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CHEST TIGHTNESS I am a female, 26 years old. For the last

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CHEST TIGHTNESS Good morning. I am...
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: 6 years ago.Category: Medical
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Answered in 2 minutes by:
9/1/2011
Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
Dr Chip (M.D.)
Category: Medical
Satisfied Customers: 34,504
Experience: 20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Can you fully describe what you're referring to as chest tightness?
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Customer reply replied 6 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.

Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
I have to ask here, so please don't be offended--has anxiety reaction been suggested as the cause of this?
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Customer reply replied 6 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

Doctor: Dr Chip (M.D.), Doctor replied 6 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?
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Customer reply replied 6 years ago
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....
Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
No pain at all? Any funny sensation in the back?
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Customer reply replied 6 years ago
Nope, no pain at all, no funny sensations. Just muscle tension in the shoulders, but I know that is from stress..
Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
Have you ever had spirometry when this was at its worst?
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Customer reply replied 6 years ago

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

Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
yet, at that time, you felt somewhat short of breath?
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Customer reply replied 6 years ago
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.
Doctor: Dr Chip (M.D.), Doctor replied 6 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?
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Customer reply replied 6 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....
Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
Did the omeprazole, at least in the beginning, seem to make any difference with the chest symptoms?
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Customer reply replied 6 years ago
it did....and I can definetely tell when I forget to take it...
Doctor: Dr Chip (M.D.), Doctor replied 6 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.
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Customer reply replied 6 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...
Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
Sorry for the delay. Anxiety is always a consideration, and relaxation techniques and hypnotism may also help.
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Customer reply replied 6 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!
Doctor: Dr Chip (M.D.), Doctor replied 6 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.
Dr Chip (M.D.)
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Customer reply replied 6 years ago

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

Sara

Doctor: Dr Chip (M.D.), Doctor replied 6 years ago
Let me know how it goes, Sara
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