Chest Tightness

[Lawrence78]

Hello. I have been here before because I was worried about a tightness sensation I was getting in my chest. I have since been to A&E to get checked, had all the tests (blood tests, ECG, x-ray), and everything was fine. Straight after the tests I was taken to a specialist part of the hospital as a follow-up (can't remember what it was called but it was specifically for heart-related issues I believe). There I basically had another chat about it and was told I would get a further follow-up, although I didn't know why seeing as they said everything was okay.

This follow-up was a phone chat from Rapid Access Clinic where they went over the same things again. I was told they would like me to have another ECG and possibly a CT scan (depending on the ECG I guess).

So now I'm thinking I might have angina? After my A&E trip I still had the tightness off and on but in the last few weeks it seems to have stopped, kinda forgot about it to be honest. But it started again just about the time of my phone call chat which makes me think it's anxiety.

When it happens I only get a tight sensation, nothing else. It's not severe or anything, like mild asthma (which I used to have). The sensation seems to be in the chest but also feels like it's in the throat, adams apple down to the chest. Comes and goes. Being active doesn't cause it, but when it happens I worry and make it worse. This again makes me think it could just be me and anxiety as I do suffer from anxiety. I'm a very nervous person overall. This all started about 2 months ago out of nowhere, one day I was fine, the next this started (does angina do that?). Could it be something to do with allergies and summer?

So now I'm worrying about this again 😑

[Tos92]

Hi Lawrence78

I’ve just seen your previous post, and I can see that I commented on that one too. I’m sorry you’re still feeling poorly.

The truth is, no one can tell you if you’re experiencing angina, especially now that you say you’ve had similar symptoms like this before when you experienced asthma.

The best thing to do with any type of chest pain is to call 111 or 999.

I can see you’re very anxious about it, and I think you would benefit from speaking to a cardiac nurse just for some reassurance before your appointment for your tests come through.

0300 330 3311

You need to trust the doctors for the time being and know that they are investigating your pain further by doing the ECG and CT scan.

Make a list of questions for them, so when you do see them, any doubts or concerns you may have might be addressed.

You may also benefit from logging your symptoms, any noticeable triggers and the frequency of them.

Good luck and let us know how you get on.

Tos

[Lawrence78 in reply to Tos92]

Do you know if angina can just start out of nowhere? Literally one day I'm fine with no previous issues, then the next day it starts just like that. Doesn't seem normal to me. Can't help but think its something else. My cholesterol levels are okay, I think about 5.7 at last check.

[Tos92 in reply to Lawrence78]

It’s difficult to say. I developed angina pretty much “out of the blue” but it went undiagnosed for a 1.5 years before triggering an NSTEMI. I have a niche form of angina called vasospastic angina. This causes my arteries to spasm which in turn, causes restricted blood flow and oxygen to my heart.

There is no set trigger for my pain, as it’s there most of the time, primarily on rest. I do have triggers which increases the intensity of the pain such as the cold, stress, and sometimes too much physical activity / exertion.

The root cause of my angina is mainly attributed to a congenital heart defect called a myocardial bridge. The defect is mostly benign however, can cause symptoms in a few and I’m unfortunately, one of those.

It is hard to diagnose this type of angina without specific tests. We do have another member, Milkfairy who might be able to better assist with your query of “can angina just start out of nowhere”.

I hope you can get to the root cause of your chest pain soon.

[Lawrence78 in reply to Tos92]

I know now there are different types of angina. The tightness that is occurring can happen for quite long periods, as in hours, coming and going. Sometimes it will carry on for say, half an hour before fading away for a while and coming back, could be quickly or not at all. Sometimes it can go on continuously for easily an hour or more. Nothing major, just uncomfortable, sometimes just in the background so to speak. Seems to be worse when I'm not doing anything which allows me to worry about it when it happens. This is why I think (and hope) its anxiety. I'm guessing if it was maybe angina I might be having serious repercussions by now? When I'm active it mostly doesn't happen. I also go running (not as much as I used to) and I have no issues during or after that.

The sensation seems like it affects my throat too which does cause irritation and makes me cough a little here and there (to try and ''scratch'' or ease the irritation sensation). Throat can feel thick and heavy at times, right behind the adams apple, which feels like it radiates down to my chest. Its all very weird.

[Tos92 in reply to Lawrence78]

Again, it wouldn’t be possible to say exactly what is causing these symptoms without having your ECG and CT scan first. It would be best to wait for those. As previously stated, if the symptoms become worse, or you have new symptoms, it’s a call to 111 or your GP.

[Hidden]

Have you discussed with your medics the possibility of you having a gastro related condition rather than a cardio condition? I was told I had angina just over a year ago after two visits to A&E with mild chest discomfort (diagnosis primarily based on a previous HA) but it wasn't, it turned out to be gastro related, probably a grumbling hiatus hernia.

[Lawrence78 in reply to Hidden]

Could I ask how they found out your problem was gastro related.

[bridgeit]

Hi Lawrence, I think you're right about anxiety causing tightness across the chest, at least, it certainly won't help your chest muscles to relax. As well as Lowerfield's gastro suggestion, something you might like to focus upon is your breathing technique. This sounds weird, but breathing the "wrong" way can result in chest muscle tension, inadequate oxygen intake and chest (and neck) pain. If you don't already, try to make sure that when you breathe, it's from the thoracic/diaphragm area (ribs outwards) and not raising the shoulders or breathing upwards.

Diaphragm breathing is not the same as "belly" breathing. The aim is to expand the chest outwards and relax the spine at the same time. I think this video is a helpful explanation of how to breathe wisely:

bing.com/videos/search?q=Ho...

Breathe evenly and slowly, not too fast and not too deep every time you inhale - don't hyperventilate!

Controlled, focused breathing is also very good for relieving anxiety; it's the first step towards meditation and meditation/mindfulness can work wonders with anxiety when practised regularly.

Just a thought; hope it's helpful for you.

[Lawrence78]

It's the oddest thing. It started out of nowhere, one day I'm fine with no previous issues, the next day I have this problem. Its a weird sensation because it feels like its going from behind my adams apple down my throat to the top of my chest. Was thinking it could be some kind of allergy 🤷

[Milkfairy Heart Star]

Hello,

The BHF has this information about angina.

bhf.org.uk/informationsuppo...

Perhaps give the BHF helpline a call and speak to one of the Cardiac nurses.

bhf.org.uk/informationsuppo...

[Lawrence78 in reply to Milkfairy]

Hi. Just wondering, can angina symptoms literally start outta nowhere on one day? The day before absolutely fine, nothing. Next day I have this tightness issue. Can it start just like that? The day it started I was stressing/worrying over an issue 🤷 I am finding I'm worrying about this badly and any 'symptoms' I get tend to be when I'm alone with time to think to myself 😖

[Milkfairy Heart Star in reply to Lawrence78]

Hello,Everyone is different and for some their angina creeps up on them for others it comes out of the blue.

It good that you have been seen by the Rapid Chest Pain Clinic. They can offer the tests to help determine whether you have angina or not.

You have had some really good advice already about using breathing techniques to help manage your anxiety.

My angina can be triggered by the cold, emotional, mental and physical stress.

I find using breathing and relaxation techniques helpful as well as practicing Tai Chi and yoga.

I also use this free app Insight Timer, it has lots of different techniques which may help you.

insighttimer.com/en-gb

Have you discussed your feelings of anxiety with your GP?

I hope you can find ways of feeling more at ease soon.

[Lawrence78 in reply to Milkfairy]

Thanks for the links.

What's getting me is when I had all my tests (bloods, ECG, X-ray), I was told everything came back okay. The only thing was on the ECG something came back ''incomplete'' at the time of the test. The lady did explain it to me but I can't remember. But again she said they weren't concerned. So why did they give me a follow-up if everything was okay? I'm thinking they maybe didn't tell me everything and something wasn't okay, or they just wanted a second opinion from another department before letting me go completely (?).

The follow-up (Rapid clinic) wanted me to have another ECG, which is fine, but also mentioned a possible CT scan which really upset my anxiety I can't lie 😖

[Milkfairy Heart Star in reply to Lawrence78]

Healthcare professionals sometimes forget that us mere patients can get spooked by their side comments.

It sounds as though the staff at the rapid chest pain clinic are being thorough, which hopefully is reassuring.

A CT angiogram is a non invasive way of looking for blockages in your coronary arteries.

Maybe cross that bridge when you have to rather than worry about something that may not happen?

It may help to take one step at a time starting with the ECG first.

Have you had any support for your anxiety from your GP?

[Lawrence78 in reply to Milkfairy]

What I don't get is I have previously been to A&E 3 times since 2019 with issues. Twice for chest pain and once for abdominal pain. Both times I had all the tests and they said everything was fine and that was that. So how come this time I got a follow-up?

[Milkfairy Heart Star in reply to Lawrence78]

I don't think anybody with certainty can give you an answer.

Some problems develop overtime, some are transient.

Perhaps be reassured that the staff are taking a belts and braces approach?

[Lawrence78 in reply to Milkfairy]

I had my ECG today, so now waiting on that. I asked the nurse if she could tell me if everything was okay after, she said if anything was wrong they'd probably keep me in. I know my heart rate was up at the time, I presume they can tell if that's a specific issue or just nerves or whatever? Anyway it was all very quick and she said it was okay (I presume she would be able to recognise any issues?) but we'll see what the rapid clinic thinks.

[Milkfairy Heart Star in reply to Lawrence78]

That sounds like a positive step forward.

While you are waiting for your appointment at the Rapid Chest Pain Clinic , it might be worth, keeping a log of your symptoms and write down all the questions you have.

I hope your wait isn't too long.

[Lawrence78 in reply to Milkfairy]

I presume if there had been anything obviously wrong with the ECG they wouldn't have let me go right?

(I didn't have an actual appointment, I just turned up for the ECG as I was told by the rapid clinic to get the ECG within 2 weeks from the time they called me).

[Jack2019]

I can understand what you are feeling, I have experienced the same. Have you ever been tested for seasonal allergies? That what it turned out to be for me, I was prescribed an inhaler to open the lungs and that took care of it. I do remember worrying about what was going on and that raised the anxiety which as you know can tense you up.