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Is this chest pain a heart attack?


Green Xenon
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Hi:

 

A 23-year-old slim and athletic patient is admitted to ER with extremely sharp and intense pain localized deep in the middle of his chest. The pain is steady and does not radiate anywhere, it just stay in the middle of his chest. He says it feels like "a knife in my heart". No nausea/vomiting, no shortness of breath, no feeling of chest pressure or tightness. According to patient, the pain started of as barely-noticeable but gradually became excruciating as an hour passed. Type of pain [sharp] and location [middle of chest] remained the same throughout the episode.

 

Upon entry to ER, heart rate is only 35 bpm. Heart beats are very strong and cause patient's chest to vibrate. Pulse is also slow and strong. Blood pressure is 80/50.

 

No family history of any disease. No use of alcohol or illicit drugs. No tobacco use.

 

Diet is high in butter.

 

Is this a heart attack due to the high butter content of the patient's diet?

 

 

Thanks,

 

Green Xenon

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We can't say although the patient's diet is high in buttert and have no history of heart disease, it is impossible for him not to have a heart attack. That chest pain probably a sign that something happening in his heart. So its better for him to go to the heart specialist just to be sure the patient is okay.

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  • 2 weeks later...

I doubt its a full-blown heart attack, but it's probably a heart anomaly of some kind. Maybe partial blockage of an artery, or angina like previously mentioned.

 

Doesn't sound like a panic attack though...

 

So the results came back negative for drugs? Specifically painkillers? Strenuous upper-body exercise and withdrawal from opiates can cause this same effect.

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Wouldn't "middle of the chest, indicate a digestive problem? At 23 yo, how would butter have anything to do with it? Don't know if this describes an anxiety attack, but sure sounds like what I was diagnosed, many years ago, at 21.

 

On an unrelated item, Rush Limbaugh recently thought he had a heart attack, described it on the left side his chest, Any one familiar with muscle tissue breaking loose from the rib cage and the feeling?

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I doubt its a full-blown heart attack, but it's probably a heart anomaly of some kind. Maybe partial blockage of an artery, or angina like previously mentioned.

 

Doesn't sound like a panic attack though...

 

So the results came back negative for drugs? Specifically painkillers? Strenuous upper-body exercise and withdrawal from opiates can cause this same effect.

 

All drug tests [including pain killers] are negative.

 

In addition, the patient has optimum physical fitness in stretch and aerobic exercises.

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  • 3 months later...

Chest pain is a funny thing. There is no way to guess the right answer without at least a basic workup of labs and EKG, and possibly even echocardiogram. An MI in a 23 year old with no medical problems and no drug use is pretty unheard of, but I never say never.

 

In a 23 year old, it could be anxiety, pericardiitis, congenital defect, some sort of toxicity? The drug screen doesn't detect everything either. Maybe he was taking drugs he lied about, or he was given something he didn't know about. Could also be something like dangerously low potassium/sodium or severe dehydration or even overhydration (water intoxication). Could even be musculoskeletal. These are some of the possibilities, but nowhere near a full list of what is going on. What is the family history?

 

Butter has nothing to do with it. What is concerning to me is that his b/p and heartrate are pretty low, he should be admitted for further workup. Even if he is in good health, that heartrate is low even for someone in optimal health at his age.

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Well, as routine a hospital would do tests for heart attack. Elevated levels of troponin remain in the blood for 5-14 days after a heart attack. As well as an ECG, this should be the first port of call.

 

Heart attacks are usually characterised by extreme pressure as well as pain in the chest, which often radiates to the neck and left arm. Although some people only get heart burn type pain.#

 

EDIT: sorry, someone's already pretty much said this.

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  • 2 weeks later...
Hi:

 

A 23-year-old slim and athletic patient is admitted to ER with extremely sharp and intense pain localized deep in the middle of his chest. The pain is steady and does not radiate anywhere, it just stay in the middle of his chest. He says it feels like "a knife in my heart". No nausea/vomiting, no shortness of breath, no feeling of chest pressure or tightness. According to patient, the pain started of as barely-noticeable but gradually became excruciating as an hour passed. Type of pain [sharp] and location [middle of chest] remained the same throughout the episode.

 

Upon entry to ER, heart rate is only 35 bpm. Heart beats are very strong and cause patient's chest to vibrate. Pulse is also slow and strong. Blood pressure is 80/50.

 

No family history of any disease. No use of alcohol or illicit drugs. No tobacco use.

 

Diet is high in butter.

 

Is this a heart attack due to the high butter content of the patient's diet?

 

 

Thanks,

 

Green Xenon

 

this chest pain is not a heart attack. early symptoms of heart attack is dizziness.

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