Feb 06, 2012 - 7:24 pm (MST)
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Asked by efxmgr (Male; 35; 78731; no major illness. I have had a battle with anxiety for the last couple of years due to my moms death but I
thnk i am getting better at managing it.; Relevant drugs:none )
on Sat 19, Jun 2010 02:34pm for $19.00:

i have been having an ache/discomfort on the left top side of my rib cage feels like its over my heart. I have been having it for a couple months now and I dont know what it could be. i thought i was from sleeping wrong but im asuming it would have gone away by now. i was reading on something that i stumbled upon and read the symptoms for an enlarged heart. i also went to the local drug store and took a blood pressure reading and it said i had prehypertension stage 1. im only 35 years old. Is this possible? What does that mean? My reading was BP-146 DP-89 Pulse rate 72.
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Answer by Dr. A. Srivastava (doctor) on Sun 20, Jun 2010 12:01pm:

Hi, I completely understand your anxiety due to unfortunate departure of your father. I would try to provide you some differentials of the possibilities in your case for which you may require a cardiologist's opinion to confirm and get treated as required. This could be simply due to your anxiety or panic attacks though as a rule of thumb it is best to get cardiac health evaluation by stat ECG recording which may record any abnormalities. During panic or anxiety attacks, patient may feel certain heightened cardiac symptoms like pain, palpitations, trembling, and derealization etc without any organic cardiac causes found during evaluation. This may especially occur whenever a person is emotionally weakened. Staying calm and Anti-anxiety drugs play the main stay role in such anxiety situation (only after ruling out cardiac causes). Though, increased blood pressure to potentially high levels is not a big sign of heart problems as this may even occur due to anxiety also. But, high systolic blood pressure (>140 mm Hg) is called "Systolic hypertension". It may occur due to reduced compliance of aorta with increasing age. In stage 1 hypertension, the crucial elements for control are low sodium diet, whole grains, fruits and vegetables, increased physical activities, avoidance of alcohol and smoking, weight loss in obese individuals can prove beneficial. As you have mildly high levels so above mentioned measures, precautionary consultation with cardiologist and try meditation and other relaxation techniques to reduce anxiety may benefit you. Please don’t become apprehensive by researching a lot upon net as a matter of fact many articles deal with typical and more severe forms of conditions (your case seems more of anxiety related). Therefore, it is recommended to consult a doctor for custom-made answer for your specific case. Hope this helps. Take care and do keep us posted in case of further doubts.
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Comments:

Comment by Dr Ajit Singh on Sun 20, Jun 2010 08:40pm:
Hello efxmar, Welcome to ask medical doctor.com. The most likely possible cause – Anxiety, was very well briefed by Dr.A.Shrivastava. I would like to rule out other possible medical conditions which might be quiet possible. They are APD {Acid peptic disease}, Costochondritis, and Angina or may be any infective lung pathology like Pleuritis. Get an EKG and chest x ray done to rule these conditions. Meanwhile start on with antacids, proton pump inhibitors and non steroidal anti inflammatory drugs. Your high blood pressure is mainly because of anxiety disorder, but never the less have cardiologist opinion for further evaluation and diagnosis, as you may need 2 D Echo also to be done. You can also try meditation and yoga to fight anxiety and elevated blood pressure, with strict salt control. Avoid oily and junk foods. Have a Psychologist opinion it all these fails. Hope this additional information helps you. If any doubts, kindly keep posting. Regards

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