Monday, September 01, 2008 melfreeman08 asks

Q: I'm 25 and worried about having a heart attack

I'm a 25 y/o female. I weigh 112 pounds and I am aprox 5'5. The only medication I take is Lutera the birth control pill. I eat healthy and I lead a very active lifestyle. I have no know health problems but I am worried that I may be suffering "heart related symptoms." Sometimes I get pain and tingling in my left arm acompanied by some chest pain that can sometimes be felt radiating into my jaw. During these episodes I also have a lot of belching. They tend to last for a couple days and then I return to normal. A few years ago ( about 3) I had a heart ultrasound, EKG, and thyroid test, and all came back normal. Sometimes I feel slight palpitations and sometimes I feel my heart rate go up out of no-where. ex. would be like 120 while sitting and eating dinner. Normally it ranges between 70-90. I have no family history of heart attacks, and I think I am still too young to get one, but I can't let my mind rest. I have tried relaxing and yoga but it doesn't seem to help. Do you think these are heart related symptoms? Do you think I might be starting to show symptoms of a heart attack?

Thanks for the help.

Answers (2)

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Martin Cane, M.D.

9/ 2/08 3:06pm

Melfreeman08,

Thanks for your question. Your age, family history, diet, body type, and lifestyle seem to put you at a lower risk of having a heart problem, but more information is needed about possible risk factors (cholesterol panel levels?, smoker?).

The bottom line is chest pain can be a very difficult symptom to diagnose, especially in females who tend to experience cardiac discomfort in many different ways than males. It's obvious from your post that you are very concerned about this possibility. It's time to check this out and rule out heart disease as a possibility. I would make an appointment with your physician for a checkup. I would request a lipid panel (done while fasting overnight) as well as general blood count (CBC), thyroid function tests, general chemistry screen, and urinalysis. I would explain your concerns to him and ask that a cardiac stress test be performed. Adding a Chest X-ray would also be a good idea.

I think the likelihood of your having heart disease is very low, but the only way to be sure is to have a stress test as a screen. If this is totally normal, your mind should then be at ease. If you're still experiencing symptoms, I would press your physician to pursue other possible causes such as gastrointestinal etiologies. Sometimes hormone pills can affect the lower esophageal sphincter (the weal valve that empties the esophagus into the stomach) causing it to relax and thus allowing gastric contents and acid to splash up into the esophagus with resultant chest discomfort.

I hope this has been helpful. Best wishes and feel better.

Martin Cane, M.D.