In a patient with a history of anxiety and GERD, at what point do you push the idea that the patients symptoms just COULD be cardiac in origin.
Symptoms reported included mild substernal ache with occasional "difficulty taking deep breaths", light headedness, tight sensation around the throat area, and occasional "jaw ache". Patients exercises 3-5 times per week for 1-2 hours at high intensity with no symptoms.
Last 12 lead was normal although intermittent monitoring strips have shown unifocal PVC's. Patient is 38 with normal to low bp and no known other health issues.
Dec 14, '10
not sure if you are a nurse lookin for feedback or a patient looking for feedback. if the latter,please see your health careprovider for a work up. or call your local ems if symptoms warrant it!
Dec 19, '10
In our hospital patients are referred for Echo Stress tests (or nuclear stress tests) for these symptoms but an important risk factor not mentioned for a patient age 38 is family history of heart disease or stroke (<55 years old).
Dec 22, '10
You need to rule out cardiac in this scenario. Denial has killed a lot of people.
What you mention could be nothing, or it could be everything. I work with a guy whose only symptoms were feeling hot and getting dizzy. This happened twice, and on the third occasion he went to the hospital. Within a week he received a triple bypass.
Dec 25, '10
The exercise that this pt does is similar to a stress test, so it's good that they have no symptoms.
And the symptoms that they do have sound just like anxiety.
However, many people have had no symptoms and have had heart attacks. A stress test can evaluate the heart a bit better.
My guess is that the physician assessed this patient and thinks it's all anxiety.
Dec 30, '10
I would need to know a lot more information about the symptoms as that report is rather thin on details. They should go to a cardiologist for evaluation if they are concerned.
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