really scared right now

[davey]

Hi guys, I usually suffer severe chest pains which I've finally come to terms with but tonight my ribs on my left are giving me hell and im not exagerating it's coming in phases but its so painful-its spread to my back and throat-now im all worried that something awful is going to happen like a heart attack or something.Also my left breast is swollen and painful (which has been for 2 years but doctor said its nothing). I just phoned nhs direct and they said there is a 12 hour wait for a call back which doesnt help. Please help me guys im really worried about the pain coming back,worried ill collapse,worried ill phone an ambulance

[RLR]

Okay, while the internet certainly represents the absolute poorest medium to obtain a medical diagnosis, I'll share some information with you that may be helpful depending upon certain factors. It's fair to presume that your presence on this forum would include dealing with emotional anxiety and its relative influence on your health or well-being.

One of the most common forms of chest pain in persons with anxiety is a phenomenon known as DaCosta's Syndrome. The features of this syndrome have historically been misdiagnosed as those of a heart attack, when in fact it is merely the physical reaction to intense levels of stress or anxiety. True heart attacks are very seldom witnessed, but patients with symptoms they feel are related most often create a direct relationship in the absence of other factors not known to them at the time. Chest pain in the case of an actual heart attack is solely caused by ischemia, or loss of blood and oxygen supply to certain tissues. The consequences are quite dramatic and patients demonstrate no indecision about whether something serious is taking place.

GI distress is another common problem as a feature of emotional stress or anxiety that can result in sometimes dramatic patient presentations of pain, discomfort and apprehension about some type of impending event like a heart attack.

My impression, based upon your description and previous experience with chest discomfort, is that you are experiencing the features of DaCosta's Syndrome. If you observe, however, that your symptoms change or grow worse over the next 12 hours or sooner, then you are certainly within the reasonable capacity to phone your doctor or local ER department. My thoughts, however, are that this incidence too will subside.

You'll be fine.

Best regards,

Rutheford Rane, MD (ret.)