Vascular Issues: Symptoms and Solutions for Neck Pain and Discomfort

Do I have blood clots in my blood vessels? I have had issues detected in both sides of my carotid arteries during the examination?

I used to sit for long periods every day, combined with smoking and a diet high in salt and oil.
For the past six months, I have been eating a lighter diet and have quit smoking.
However, whenever I sit for more than an hour, I experience heat in my upper body, particularly in the back of my neck, the back of my head, and my ears.
This sensation starts in my head and spreads to my upper body, sometimes accompanied by chest tightness, difficulty breathing, and a rapid heartbeat.
The dizziness is particularly troubling, and I have had thoughts of suicide due to my inability to lie flat.
Whenever I lie down, the heat in the back of my neck and head becomes unbearable.
I am unsure if this is due to vascular issues or autonomic nervous system dysfunction.
Fortunately, I have seen some improvement with traditional Chinese medicine, and my doctor has prescribed Clonazepam, which helps with the heat when lying flat but does not alleviate it completely.
However, it allows me to sleep better without fragmented sleep.
I once sat for 34 hours because I was disturbed by barking dogs and ended up drinking a lot of milk tea, which made it difficult for me to fall asleep naturally and caused the heat when lying flat.
I have reported the police to the district prosecutor's office, and since then, I have seen improvements and can sleep better.
For four years, they kept passing the issue to the Environmental Protection Agency, which did nothing.
Now, I frequently get up to walk around, and I feel fine, but my legs do not swell or feel hot; only the soles of my feet experience tingling, which I cannot feel when the weather gets hot.
Additionally, I find that using the 4-7-8 breathing technique for sleep makes me feel breathless.

Niming, 20~29 year old female. Ask Date: 2023/03/10

Dr. Li Shengkai reply Cardiology

Hello, based solely on the information you provided, it is not possible to determine if there are any blood clots.
If examinations reveal carotid artery stenosis, regular follow-up is recommended.
Based on your situation, if there are no significant issues with cardiac-related tests, I strongly suggest seeking treatment at a psychosomatic medicine clinic.

Reply Date: 2023/03/10

More Info

Your symptoms suggest a complex interplay of vascular, neurological, and possibly psychological factors. Given your history of prolonged sitting, smoking, and a diet high in salt and fat, it's commendable that you've made significant lifestyle changes over the past six months, including adopting a lighter diet and quitting smoking. However, the persistence of your symptoms indicates that further evaluation and management are necessary.

Understanding Your Symptoms
1. Neck Pain and Heat Sensation: The heat sensation in your neck and head, particularly after prolonged sitting, could be attributed to muscle tension or vascular issues. Prolonged sitting can lead to poor posture, which may strain the neck muscles and compress blood vessels, leading to discomfort and heat sensations. Additionally, if you have a history of vascular issues, this could exacerbate symptoms.

2. Chest Discomfort and Palpitations: The feelings of chest tightness, difficulty breathing, and rapid heartbeat are concerning. These symptoms can be associated with anxiety, but they may also indicate underlying cardiovascular issues. Given your family history of cardiovascular disease, it’s crucial to rule out any serious conditions.

3. Dizziness and Sleep Issues: Your dizziness, especially when lying down, could be related to blood flow dynamics or inner ear issues. The fact that you experience relief with certain medications suggests a possible neurological component. Clonazepam, while primarily an anti-anxiety medication, can help with sleep disturbances and may indirectly alleviate some of your symptoms.

4. Nerve and Vascular Health: The tingling in your feet and the heat sensation in your neck could indicate nerve involvement, possibly due to compression or vascular insufficiency. Conditions like cervical radiculopathy or thoracic outlet syndrome could be contributing factors, especially if there’s a history of prolonged poor posture.

Recommendations for Management
1. Medical Evaluation: It’s essential to consult with a healthcare provider who can perform a thorough evaluation. This should include a physical examination, a review of your medical history, and possibly imaging studies (like an MRI or CT scan) to assess for any structural issues in the neck or brain.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to improve posture, strengthen neck muscles, and enhance flexibility. They can also teach you techniques to manage muscle tension and improve overall body mechanics.

3. Lifestyle Modifications: Continue with your dietary changes and incorporate regular physical activity into your routine. Aim for at least 30 minutes of moderate exercise most days of the week. This can improve circulation, reduce muscle tension, and enhance overall well-being.

4. Stress Management: Since you mentioned feeling overwhelmed, consider integrating stress management techniques into your daily routine. Mindfulness, meditation, and breathing exercises can help reduce anxiety and improve your overall mental health.

5. Follow-Up on Medication: Discuss with your doctor the effectiveness of Clonazepam and whether adjustments are needed. It’s important to ensure that any medication you take is appropriate for your symptoms and does not contribute to any adverse effects.

6. Regular Check-Ups: Given your family history of cardiovascular issues, regular check-ups with a cardiologist may be warranted. Monitoring your blood pressure, cholesterol levels, and overall cardiovascular health is crucial.

Conclusion
Your symptoms are multifaceted and warrant a comprehensive approach to diagnosis and treatment. By addressing both the physical and psychological aspects of your health, you can work towards alleviating your symptoms and improving your quality of life. Remember, it’s essential to communicate openly with your healthcare providers about all your symptoms and concerns to ensure a tailored and effective treatment plan.

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