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Dr Chip (M.D.)
Dr Chip (M.D.), Doctor
Category: Medical
Satisfied Customers: 29267
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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CHEST TIGHTNESS Good morning. I am a female, 26 years old.

Customer Question

CHEST TIGHTNESS

Good morning. I am a female, 26 years old. For the last month I have been experiencing tightness or pressure (no pain) in my chest and upper abdominal area. The tightness varies in degree from day to day. Some says it will be pretty constant, lasting all day - and other days I do not have it at all. I have had several EKG's, a stresstest, a chest XRAY and an abdominal XRay - all are normal. Had a Barium swallo, and it was normal. I also had a pulmonary function test, which showed a VERY MILD asthma - the doctor put me on flovent 100 twice a day, but she said my asthma is TOO MILD to be causing that much chest tightness. I have not seen any improvement in the chest tightness with the flovent. I am also taking omeoprazol 20 mg daily for acid reflux (I have ben on it for 2 months). The only other medicine I am on is Lexapro 2.5 mg daily (about to go to 5 mg daily) for generalized anxiety disorder (which I developed 4 months ago) and have been on lexapro for 2 weeks. I am also on YAZ birth control.

Any thoughts?

Thanks,
Sara
Submitted: 5 years ago.
Category: Medical
Expert:  Dr Chip (M.D.) replied 5 years ago.
Can you fully describe what you're referring to as chest tightness?
Customer: replied 5 years ago.

There is no pain, it just a feeling of pressure or tightness in the chest/upper abdomen. Sometimes I feel that I can not suck my stomach in at all, and feel kinda bloated. Feels like someone is sitting on my chest too. This feeling comes and goes...sometimes (mostly on the weekends) I will be free of the feeling for a whole day....but other days the feeling lasts all day long.

Expert:  Dr Chip (M.D.) replied 5 years ago.
I have to ask here, so please don't be offended--has anxiety reaction been suggested as the cause of this?
Customer: replied 5 years ago.

YES- I got diagnosed with GAD 4 months ago. But I am not having panic attacks. I thought chest tightness due to anxiety happens ONLY when you have a panic attack. My chest tightness occurs out of the blue, with no other symptoms, lasts for a few hours, goes away and comes back later on.... Could this really be anxiety?

 

Thanks a lot and no offense taken! It is just hard for me to believe anxiety could cause such a weird physical symptom, that is not accopanied by a panic attack?

 

Sara

Expert:  Dr Chip (M.D.) replied 5 years ago.
Had to ask, and anxiety attacks can come without stress. Let me ask this--when it happens, have you ever tried just lying down and concentrating on slow deep breaths? The feeling is across the chest, not just on one side? When it happens, is it as though you can't get a deep breath?
Customer: replied 5 years ago.
yes, it does feel like I can't get a deep breath. I do try doing the breathing techniques, but does not really help. I am very aware I have an anxiety disorder....but what baffles me about this chest tightness is that it comes out of the blue, withouth being accompanies by a panic attack....
Expert:  Dr Chip (M.D.) replied 5 years ago.
No pain at all? Any funny sensation in the back?
Customer: replied 5 years ago.
Nope, no pain at all, no funny sensations. Just muscle tension in the shoulders, but I know that is from stress..
Expert:  Dr Chip (M.D.) replied 5 years ago.
Have you ever had spirometry when this was at its worst?
Customer: replied 5 years ago.

Yes, I had a full PFT. Came back showing VERY MILD asthma only.

Expert:  Dr Chip (M.D.) replied 5 years ago.
And yet, at that time, you felt somewhat short of breath?
Customer: replied 5 years ago.
yes I did at the time of the PFT. Now in the last 2 weeks, I do not feel necessary short of breath, but feel pressure.
Expert:  Dr Chip (M.D.) replied 5 years ago.
Well, it doesn't seem this has anything to do with lung function, asthma, or restriction of chest wall motion. Has gastric reflux, by chance, been suggested?
Customer: replied 5 years ago.
it has. I have been taking omeoprazole for 3 months though....but sometimes I do feel the acid comes back into my mouth a lil bit after eating....
Expert:  Dr Chip (M.D.) replied 5 years ago.
Did the omeprazole, at least in the beginning, seem to make any difference with the chest symptoms?
Customer: replied 5 years ago.
it did....and I can definetely tell when I forget to take it...
Expert:  Dr Chip (M.D.) replied 5 years ago.
Then I suggest that this is from reflux, and you need to see a gastroenterologist for endoscopy and, perhaps be more consistent with the omeprazole. I think we've ruled out anxiety, heart disease, and pulmonary conditions as a cause for this. That basically only leaves reflux.
Customer: replied 5 years ago.
thank you so much. So, anxiety could be causing this too? Because I do have GAD, but this chest feeling NEVER comes accompanied by a panic attack...
Expert:  Dr Chip (M.D.) replied 5 years ago.
Sorry for the delay. Anxiety is always a consideration, and relaxation techniques and hypnotism may also help.
Customer: replied 5 years ago.
Can anxiety cause chest tightness without panic attack? I'm not having panic attacks. If so, why? Maybe understanding what is going on in my body will help me. Thanks a lot!
Expert:  Dr Chip (M.D.) replied 5 years ago.
OK--not so much anxiety itself but, if there's hyperventilation, and that doesn't require huffing and puffing, then the pH of the blood can change and any or all of the following occur--numbness and tingling, expecially around the mouth and in the fingertips, blurry vision, dizziness, light headedness, palpitations, rapid heart rate, etc. Sometimes it becomes a vicious circle--your attention is directed to the chest and heart--oh, my God, am I having a heart attack?--the breathing increases, etc. Relaxation exercises and breathing control stop the pH change and redirect the mind away from worrisome things.
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Customer: replied 5 years ago.

gotcha...makes sense. Thanks so much! I will follw up with GI doctor too , JIC.

 

Sara

Expert:  Dr Chip (M.D.) replied 5 years ago.
Let me know how it goes, Sara