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Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

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Old 10-20-2012, 04:58 PM   #1
Stay Frosty
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Question Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Hey guys, this is going to be a little long so please bear with me. I would *love* to have some clue as to what's going on because so far my doctors haven't been able to make a diagnosis and I've been having some very worrisome symptoms.

Note that ALL of my symptoms have thus far occurred at rest, under non-stressful circumstances. I'm 28, 5'11", about 145 lbs. No medications and no lifestyle changes that would cause any of this.


Early in the summer, I had began to develop some chest pain and discomforts. These were mostly quick jabs of sharp and sometimes shooting pain. Some severe, others that I brushed off. Almost always ending within a second or two. But the frequency of these pains and some of the feelings that I was getting were definitely not normal for me.

I went to my doc who did an EKG which was normal. He ordered me to get an echo in the coming weeks. Literally the day before the echo, I had some kind of cardiac episode. I was at work on my computer when all of a sudden I got this wave of upper chest panic and lightheadedness out of nowhere. It was so scary that I thought my heart had stopped. This "lightheadedness" wave lasted only about 5 seconds and it was immediately followed by a run of very fast heartbeats (estimated 130-140 bpm or more). These were beats that I was self-aware of, strong and hard in the center of my chest. I described these as palpitations, although I am using that term in a very general sense. These self-aware beats terminated in about 30 seconds.

Naturally, I freaked out and thought that I was dying, so I dialed 911 and had an ambulance pick me up from work. Because this was all so overwhelming for me, I sent myself into a panic attack. Elevated heart rate, super high blood pressure (systolic was in the 160's, I forget was diastolic was), extreme trembling, and even some numbness/pins and needles in my arms. My face was also very pale. They told me that I was panicking and depriving myself of oxygen so eventually I calmed down and everything went back to normal. They gave me a Xanax which helped a lot. They ran an EKG, chest x-ray, and bloodwork at the hospital. All normal. Of interest is that my potassium levels were low @ 2.9. Previous bloodwork around the same time period indicated borderline pottasium @ 3.5.

I was dismissed with the typical diagnosis of anxiety, but I guarantee that the anxiety was caused by the episode and not the other way around.

These episodes happened a few more times throughout August, and I made repeated visits to the ER for each of them. I started to get really depressed and had a lot of anticipatory anxiety because I never knew when another episode would occur.

So I decided to make some lifestyle changes:

- Took a week off from work to relax
- Cut out all caffeine and soda
- Increased fluid intake (much more water)
- Greatly increased pottasium intake (orange juice, bananas, etc...)
- Started taking a small amount of magnesium supplement

I also visited a cardiologist who put me on a heart monitor. And guess what? No more episodes up until now. I was on the monitor for nearly a month and not one episode! I should also mention that I had the echo performed and it was perfectly normal. I had more blood work which was good as well. Cholesterol 175, CRP very low, very low risk for heart disease.

September 22nd - Present:

I started to develop a chest tightness in sternum area, which sometimes extends or occurs on the left side of my chest. This is a very peculiar tightness. It's usually a concentrated knot-like feeling in the center of my chest or a feeling that something is physically in there that doesn't belong. Sometimes it feels deep. And while it's mostly in the sternum area, the tightness can sometimes occur on the left side of my chest. It can last for hours, or it can last for minutes. But every single day it's there and it's rare that my chest ever feels completely normal.

Position definitely seems to influence it. Arm position, leaning forward/backward, lying down or standing up all seem to influence it, whether providing relief or making it more tight. Sometimes a deep breath will aggravate it. When the tightness first started, I noticed that it was worst when lying down on my back with my hands/arms behind my head, and more relieving when sitting up and leaning forward.

Sometimes while standing up and walking I feel the knot in the center of my chest and it feels funny as I swing my arms back and forth. Also, sometimes there is a band of tightness extending from my sternum to the left side of my chest which gets tighter when I swing my arm back, and more relieving when I swing my arm forward.

Aside from changing position, I feel that massaging the area of tightness can provide some level of relief. Though once I stop it usually comes back seconds later.

Also of interest is that I get a popping sensation in the center of my chest every so often. It usually happens when I do something which stretches or tenses up the chest, such as standing up, walking, pulling my arm back, or bending backwards. The "pop" doesn't hurt but it's kind of a nasty feeling because I don't know if it's a palpitation or if it's muscle/cartilage/bone that's popping. Sometimes I notice that my heart speeds up after it happens.

But enough with the tightness. I also experience a variety of chest pains which I'm sure are related. They are usually quick 1-2 second jabs and jolts of pain. Some directly in the sternum area where the tightness usually occurs. It's a nasty pain, as if my sternum was bruised and somebody poked it with their finger. But it feels deeper at times, as if it's cardiac. Sometimes I get more generalized and a bit longer lasting aching in the center of my chest.

Sometimes I feel as though I have quick spasms or squeezing in my chest, some severe enough where it feels like a bolt of lightning shoots through my chest and releases a wave of adrenaline/nervousness throughout my upper chest. Again, these come and go within a second or two.

I recall lying down on my back a few times and getting this bad pain in the sternum area for like 10 seconds or so. What I did notice is that when this happens, I can press on my sternum and make the pain much worse.

I also get jabs and jolts on the left side of my chest. Some deep feeling, some which feel more on the surface. More rarely, there are times when talking/laughing/deep breathing causes an extremely sharp and/or shooting pain on my left side.

Also, sometimes in the middle of the night, I will wake up in a terrified state thinking that my heart and/or breathing stopped. I will actually grab my chest and have this feeling of panic as if I'm dying. This passes within a couple of seconds but then I have a hard time falling back asleep because I am so panicked and afraid that it will happen again. Luckily this is pretty rare. I still wake up in the middle of the night, but hardly ever with this feeling.

Now to the present. On Oct 18th I was at work. I had just come back from lunch and I was walking back to my desk. I had another band of tightness across my chest while walking again. Swinging my arms back made it tighter, and swinging them forward provided relief. What was different this time is that I had some tightness on the right side of my chest as well. I think this was the first time I felt it on the right. So I get back to my desk and sit down.

At this point I noticed that my vision was a bit hazy and that I didn't feel quite right. Like I was disconnected from myself. I felt for my pulse and I couldn't really find it so I started freaking out. I sat there for a minute, felt for my pulse again, and noticed a very strong pulse in my neck, like a bounding pulse. Not super fast but faster than normal and strong. Over the next few minutes I would go from feeling alright back to the hazy vision, slight lightheadedness, and a bad feeling of oncoming death. The thing that freaked me out most is that I would lose my pulse at times. But I was so tense with anxiety that maybe I was just tensing up and making it hard to find it? I don't know... I decided to play it safe and called over a coworker who called 911 for me. My coworker noted that I was pale.

As I was waiting for the EMTs I was already recovering. When they arrived they asked if I really wanted to go to the hospital because I was seemingly back to normal, just freaked the hell out. I went to the hospital anyway. In the ambulance my BP was high again in the 160's (systolic). The EMT calmed me down and because I had been through this before I started to relax and within 10 minutes I was in the 120's. Once at the hospital, they did EKGs, bloodwork, and yet another chest x-ray. All normal.

I had a more mild episode of this about a month prior. It was the same symptoms. Slight haziness of vision, lightheadedness, hard time finding pulse, and sometimes a strong bounding pulse. I actually had a bowel movement during this episode and I guess that stimulated the vagus nerve and returned me to normal pretty quickly, because I didn't feel the need to call 911 during this episode.

I can't help but think that all of this is related. The chest tightness, the pains I've been having, and these scary cardiac episodes.

After reading a whole bunch of stuff online, I am now deathly afraid of ventricular tachycardia. My cardiologist immediately said no when I mentioned it, but how would he really know? I know that SVT can cause similar episodes but then again, so can VT. So how do I know that I didn't have VT? Especially since I had a hard time finding my pulse. I mean I'm sure I had some kind of pulse because I was still conscious and breathing ok, but it still scares the hell out of me when I'm trying to feel that nice pronounced beat in my neck and it's just not there.

The plan from my cardiologist is:

1) Rule out GERD (which I highly doubt) - Take Zantac for two weeks and see if there's any improvement with chest tightness/discomfort.

2) Rule out pericarditis. Wouldn't this have shown up on my echo and/or one of my many chest x-rays? If the above doesn't work, he wants me to go on Motrin for two weeks to see if there's any relief.

3) Start looking further into arrhythmia's and determine what might be causing my episodes.

Any other ideas? Should I look into hiatial hernias? Pleurisy? Clots? I don't know what to do at this point. I'm so scared of going into cardiac arrest during one of my episodes, especially after reading about VT. Even though I have zero proof that it was VT or even SVT.

Any help would be much appreciated. Thank you guys so much!

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Old 10-21-2012, 12:46 PM   #2
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Has there been a family recent diagnosed with a heart condition? With the inernet, one can get too much information and begin to imagine something there that it is not. No, you are not a nut case or anything. Sometimes, when a relative has a health issue, it can send one into a tailspin and start worrying over nothing. You are young and impressionable and you will soon calm down when all the testing is over. Just calm down, if you don't, you will have a nervous breakdown that you do not need. Just wait it out and calm down, relax and don't look up every single thing online. There is a lot of misinformation out there and will only confuse you. Just calm down and things will be fine. Let us know how those test come out. Promise me you will calm down. Hugs for today.

Never give up.

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cheer up (12-26-2012)
Old 10-21-2012, 01:12 PM   #3
Stay Frosty
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

No family history of heart conditions. My grandfather did have a non-fatal heart attack @ 55. And my other grandfather died of one but he had diabetes. No problems in the immediate family. I've been perfectly healthy up until now. It's just really depressing not knowing what it is and whether or not I have anything life threatening. My job has been pressuring me to travel but I've been putting it off because of this. The last thing I want is to have an episode when I'm all alone in some hotel room in another state.

Thank you for the kind words.

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Old 12-02-2012, 09:28 PM   #4
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Ruling out the Worst

I know I've said this on another forum, but I could've written that first post myself. I've been to the ER half a dozen times over the last three months, given many medications, and seen over a dozen doctors. My symptoms mimic yours almost exactly (with the exception of the popping). I've also been through much of the testing you've been through and are planning to: multiple EKGs, blood work, Echo, a 48-hour Holter monitor, a 30-day Event monitor, and even a stress test. I've been told this: I have had PACs and PVCs, but no more than are normal. I've had runs of tachycardia, which is "not normal, but not abnormal" and none of them too high into a dangerous range. Regardless, I've been put on a low dose beta-blocker, which has helped the intensity of these events by quite a bit. I still feel them, and still worry (trying to keep that to a minimum too) , but they are much weaker now, and seem to be decreasing in number as well.

As far as the chest pain, has anyone mentioned to you or looked into costochondritis at all? It's when the cartilage that connects your ribs to your sternum (that center part of your chest that feels stabbing pain some times) becomes inflamed. It's painful, and takes time to heal, and could explain why it feels worse when you push on it. I've had multiple doctors suggest this as the reason for the chest pain, and that seems to be backed up by what I'm hearing from my chiropractor and physical therapist. They also said that there is some rib dislocation, which could be causing some nerve issues. It's been hinted at that those nerves may be PART of the reason for the new events. I've heard the phrase "electrical issue" quite a bit when it comes to those missed beats, or tachycardia, and it seems that the nerve problem may be playing into that.

I am NOT a doctor, but this is what I've been through, heard, and interpreted. So, going forward with your plan, might I suggest also:
-having someone look at your chest for inflammation, ribs, etc.
-possibly an Echo, just to rule out anything more serious
-asking about beta-blockers
-possibly getting on an anti-anxiety med (DON'T be offended by this! I heard the same thing: "it's just anxiety" and wanting to scream that the heart and chest pain TRIGGERED the anxiety, but it's still there. Also, I was told that some of the anti-anxiety meds prescribed now, like Xanax, ALSO help with these events. My experience with it has been positive.)

Please keep us in touch. And prayers are with you. Hopefully you can take comfort in the fact that there ARE others out there who are experiencing this and surviving with you.

Old 12-03-2012, 06:13 PM   #5
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Is the pain usually after you eat ? If so it could be gas in your stomach pressing on the vagus nerve.
Sounds like you have some anxiety. Next time it happens try to stay relaxed so you can focus on the real symptoms. Also doctors will take you more seriously if they rule out anxiety.
BTW, BP of 160 is not high. I have gone for weeks with it above 180 , when my meds were not working. My usual is about 155-170.

Old 12-26-2012, 01:31 PM   #6
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

To Stay Frosty -- Your issues sound so much like mine over the past dozen years -- Agree totally with 'dakotamama' in that your description of events is very similar to mine was (and is). I take some Xanax (love it, low dose) and Atenolol, a beta blocker, again a low dose.

These episodes come and go and the more you think about them, the worse they will be. BTW, stabbing short pains are RARELY if ever cardiac related -- and you are no doubt suffering panic/anxiety attacks. I too, have had the 'electrical impulses' surging thru my chest (during my worst days long ago). Really amazing stuff. Know what the cardiologist said about me in his notes? He said I presented with an 'amazing array of symptoms, a constellation of symptoms, actually.' How embarrassing is THAT, when you are told you are OK, need to avoid stress and things that make palps worse like various foods (chocolate, anything with caffeine, alcohol, tobacco, etc.) I'm glad I saw his notes because they 'jolted' me back to the reality that I did not just have a rhythm issue re heartbeat... I was also a bit of a nervous wreck Take good care and keep us informed as to your progress. You will be FINE!

Old 12-26-2012, 02:12 PM   #7
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Just to update, I requested a 48 hour holter which did pick up two things:

1) SVT during exercising. I went bike riding and gave it my all to get some stress testing on the monitor. During my equivalent of "full sprint" on the bike, my heart rate got up to 185 bpm and my cardiologist said it was SVT. The weird thing is that I had no symptoms. I felt as if I could keep riding no problem. The hourly report generated by the holter software didn't list any occurrences of SVT, but both a cardiologist and an EP said that it was SVT, so I guess they know what they're talking about... Since it was asymptomatic, I'm thinking that maybe I had this my whole life and just didn't realize it. And maybe it's triggered by exercise?

2) 7 beats of non-sustained VT (EEK!) as I was sleeping. Hearing about this sent me into an immediate panic but my cardiologist and EP said that in a structurally normal heart like mine, this is not a huge concern. EP said that it could've been caused by my low potassium levels. It's in range now, but still at the low end (3.5-3.6). So I upped my OJ and banana intake hoping to get it higher. A blood test from several years ago shows that I was in the much more healthy 4.5 range. I have no idea how it got so low since then. My diet hasn't really changed. In fact, I've been eating much healthier these past few months.

Based on those two findings, I was referred to an EP who said that an EP study is a "no brainer" in my case. He also said that he would mainly be doing it for the SVT, as there was a good chance that the VT wouldn't be reproducible - but he would try at least.

I'm a little skeptical about doing it because of the risks, no matter how small they are, but I suppose it's for the best. And there's no way that I could say 100% that the VT was potassium related, so I guess I have to force myself to do this.

I'm having no obvious palpitations as of the past few months. My heart rate still gets elevated at times, but no symptoms other than some attached anxiety. I've measured it at 120-130 just by walking around at times. So maybe that's inappropriate sinus tach. Other times it's as low as 60.

Various pains and discomforts are still there (although subsiding a bit lately) and I was going to get a chest CT, but after thinking about all the radiation from the CT + the EP study, I'm going to ask about a chest MRI with heart scan instead.

Last edited by Stay Frosty; 12-26-2012 at 02:16 PM.

Old 04-01-2013, 12:18 PM   #8
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Hi Stay Frosty,

I know this is 4 months later, but I was wondering what you found out from the EP study or any other tests you've had since the last time you wrote.

I have so many of the same symptoms that you have. The jolts of chest pain with that panic/fear/adrenaline feeling, I've also had 2 of those dizziness/racing heart episodes - one of which I went to the ER for and was cleared. My potassium, like you, is always on the lower end now (3.4-3.6) and blood work I had 2 years ago showed that it was 4.6. In addition, I have PAC's and palpitations. My echo was normal except "trace regurgitation" in all valves. I'm currently seeing an EP.

Just wanted to know if you have any updates. Thanks!

Last edited by flanspoon; 04-01-2013 at 12:21 PM.

Old 07-04-2013, 09:49 AM   #9
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

Hi, I'm sorry to hear that all of you are suffering from the same thing as me, because it is a disconcerting feeling.

I'm 25 and 140 lbs and have had almost identical symptoms as Stay Frosty for almost a week. Mine started when I heard that my aunt tried to kill herself, so I thought it started from anxiety, but Stay Frosty's descriptions fit mine exactly, and it seems like the pain triggers the anxiety, not the other way around. My great grandmother has/had the same symptoms, and there has been discussion about her aortic valve or something possibly causing problems.

I am curious about what areas you all live in. I wonder if there could be an environmental factor here. I'm in Atlanta, Georgia.

I hope this all goes away for all of us soon, so maybe we can help each other.

Old 07-10-2013, 06:12 PM   #10
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

So I have had similar issues for over 2 years now. I get a tight chest, I feel like I have drank 20 cups of coffee (anxiety?) blurry vision, light head, palpitations, disassociation, no sharp pains in the chest just severe tightness and discomfort and I start having frequent bowel movements, No diarrhea, as many as 3 or 4 over a period of 4 hours until I am all cleaned out, then I don't go #2 again for days. My heart no longer races because I talk myself down and tell myself I am not going to dye.
Here is my story, and I will try to have some detail in hopes something similar will help us all make an association. I will start by saying that this is the most frustrating thing I have ever been through in my life (turning 47 this year) , I am fairly disheartened that the medical industry really has no clue what is going on with us and even with good medical insurance I am into this over $15K with no real diagnoses. I am not overweight and in all other regards I am healthy, I only take anxiety pills when I feel this coming on and only need them maybe one time a month . Yes, I did have a stressful job when this all started and it also really hit me the for fist time after a severe workout with my Son that caused every muscle in my body to hurt followed by the next evening of more than normal drinking. Next day I ended up in the ER, strange chest pains in the left chest, rapid heart beat, disassociated and I thought I was done. The result was my CPK levels were though the roof and the docs swore that I had a major muscle injury caused by muscle being crushed or something similar to cause the extremely high CPK levels, they pumped me full of fluids for the next 24 hours and released me the next day.
Went through the panic attacks ending up in the ER room on several occasions thereafter, yep, thought I was a goner then too. Wore heart monitors and had almost every heart test possible, no issues there. They went up the backside once and down by throat twice and found no real concerns there either however they treated me for GERD (not). Had severe chest discomfort for over 4 months, as the months went by my general doctor told me to come in when I have the symptoms so I did. First real diagnosis that I had has was esophagus spasms, the main trigger was later determined to be wine & beers so I quit this favorite past time, that was tuff! Now I seem to have other odd foods that set it off, vinaigrette dressings are the worst, certain but not all caffeine drinks, some juices but never one I can reproduce, foods with heavy preservatives, splenda other artificial sweeteners . I sit here responding to your post today because I am not sure why I am having all the symptoms I mentioned above today and I left work to came home to suffer. Took and anxiety pill and have had a bit of relief but as always, I will wait it out and assume I am not going to kick the bucket. Hope this helps and I further hope someone sees this who has been diagnosed with something that can help us all. Is this all caused by stress? I don't think so, Why does the anxiety pill help? One thing that has been a positive result in the mists of all this is my rekindled relationship with God and my spiritual well being :^) Blessings

Old 08-22-2013, 08:48 PM   #11
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

I know this was posted long ago, but I have the same issues. My doctor never really takes me seriously when I tell him about my symptoms, saying im too young to worry about heart issues..really!? Then he tells me its all in my head and brought on by anxiety. I looked at several different articles about my symptoms, and the one diagnosis that stood out to me the most was Precordial catch syndrome. Check it out and let me know what u guys think!

Old 09-09-2013, 09:30 PM   #12
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

I have been experiencing some of the exact same symptoms. I'm 28 and 145lbs. Started about 5 weeks ago, been to the er a few times. CTA scan, EKG, echo, xrays, blood work all came back healthy. Next is an upper GI but I don't think that's it, but I'll try anything at this point. Any update from Stay Frosty?

Old 09-10-2013, 07:04 AM   #13
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Re: Chest Tightness, Pain, Spasm Feelings, Occasional Tachycardia Episodes

The most likely cause of the various irregular rhythms is the low potassium. Why doesn't someone prescribe some cheap 20 Meq. Potassium Chloride pills that I take almost every day (because I also take furosemide which lowers potassium.)

I find that if my rhythm gets at all wonky, one potassium and one 500 mg. magnesium oxide settles everything down within 5 minutes.

As for the chest pain, it sounds like costochondritis. As an earlier poster said, pain from the heart is never "positional." Whereas pain from inflammation of the chest muscles and tendons is VERY positionally dependent.

It also sounds like you have more than a bit of hypervigilance going on. Listen hard for a "palpitation" and you are sure to find one. Human nature.

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