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Family Physician
Family Physician, Doctor
Category: Medical
Satisfied Customers: 2592
Experience:  Emergency Medicine and Family Practice for over 26 years
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You can't. Because you know very little about how the

Customer Question

You can't. Because you know very little about how the billions of different ways your heart can fail. Neither you have the right tools to check that because medicine simply hasn't made it yet.
Yet you pretend to solve issues you know almost nothing about. And you insist that a heart problem is instead a GI tract issue.
Many more chest pain cases when lying down are due to some form of heart failure than you can possibly imagine.
There is no need to make a diagnosis up only because you are incapable not only of curing but even to diagnose a heart problem that only happens at night (mostly because you like to sleep).
You will never know truth until you manage to catch the heart dynamics of a sleeping symptomatic individual.
Yes, only something like a 24-hour Holter echocardiogram would possibly get new insights into this class of problems.
Unfortunately that doesn't exist yet.
And even if existed, it would always certainly be way too invasive for the state in which your patient wo
Submitted: 2 years ago.
Category: Medical
Expert:  Vakul Aren replied 2 years ago.

Hello,I am Dr. Aren and I will help with your query.Please do explain the symptoms and the larger problem again.Thank you.

Expert:  Vakul Aren replied 2 years ago.

I agree that we have limited means of investigations,we are often unable to pinpoint a diagnosis because we lack very sensitive tools.But we do manage to get close to the problem fairly often.

Customer: replied 2 years ago.

Caucasian male, 40. 182 cm. 60 kg.

Since October 2009 left hemithorax pain only lying down, palpitations (stronger beats), retrosternal oppression and discomfort, dyspnea, pulsating pain left carotid and/or under last left rib. Unwanted erection. Pain then spreads to left hip, back of left knee, top of left foot. Neck pain along carotid can be stinging. Sense of impending doom.

Nothing to do with mental status.

This is a positional issue.

Extremely fatigued while in bed. Main trigger is the horizontal position. Total relaxation, immobility and sleep also allow the syndrome to start and slowly grow.

It's like a choking engine.

Pain is so intense I wish to die while symptoms are present. Sitting or standing removes symptoms in minutes. Blood found sometimes in nose upon standing.

iRBBB, mild MVP, mild pectus, left lung decoration for pneumothorax (1994), D-dimer 585 ug/l, poor endothelial function (FMD), prothrombin mutation, high CTX, mild neutropenia.

Dad died 67 with lung cancer, maternal uncles 62 and 42 (stroke). Maternal grandfather 52 with angina. Paternal grandfather 34.

Expert:  Vakul Aren replied 2 years ago.

You appear to have multiple problems which do not apparently appear to arise from any one single cause.Apparently you have already ruled out possible thyroid and diabetes issues,cardiac issues would all have been investigated by echocardiography,Holter monitoring/Cardiac angiography and ECGs,lipid profile and lung/kidney and liver function tests would also be in the normal range after so many years of therapy.It would be prudent to rule out any stress/anxiety related panic attack type of reaction by seeking a mental health evaluation since there does not seem to be any real organic issue. IRBBB,pectus,loss of one lung,mild neutropenia do not appear to be causing any major issues.Sense of impending doom,chest pressure /heaviness,palpitations,fatigue,restlessness would be symptoms related to severe stress and anxiety.

Customer: replied 2 years ago.

I am amazed at this incredible lack of competence among physicians.

Your superficiality did not impress me at all. Although, I must admit, it was expected.

I'm not stressed neither anxious. I go to bed each night with the best atmosphere and calmness you could possibly imagine.

Also, I did not lose one lung. It has only been decorticated.

If this is the level of accuracy of the service, I'd rather have my money back.

Good luck.