Chest pain, PVC and Bradycardia - need answers :(

[Izzyrizzy1998]

Chest pain, PVC and Bradycardia?


Hello! Just looking for some insight on what I may be dealing with.

30 year old female, moderate alcohol use (weekends 5 ish drinks), previously vaped nicotine for 3 years and quit 2 weeks ago.

Two weeks ago I went to the ER with chest pain on my left side. They ran an EKG, chest X-rays, and Troponin bloodwork. Everything came back completely normal.

I then started Prozac (20mg) for ongoing general anxiety - I took it for five days before I started experiencing Bradycardia with a resting heart rate of 32-49. I went to emergency again and the doctor told me to get off ASAP. They took bloodwork to look at my electrolytes, thyroid function and hormones and everything was perfect. The EKG showed that I have Trigeminy. My blood pressure was 120/89.

I’m still having the chest pain which also moves to my back (between shoulder blade and spine) on my left side. The pain feels internal, almost like a quick muscle cramp (sharp squeeze) that happens for about a second and then goes away. This happens intermittently all day. Nothing seems to make it better or worse. I’ve tried Asprin, Aleve, Advil, and Tylenol and none seem to cut the pain. It doesn’t feel muscular or like a nerve because movement and positional changes don’t seem to affect it. Deep breathing doesn’t make it worse.

I did see a chiropractor last week and the pain went away for a few days but it back again. He took X-rays and said everything looked fine with my spine and hips.

I just don’t know what to do about the pain. Both emergency room doctors had no answers for me and it’s making my health anxiety skyrocket.

I have an appointment with my GP Tuesday, is there anything I should ask her to check that can help me get some answers?

[specialmom]

I want you to know that I care. But you may be going to ER way too often. Do you have health anxiety? I'm suspecting. Do you have a general practitioner? That's the appropriate person to see at this point and to start seeing regularly. You were on a low dose or prozac and it was likely your anxiety still spiking causing the spike in heart rate.

I'm a long time blood pressure patient. It will get higher when stressed or anxious. So will my heart rate. It sounds like treating the anxiety is a good route to take. You have to expect side effects or feeling 'weird' for the first two to three weeks and the condition being treated (like anxiety) to not be fully addressed at the current dose until 6 weeks at which point, increasing the dose often happens since anxiety often takes more than a general starting dose. What most do with SSRI's who are sensitive or fighting extreme anxiety is to titrate up. So. You could start at 10 mg for a week and THEN go to 20 and you'd have less intense start up side effects.

So, I hope my being direct is okay. You've had a cardiac work up and two ER docs who are not finding you to have any cardiac issues. Anxiety can show itself squarely in our chest. It sure does mine and is extremely uncomfortable.

Do you exercise? What happens during exertion in exercise? Important to note this. A, it gives some cardiac info. But also, if you start exercising, you may find your anxiety decreases overall.

What are stress triggers for you? (besides health anxiety)?

[specialmom]

Oh, and let me clarify here. If you had chest pain, the ER was right to eliminate fear of a cardiac condition. And I guess I shouldn't say you shouldn't have gone the second time. But in general, reserve that for emergencies. Your primary may have been able to help you without the trip to the ER. But I don't know for sure so will retract that statement that you are overusing the ER. I get it. You needed to make sure you weren't having a coronary event. That's important.

[Izzyrizzy1998]

Hi! So I do see my GP. The chest pain started before I began the Prozac, which is why I went to the ER the first time. It felt like a heart attack, and I’m a new mom so I was worried about a pulmonary embolism.

Then I began Prozac for my PPA and the chest/back shoulder pain continued. I started having frequent dizzy spells and wooziness so I checked my pulse and it was 35, which prompted me to visit the ER again because the chest pain was continuing.

I’m worried at this point that I have lung cancer or something because although everything is coming back normal; I’m going on nearly two weeks of intermittent (but daily) chest and shoulder pain.

I’m just looking to see if anyone else had similar symptoms and it ended up being something else.

[Izzyrizzy1998]

My GP is also a 2-4 week wait, so I didn’t want to risk chest pains for that long. The ER is where they told me to immediately stop Prozac because SSRIs can cause heart issues with people who have arrhythmias.

[specialmom]

Okay, yes. I had chest pains that were anxiety related. I do have high blood pressure but have had that for many years. I had a family, extended crisis (my son had a mental health situation that was quite serious and we have dealt with it for over 2 years). I take blood pressure medication but will get chest pain when in an anxiety spiral myself over things. I do deep breathing. I run in place. I talk myself down. I also have high cortisol. This is the stress hormone. I wake up with a racing heart and chest pains sometimes and it is the surge or cortisol that everyone has in the morning (we all have an increase in cortisol which wakes us up) but if you have extra from stress, it fees really bad and for me, it always settles in the chest. I hate it. I can not tell you how much. But once I knew what it was, I breath threw it and it goes away. I'm working on the overall reduction of stress and anxiety. I know it is hard. I'm with you! And really prozac is very widely given and not known for heart issues. It may not be the drug for you but it doesn't cause heart problems or it would be common knowledge and acknowledged in the drug literature. It's well studied and used frequently.

I took prozac for a bit years ago. Lexapro is a drug many use now. Zoloft is another.

[SassyLassie]

Hello~I understand your fears and concerns. I have had the same issues and have gone to the ER so many times I have lost count and every darn time I do, they do the EKG, and blood work and all is "normal" I have had anxiety over this so many times, I still feel that they are missing something, but they say they aren't and that I have health anxiety. So, I am trying to work on it, but it is not easy. My GP has told me not to worry, but I still don't believe it. I want more tests like and Echo, but they say I don't need it, if I had one, I would have to pay and I can't afford one as it is over one thousand dollars. If they thought I needed it, it would be paid by the government as that is that how they do tests over here. I fight fear over those horrid things daily. Thankfully, m blood pressure is perfect as is the rate of my heart, it is just those horrid skips which sometimes can go off and on for days. I worse a seven day monitor, the results were good, no serious beats, but I didn't have the ones that can scare me. I had to pay for that as well as they said I didn't need it, but I wanted it for reassurance, sadly, it did not give me that as I did not have some of the "atrial runs" etc that I normally have.

I am a member of a heart forum here, you may want to post there as well, they do have some good thoughts and ideas.

I hope you feel better soon and the answers and help you need, worry about them is awful, and sadly, makes them worse, I know, but I still can't stop. I refuse to take any anti-anxiety drugs, they work opposite on me.