Struggling with Unresolved Heart Issues: A Patient's Journey

(I am very troubled) I have visited the hospital multiple times without receiving a definitive diagnosis or treatment, and I am still struggling with this issue?

Hello, first of all, I have no bad habits, but I often work 12-hour shifts (physical labor, I can only sit during break times).
I take a half-hour break for meals and attend night school two days a week (this has been ongoing for a year and a half), which results in late nights.
Initially, I experienced mild dizziness that would resolve whether I sat down or not, and I was still able to work without issues.
Gradually, I began to experience chest pain and a feeling of pressure in my heart.
The dizziness worsened to the point where sitting down no longer helped, leading to fainting and falling, resulting in injuries and a period of unconsciousness on the ground.
For the next two to three days, I felt extremely weak and unable to move, making it impossible to go to work.
These symptoms have persisted for six months (two months after the initial dizziness, my weight dropped sharply to 44 kg from a standard weight of 48 kg, and it has continued to decline).
Some doctors have suggested that I have arrhythmia (24-hour heart monitoring showed no abnormalities), while others mentioned issues related to the vagus nerve and advised me to relax.
There are no treatment methods, but I can avoid triggers.
My condition causes me to feel dizzy after walking or standing for about one to two hours, and when it occurs, it escalates quickly, severely impacting my normal life and survival for the past six months; I spend about 80% of my time in bed.
The physical state I've been in for six months has caused significant financial stress.
Some doctors suggested that I see a psychologist, which might help.
My family background is quite unique, and the environment I grew up in for over a decade has left me feeling fearful and deeply saddened.
Although I frequently suffer from nightmares, I wake up feeling calm without particular sadness or fear.
When I see my family, my mind goes blank, and my hands become weak and shaky, which I believe is a natural bodily response.
I feel emotionally numb and question whether I can hold on psychologically.
My mental state has been filled with sadness and fear for over ten years; could this really affect my physical health?

Wang, 10~19 year old female. Ask Date: 2015/11/29

Dr. He Dongjin reply Cardiology

Hello, if your mental state has been persistently filled with sadness and fear for over ten years, it can indeed affect your physical health.
It is advisable to seek a psychological support system and consider visiting a psychosomatic medicine department at Changhua Hospital for assistance.

Reply Date: 2015/11/29

More Info

It sounds like you have been experiencing a challenging journey with your heart health and overall well-being. Your symptoms, including episodes of fainting, chest pain, and feelings of pressure in your heart, are concerning and warrant thorough evaluation and management. Given the complexity of your situation, it is essential to address both the physical and psychological aspects of your health.

Firstly, the physical symptoms you describe, such as dizziness and chest pain, can be indicative of various underlying conditions. While you mentioned that doctors have ruled out significant arrhythmias through a 24-hour Holter monitor, it is crucial to consider other potential causes. These could include issues related to blood pressure, heart function, or even anxiety-related symptoms that manifest physically. The fact that you have experienced significant weight loss and prolonged weakness is also alarming and should be addressed with your healthcare provider.

Your work schedule and lifestyle may contribute to your symptoms. Working long hours without adequate rest can lead to physical exhaustion, which might exacerbate feelings of dizziness and fatigue. Additionally, the stress of balancing work and night school could be impacting your mental health, leading to increased anxiety or panic attacks. It’s important to prioritize self-care, including adequate sleep, nutrition, and stress management techniques.

Regarding your psychological state, it is well-documented that chronic stress, anxiety, and unresolved emotional issues can have profound effects on physical health. The symptoms you describe, such as feeling faint, shaky, or having a racing heart, can be manifestations of anxiety or panic attacks. It is not uncommon for individuals with a history of trauma or prolonged stress to experience physical symptoms that mimic cardiac issues. Therefore, addressing your mental health is just as important as managing your physical symptoms.

You mentioned that a doctor suggested seeing a psychologist, which could be a beneficial step. Therapy can provide you with tools to manage anxiety, process past trauma, and develop coping strategies for stress. Cognitive-behavioral therapy (CBT), for instance, is effective for many individuals dealing with anxiety and panic disorders. It can help you reframe negative thoughts and reduce the intensity of your physical symptoms.

In terms of your heart health, it is essential to maintain regular follow-ups with your cardiologist. They can monitor your symptoms and adjust your treatment plan as necessary. If you are hesitant about medications due to side effects, discuss alternative options with your doctor. There may be other medications or lifestyle modifications that could help manage your symptoms without causing significant side effects.

Lastly, consider incorporating relaxation techniques into your daily routine. Practices such as mindfulness meditation, deep breathing exercises, or gentle yoga can help reduce anxiety and improve your overall sense of well-being. Engaging in regular physical activity, as tolerated, can also be beneficial for both your heart health and mental health.

In summary, your journey involves both physical and psychological components that need to be addressed holistically. Regular communication with your healthcare providers, a focus on self-care, and seeking support for your mental health can significantly improve your quality of life. Remember, you are not alone in this journey, and there are resources available to help you navigate these challenges.

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