Help reassure me about angina

[damianjmcgrath]

Hello all,

I'm not after a diagnosis, I know that there's probably very few doctors on here. However, there's a large amount of people that have probably thought the same as me, probably researched into various illnesses and have a good amount of knowledge and information, and perhaps some first hand experience. Your comments would be very much appreciated.

My current anxiety is around angina. I get a dull chest ache whenever I do any sort of exertion, even walking around the office. It is a sort of tightness or ache that makes me feel slightly breathless too. My heart beats slightly faster and takes ages to get back down again. I feel slightly dizzy, and it's definitely constantly on my mind. Even when I'm relaxing, stressful situations can bring on the same deep ache. Arguing with people, my daughter crying, etc can make me feel the same way. It's like the feeling I used to get after a long run - a sort of heavy breathless pulsing ache.

It tends to go away fairly quickly with rest. Although when I'm resting, I'm calming down too.

It seems to match the angina symptoms pretty well.

I have had multiple ECGs and a echo, a chest X-ray and blood tests and a 24hr urine test in the last 12 months. I had a stress ECG 2 years ago. The doctor has never checked specifically for angina, and I've never asked about it - it's a fairly new thought of mine. But would angina show up on those tests? Could I suddenly have developed it within the last 6 months or so?

Up until about 6 weeks ago, I could cycle around 10 miles three times a week with no specific problem. I haven't cycled in the last 6 weeks due to me not getting around to fixing my bike, but I played football for a bit last week and felt tired very quickly, and the chest was hurting a bit. Not enough to make me stop, but it was hurting, and made me sweaty and exhausted a lot quicker than I remember being in the past.

Do people think this is anxiety, and my mind being aware that exercising can cause pain, therefore it does in my head? Has anyone had angina - did it stop you even walking, and was it physically impossible to keep going, i.e., did you have to sit down, or did you get completely breathless?

I feel a bit uneducated and that's not good for my brain.

Can anxiety come and go, to mimic a condition you're thinking about?

[tmckenzie-orr]

Anxiety is horrible, It sounds like your main focus Ocd is about your heart every post is about somethign up with your heart, different things, the test would pick up the angina , u need some help therapy to nip it in the bud, Its horrible when u focus on different parts of your body and try and find every excuse with it, because it doesnt feel normal, Like me when i was focused on my throat i was worreid i had hyper thyroid, tyroid cancer, throat cancer horse throat nodules on throat, etc etc just because it didnt feel normal but in the end it was just anxiety,

[damianjmcgrath]

Yeah absolutely my heart is the only worry I have. I focus because I'm trying to find answers. I don't really feel particularly anxious normally, then the pains hit and then I get anxious. I'm trying to rule out certain conditions and research into the possibles in the hope of finding out what it could be.

I apologise for posting a lot. I'm just desperate to find an answer - and if I can rule out the biggest worries for me, I'll be more willing to accept anxiety. I just don't know enough about how certain conditions manifest themselves so thought people on here might have experience.

[tmckenzie-orr]

Of corse i completly understand , as you think to yourself if its just anxiety why am i getting these twinges these pains these aches, The answer 80% of the time it is anxiety and you much more aware of the area in question due to the anxiety you alot more focused every ache or twinge is intensfied x 100 , It could be even reflux or somethign thats making u have the twinges or even a pulled muscle if it was something serious you would of had a heaert attack by now you dont have heart troubles and not heart attack in the length you have had these worrys, i know its easier than said than does its always easier some 1 else telling you the realisation of things, Myself when i get in my skin cancer worrys moments and stuff i am in total panic, I just cannot wait to recieve help on monday for my first cbt meeting, Am fed up off worrying about things and stuff wasting our life being like this we should be enjoying ourself not wasting and worrying every day away

[damianjmcgrath]

Yeah I understand. My brain sort of goes through a mental ticklist, like a flow diagram. It sort of says "right, you're getting pains, I know the symptoms for a few heart problems, let's check to see how many of them I've got. If it's not enough, then great, I don't have that.....let's move on.....what next......is it acid reflux, do I have x, or y, no.....ok.....is it a pulled muscle, let's check if I can move my arms around properly etc........is it angina, do I have x and y.....actually yes, I do....right, what are the other signs of it?

If I can say no to all the parts of my flow diagram, the last answer is "it must be anxiety then", and then I can start to relax and accept it.

I don't know if that makes sense, but I seem to want to rule out serious problems first, and then accept anxiety, and I'm struggling to rule out angina. A few websites says it doesn't show up on ECG's. I'm not sure if an echo would definitely show it, or a chest x-ray.

[Frenchy]

Hi there

Here are my thoughts. Yes, the symptoms you describe could be anxiety driven. Just because they come on when you are exerting yourself does not necessarily mean angina. It could just be that deep down, you feel anxiety (for whatever reason) that something "might" happen when you are exercising which is causing you to experience tightness and tension/pain in the chest. That is how anxiety works in a lot of people.

Secondly I would point out that although Angina is not always picked up in resting ECGs - it is identified as ischemia in Exercise ECGs (where you are on a treadmill having your ECG recorded). So if you have had execrise stress tests where your ECG has been taken, this probably would have shown.

Angina vs. anxiety is a tricky one, because angina can emerge gradually over time, but not always - and the severity and exact sensation of it is sometimes different for different people, ranging from very mild, to extreme discomfort. I experience Angina as a dull ache/burn sensation, which starts in my chest and then migrates to my neck and shoulders and then down my left arm. Which is fairly typical Angina. Mine is uncomfortable and noticable but not extreme and it doesn't tend to stop me completely, although I tend to slow down whatever I am doing, as the effect is that you basically run out of "puff". As I slow down, so does the tighness ease.

How old are you, if you don't mind me asking?

I tend to suggest airing on the side of caution when it comes to chest pain if someone is in their mid 40's or over and would suggest the best thing to do is to go to your doctor, describe your symptoms and get it checked out. As well as an exercise ECG, your doctor/cardiologist may also take bloods to check certain enzym levels. When the heart sustains damage it releases these enzyms and blood tests to check these enzyms levels are most often taken to confirm a heart attack, however these enzym levels can also be checked for angina too. Although for angina these enzyms levels are likely to be lower and so their presense might only be used as a sign/indicator, rather than a firm diagnosis of angina.

[nomorepanic]

I have merged your threads and moved them to the heart forum for you

[damianjmcgrath]

I'm 30, and have had these dull aches for about 4-5 months. I realise it's young, but it's obviously concerning pain due to the location. I recognise I am anxious, but I don't actually tick a few anxiety boxes. I'm not anxious generally, I don't have social problems or work problems, and I'm not anxious about any other health problem at all except for heart. I don't think every headache is a brain tumour. Every single anxious moment I get is around my heart.

A lot of health anxiety people seem to think they are having many different health problems. I don't seem to fit into that.

---------- Post added at 12:33 ---------- Previous post was at 12:32 ----------


I have merged your threads and moved them to the heart forum for you
Thank you. Apologies for posting twice. I wasn't sure how to categorise it and the two forums seemed to approach it from different avenues.

[Frenchy]

I'm 30, and have had these dull aches for about 4-5 months. I realise it's young, but it's obviously concerning pain due to the location. I recognise I am anxious, but I don't actually tick a few anxiety boxes. I'm not anxious generally, I don't have social problems or work problems, and I'm not anxious about any other health problem at all except for heart. I don't think every headache is a brain tumour. Every single anxious moment I get is around my heart.

A lot of health anxiety people seem to think they are having many different health problems. I don't seem to fit into that.

Well, some HA suffers do have general issues and a variety of health fears, but its actually not uncommon for people with health anxiety to be focused on one particular issue/area... especially the heart. The heart is a very special organ, not just because it is important physically - but because it's thought of as the emotional as well as the physical center of our bodies. People are often very "aware" of their heart and it's criticality for life (even more so than their brain sometimes!) and human's are generally very sensitive to anything that might be going on in there. And once anxiety sets in, a large number of people feel symptoms around their heart and chest. It is one of the most common areas where anxiety is felt.

To be honest, 30 is very young to be concerned about Angina. Even if there were a history of heart disease in your family, or you felt like your diet had been extremely poor, it still would be highly unusual for a 30 year old to have blocking arteries - and certainly not arteries that were clogged enough to cause angina like symptoms. I suspect most doctors would probably even be resistant to undertaking much testing at all for a 30 year old for angina or coronary artery disease specifically, besides perhaps a normal resting ECG and blood pressure just to check everything looks normal electrically and structurally in the heart.

You have a couple of options I think. If I were you my immediate priority would be to try and find and work on a treatment or some techniques for your anxiety, just for a few weeks (or even a month or two) and see if you feel any better. Whilst I understand you have physical symptoms, you do know and accept that you are anxious and stressed out and so I would take the first step, to try and see for yourself if lowering that stress alleviates those physical symptoms. If after you have given that a good crack, you still feel unwell - then see your GP and explain your symptoms. In the meantime - do not google medical problems with the heart. Seriously - that is literally feeding your anxiety more and more. You are not qualified to diagnose a heart problem - and neither is internet. The internet is literally stupid and flunked out of medical school.

You could go straight to your GP now, although it's tough to predict what a GP would say or suggest to a relative youngster worried about angina/heart attack. But don't let that put you off - if you genuinely feel that is the only way to put your mind at ease, then make an appointment. They are there to help you and they will tell you honestly whether they think you need any further tests. But don't be concerned if, beyond a couple of routine checks, they say you don't have anything to worry about. Take that as a reassurance from a medical professional, and start to work on your anxiety. Good luck.

[damianjmcgrath]

That's good advice, thank you.

I have Googled angina, and obviously, I hit all of their symptoms. I think I'll go for a jog or cycle later and see how I feel. I'm guessing if I have angina, it'll make me feel terrible. Obviously, the problem is going to be if my anxiety gives me those symptoms because I'm thinking about it.

I know the chances are low. I have a concern that the doctor might dismiss me because of my age and refuse to do certain tests. That feeds my anxiety, so I'll mention it to him tomorrow.

I have had some tests. Resting ECG probably means nothing, but the stress ECG of 2 years ago would have shown something unless this problem is very recent. I have had an echo which hopefully would have shown something.

I have done CBT for a 6-week group session, and I've had 8 one-to-one sessions. I've had 4 hypnotherapy sessions. I've had 4 chiropracter sessions in case it's legitimate back and muscle pain. Nothing has removed the chest pains yet.

I have a doctor appointment tomorrow, so I'll mention my worries. I think he'll just say anxiety and I guess I'll have to trust that!

[ricardo]

Well, some HA suffers do have general issues and a variety of health fears, but its actually not uncommon for people with health anxiety to be focused on one particular issue/area... especially the heart. The heart is a very special organ, not just because it is important physically - but because it's thought of as the emotional as well as the physical center of our bodies. People are often very "aware" of their heart and it's criticality for life (even more so than their brain sometimes!) and human's are generally very sensitive to anything that might be going on in there. And once anxiety sets in, a large number of people feel symptoms around their heart and chest. It is one of the most common areas where anxiety is felt.

To be honest, 30 is very young to be concerned about Angina. Even if there were a history of heart disease in your family, or you felt like your diet had been extremely poor, it still would be highly unusual for a 30 year old to have blocking arteries - and certainly not arteries that were clogged enough to cause angina like symptoms. I suspect most doctors would probably even be resistant to undertaking much testing at all for a 30 year old for angina or coronary artery disease specifically, besides perhaps a normal resting ECG and blood pressure just to check everything looks normal electrically and structurally in the heart.

You have a couple of options I think. If I were you my immediate priority would be to try and find and work on a treatment or some techniques for your anxiety, just for a few weeks (or even a month or two) and see if you feel any better. Whilst I understand you have physical symptoms, you do know and accept that you are anxious and stressed out and so I would take the first step, to try and see for yourself if lowering that stress alleviates those physical symptoms. If after you have given that a good crack, you still feel unwell - then see your GP and explain your symptoms. In the meantime - do not google medical problems with the heart. Seriously - that is literally feeding your anxiety more and more. You are not qualified to diagnose a heart problem - and neither is internet. The internet is literally stupid and flunked out of medical school.

You could go straight to your GP now, although it's tough to predict what a GP would say or suggest to a relative youngster worried about angina/heart attack. But don't let that put you off - if you genuinely feel that is the only way to put your mind at ease, then make an appointment. They are there to help you and they will tell you honestly whether they think you need any further tests. But don't be concerned if, beyond a couple of routine checks, they say you don't have anything to worry about. Take that as a reassurance from a medical professional, and start to work on your anxiety. Good luck.

Frenchy

I am not patronising you but this is one of the best posts I have ever read about the heart on NMP.
Of course having recently had a H A (I know I keep mentioning it) I was drawn to your clear and very accurate post and also should give peace of mind to this young man.

[Frenchy]

I think I'll go for a jog or cycle later and see how I feel. .....

.....the problem is going to be if my anxiety gives me those symptoms because I'm thinking about it.


If you go for a jog/ride specifically to "see what happens", then I'm afraid my friend, that is exactly what will probably happen. That really won't be a particularly accurate way to prove or disprove Angina. All that will probably do is bring on symptoms that will further entrench your belief that you have this condition, even though there is a high probability that you do not.

Only effective management of your anxiety - OR - a professional medical diagnosis is going to be able to determine whether this is genuinely Angina or not.

---------- Post added at 19:18 ---------- Previous post was at 17:09 ----------


Frenchy

I am not patronising you but this is one of the best posts I have ever read about the heart on NMP.
Of course having recently had a H A (I know I keep mentioning it) I was drawn to your clear and very accurate post and also should give peace of mind to this young man.

Well, thank you Ricardo. That is very nice of you to say. Just trying to help and all that :D I guess, one "silver lining" for having heart problems is that I/we at least build up some good experience and knowledge that can hopefully use to reassure others occasionally.