them, palpitations included are very common symptoms of anxiety. Your ecg showed normal multiple times and being aware of the feeling of your heart beat doesnt mean there is anything wrong with it.... I know its terrifying cause it's happened to me but I do also think you are looking into this all a bit too much and almost making it worse for yourself.

Would you say the pain is agony, like you are bent over, sweating, wishing to die?
Or more like a muscle strain?

I had the same symptoms and it was my gall bladder. The pain between the shoulder blades was particularly bad but quite common with gallstones. You can still get them even if you are eating a good diet. I eat mostly vegan food and still got them.

I hope you get it sorted soon. Try a low fat diet until you see you have further tests.

@JuliaDomna
Sorry to hear about the pain you went through regarding gallstones. I did have an ultrasound scan of the abdomen & pelvis on 23/7/2022 via gp referral and in August I was told that the scan was normal so no gallstones and no problems with abdominal organs. I have requested for a copy of the ultrasound scan for my records its not showing on the NHS App eventhough I have full access. Gp first thought the pain maybe coming to the chest due to gall bladder.

So that leaves with cardiac problems so just waiting for the appointment which is 26 September. It's just that I don't think I can wait that long for an initial consultation as the pain keeps coming and going

@Bighugs88 sorry to hear that you are still so distressed by these symptoms and feelings. All of your investigations and tests have given normal results. It seems that the most likely reason for your feelings is your health anxiety. I would urge you to concentrate on persuing the treatments for this aspect of your health. Please do not spend more and more money chasing investigations in the private sector if your GP feels something can safely be a routine referral then try and wait.