Heart Pain: Causes, Symptoms, and When to Seek Help

Chest pain?

Hello Doctor: Recently, I had a health check-up at the hospital, which included blood tests, a 24-hour Holter monitor, a treadmill stress test, and an echocardiogram.
The results showed mitral valve prolapse, arrhythmia, and a slightly elevated level of a marker for heart failure (I forgot the name).
The doctor prescribed medication for arrhythmia and advised me to return in three months for a follow-up visit and additional blood tests (including CPK, CK-MB, and troponin I).
I also have dizziness due to inner ear imbalance.
Could you please tell me if this dizziness is related to my heart condition? Thank you.

Recently, I have been experiencing chest tightness and difficulty breathing, along with feelings of heart pain.
Last night, after taking a shower around 7 PM, I suddenly had a nosebleed that lasted about 20 minutes, followed by dizziness and discomfort.
Later, around 1 AM, I had another nosebleed that lasted about 10 minutes, and then I started feeling dizzy and unwell again.
After that, I experienced sharp, constricting pain in my heart, as if someone was squeezing it continuously.
At the time of the episode, I had taken my arrhythmia medication, but the pain and abnormal heartbeats persisted.
Should I return for another check-up? Thank you for your help.

Xiao Yu, 20~29 year old female. Ask Date: 2020/09/08

Dr. He Dongjin reply Cardiology

Hello, please first consult an otolaryngologist for the treatment of your nosebleed.
It seems that the panic caused by the nosebleed may have triggered symptoms related to autonomic nervous system dysregulation.
You can observe the situation for now, and if you still feel unwell, please return for an earlier follow-up.
Take care from Changhua Hospital.

Reply Date: 2020/09/08

More Info

Understanding heart pain can be complex, as it may stem from various causes, including emotional stress, physical exertion, or underlying medical conditions. Based on your description, it seems you are experiencing a combination of symptoms that warrant further investigation and possibly immediate medical attention.

Firstly, the presence of mitral valve prolapse (MVP) and arrhythmias, as indicated in your recent medical evaluations, can contribute to the symptoms you are experiencing. MVP is a condition where the mitral valve does not close properly, which can lead to palpitations, chest pain, and sometimes anxiety. While many individuals with MVP live without significant issues, it can occasionally lead to more serious complications, including arrhythmias or even heart failure in rare cases.

The symptoms you describe—chest tightness, difficulty breathing, and pain that feels like your heart is being squeezed—are concerning. These sensations can be exacerbated by emotional stress, which you mentioned has been a factor in your life recently. Stress can lead to increased heart rate and blood pressure, which may worsen your symptoms. Additionally, the episodes of nosebleeds and dizziness you experienced could indicate fluctuations in blood pressure or other underlying issues that need to be addressed.

Given that you have a history of ear imbalance and dizziness, it is essential to consider whether these symptoms are related to your heart condition. While inner ear issues typically do not directly affect heart function, they can contribute to feelings of dizziness and imbalance, which may be compounded by anxiety or panic attacks that can occur with heart-related symptoms.

Your recent episodes of nosebleeds, especially if they are recurrent, should not be overlooked. Frequent nosebleeds can be caused by various factors, including high blood pressure, dry air, or even certain medications. However, in the context of your other symptoms, it is crucial to discuss these occurrences with your healthcare provider, as they may indicate a need for further evaluation.

In light of your symptoms, it is advisable to return to your healthcare provider for a follow-up appointment. You should discuss the following:
1. Re-evaluation of your heart condition: Given your symptoms of chest pain and arrhythmias, further testing may be warranted. This could include a repeat echocardiogram, Holter monitor (for continuous heart rhythm monitoring), or additional blood tests to assess cardiac enzymes and other markers.

2. Management of symptoms: Discuss the effectiveness of the medication prescribed for your arrhythmia. If you are still experiencing significant symptoms despite medication, your doctor may need to adjust your treatment plan.

3. Assessment of dizziness and nosebleeds: Since these symptoms have been recurrent, it is essential to explore their potential causes. Your doctor may recommend seeing an ear, nose, and throat (ENT) specialist if necessary.

4. Lifestyle modifications: Given the stressors in your life, consider discussing strategies for stress management, such as relaxation techniques, regular physical activity (as tolerated), and a balanced diet rich in fruits and vegetables. These changes can positively impact both your mental and physical health.

In summary, your symptoms are concerning and warrant further evaluation. It is crucial to maintain open communication with your healthcare provider, especially regarding any new or worsening symptoms. Early intervention can help manage your condition effectively and improve your quality of life.

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