Head and neck pressure when active

[Jcrud58]

I’m 55 and in good shape. I don’t smoke and drink occasionally.  Worked out 2 to three days per week. Just recently I started getting heart palpitations (pounding) in my chest that got worse followed by chest and back pain, headache and pressure in head and neck. Fearing the worst I went to ER. Blood tests, EKG, thyroid, stress echo, CT with contrast, Holter all normal. Given Pepcid for heartburn and Xanax.  Followed up with my gp who suggested Zoloft for anxiety. Symptoms got better. Two days later tried to walk on the treadmill. I lasted 4 minutes before the symptoms returned. Then layed in bed for a day until they subsided. Xanax helps somewhat but not the head and neck pressure. I have not started the Zoloft. Since then the symptoms come and go worsening when there is activity like climbing stairs or simply bending down. I have to make appointments with the GI and Cardiologist but just getting out of bed is a struggle.  I can’t imagine what might happen if I attempt to drive somewhere so I’ve put those off for now. I’m sure I’m leaving something out but that is the jist of it.

[Paxiled]

The only reason to suspect anxiety is if you were experiencing irrational fearful thinking before your heart symptoms started.  If you're not thinking anxious thoughts, you probably don't have an anxiety problem -- it's the thinking that triggers the physiological symptoms that go along with it.  If you were having some difficulties emotionally or some stresses that were making you feel something before that heart feeling, then it's an anxiety problem.  I don't know what your thinking is like or what it was like at the time, but you do.  If it is anxiety, therapy is the place to go.  But if it isn't, all the anxiety meds in the world won't help and they are not easy to take or stop taking, so you do want to make sure your problem is an emotional one and not something physiological the docs you've seen haven't picked up on yet.  Nobody here can tell you which it is, only that anxiety is a thought process that when chronic leads to all sorts of symptoms, but it does start with a thought process.

[Jcrud58]

Thanks. Yes I’m always more or less anxious.

[Paxiled]

More or less anxious doesn't sound all that bad.  I mean, anxiety as a disease is pretty severe and really limits your life because you're too afraid to do things.  It still sounds more like something physiological is going on to me, given your symptoms and your triggers, but it's hard to tell from here.  My anxiety is crippling.  Not more or less.  To cause as much as you're feeling, it would have to be pretty severe, I'd think, but life is pretty odd.  I hope you find your answers, but again, if it's not anxiety, you don't want to be on these meds for something they can't help with as they are drugs.  If it is anxiety and it is this bad, medication will probably turn out to be necessary, though.  All the best.

[Jcrud58]

Thanks. It’s severe. I can’t get up out of chair or go up a flight of stairs without worrying if the symptoms will worsen. I basically accept that they will. I began taking the Zoloft the other night and had some relief almost immediately.  Now (2 days later) not so much.  The head and neck thing being the most troublesome.

[Paxiled]

This still begs the question -- were you suffering from irrational fears to a crippling extent before this physiological stuff started.  Anyone would be frightened by a sudden turn in health, but that's nervousness caused by a real thing.  Counseling can help with this, but only solving the problem makes it go away.  Some of us cope better than others to health problems, but Zoloft will only help if anxiety is the cause of all this.  If it isn't, know that once you're on these drugs you're on them, and getting off of them isn't so easy.  Also, Zoloft doesn't work that fast -- that was a placebo reaction most likely.  It takes about 4-6 weeks for the profound changes these medications cause in your brain to set in for most people, give or take a couple of weeks.  That's why I urge you to consider your anxiety level before this all started and to make an informed decision, with professional help and second opinions, whether you have a physiological problem or a mental one, because again, if it's physiological, the drugs will only give you more problems, not less.  For those of us with crippling anxiety, medication can be the only thing that lets us do things, but in your case, it's your physiological problems that are getting in the way.  Unless, and you still haven't answered this question, you were already feeling quite anxious when this stuff started happening.  Anyway, that's my say, and enough said, you get to decide, and I hope everything gets figured out and solved.  All the best.