Question :

Twenty one year old, chest pain and shortness of breath for two months

Dear Ask The Doctor:
I am a 21 year old female. I am over weight but I have lost 31 pounds since March and I'm continuing to lose weight. For two months now I've been experiencing shortness of breath that is often accompanied by chest pain above my left breast near the collar bone, below my left breast, and on both the left and right sides of my sternum near the center of my breast. My family thought I was having a heart attack in July so they called an ambulance. My heart was fine according to the test and my oxygen was at 100% so they diagnosed me with anxiety and sent me home. Two days later I was again feeling like I could not breath and feeling very weak. I began to panick because of this. I was taken to the ER and given anxiety meds. I told them I was still having a difficult time getting a deap, satifying breath but they insisted it was anxiety. Since then I've had one episode of very high blood pressure where I was sent to the ER where they preformed all of the heart tests, chest X-rays and labs they usually do on a chest pain patient. Everything came back fine. Then I went to my family doctor and while I was there I mentioned that I had been having a little sholder pain. He immediately decided that everything going on was related to that and sent me home with two different kind of pain pills. These have not relieved any of the chest pain and breathing symtoms. I am constantly dizzy, feel weak all the time, and have trouble just standing to take a shower. I always feel like I'm going to pass out and the pain in my chest is daily. Anxiety meds are of no help to me and I do not feel like it's anxiety. I get anxious over the symtoms I'm having...anxiety does not make the symtoms happen. I monitor my blood pressure and blood sugar at home. Both have been fine for the most part. Occationally my blood pressure will be slightly elevated but usually it's normal. The last two days it's actually been a little low. Blood sugar has been perfect. I have had issues with being hypoglycemic in the past so that's why I monitor my sugar levels. I can't make dinner without feeling like I'm going to pass out, I can't get the laundry from the dryer without my heart pounding like it's going to bust out of my chest, I can't play with my kids for very long because I immediately feel like I have to lay down and going to the grocery store for an hour is a small miracle for me. I am a homemaker and a full time student. Feeling like this constantly is simply unexceptable. I have seen 5 different doctors in the past 2 months. They keep blowing me off and sending me with anxiety meds or pain pills. I am seeing a new doctor tomorrow. I am hoping and praying this one will give me the time of day I need. Can ANYONE give me ANY insight as to what might be going on? Please, I'm desperate. I just want to feel like a normal 21 year old woman again. I want to be able to get on my tredmil without worrying that I'm going to have a heart attack or something. I want to be me again. Thank you in advance.


Answer :

Dear Patient: 
I understand your concern about your symptoms. Surely the pain that you feel in your chest might need to be studied with more detail. In my opinion I would suggest you to consult a doctor specialized in Internal Medicine to try to group all your symptoms that might be produced by one condition.
Due to your symptoms of fatigue, weakness, fatigue, changes in your blood pressure and glucose levels an evaluation of your endocrine system to look for an overactive thyroid (hyperthyroidism) that may cause low blood pressure. In addition, other conditions, such as adrenal insufficiency (Addison's disease), low blood sugar (hypoglycemia) can trigger low blood pressure. Careful study in changes of blood pressure form lying down and standing would help ruling out these causes. I wish you a prompt recovery.


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