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Comment by MrJagil | Hacker News Reader

One problem with this is that, I, as an individual suffering from anxiety, "regularly" suffer form chest pains.

This often spirals into the terrible cycle of anxiety -> chest pains -> anxiety about the chest pains being a heart attack.

I can only assume that the chest pains will be different and more severe if I should ever have a heart attack.

http://www.calmclinic.com/anxiety/symptoms/chest-pain

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Literally yesterday I treated a patient who has had 4 presentations this year to emergency with chest pain that sounds cardiac enough, except it lasts for several hours sometimes and sometimes she can 'feel it coming on' and heD it off by relaxing. Still, it could always be a heart attack and until a through work up is done to exclude it (acutely, ECG and troponins, as outpatient, stress test), it is worth investigating.

In her case the deeper I delved into her personal life the more it became apparent that this was a clear cut case of stress/anxiety related pain- that was having physical manifestations.

for her, we discussed exactly what you are describing: that anxiety leads to the pain, which then leads to fear about it being a heart attack, which worsens it etc. we went through the work up we had planned and after her second troponin was negative we sent her home to have an outpatient stress test to see if she may have some partial blockages. If that is clear, we as medical personnel feel comfortable knowing that her episodes are non-cardiac in nature- and referral to psychologist for CBT (which she had previously undertaken to good effect) was recommended. I think she will do well, she appears willing to seek help.

I hope you are also seeking help for your anxiety, and that you have had at least one good work up for your chest pain to exclude a cardiac cause.

Amazon has some home ECG monitor device. Do you recommend their use?

I execise regularly. If those device are effective, I would love to use them weekly or monthly on myself and collect the data long term for me and possibly my doctor.

the technology is very simple and very old so without knowing what sort of machines they are (if they are like [1] then they are more for monitoring abberant rhythms than detecting infarcts or ischaemia - it doesn't have enough leads to properly detect a heart attack) they may do an ok job; the real question is of benefit. There is little benefit to be obtained from regular ECG in an otherwise healthy person. You can't/shouldn't perform a home exercise stress test as you need to be in a hospital environment so that you could be resuscitated if things go badly.

For data collection or your own interest, a proper 12 lead ECG is a great reference item; but again if the machine is like [1] you are only going to get this simple trace that doesn't tell you much; even serial ECG's on a normal healthy patient (or even someone with moderate heart disease) will be almost perfectly normal day to day, month to month at rest.

So I would be inclined to suggest that it is a bit of a waste of money from any attempt at home diagnostics, however if you were concerned about your cardiovascular risk you should discuss it with your doctor.

[1] http://www.amazon.com/Medical-Real-Handheld-Portable-Monitor...

Let's say if we can get (build) a proper 12 lead ECG with proper home/protable monitor.

Is there such thing already?

Collect all 12 leads signal via bluetooth connection to a Iphone/Mobile device.

Whenever I do a 30,60 minutes exercise in the GYM, the system will collect all the data and store them in my personal cloud.

Whenever I did annual checkout with my PCP, I will go over the data/chart with him/her and see if there are any abnormalities that might trigger any concerns.

If they spot any potential issue, than we have more info to do proper stress tests in the hospital and lab setting.

Would this kind of device/process be valuable from your ( Doctor's ) point of view?

BTW, I have background in embedded system, cloud backend, and some mobile app, if any doctors think these kind of monitoring devices are useful. I can definitively love partner up working on such project. My mom suffered from heart attack a few years back - so this topic trigger a personal nerve for me.

Reading and ECG is not as easy as it sounds. Without training no a chance in hell it will mean anything to you unless your flat lining and then you won't be reading anything.

I suffer from anxiety and panic and have for years. Just reading this post and your post makes me anxious. The reason being I have seen a Cardiologist and had stress tests but years ago. 2 of them about 9-10 years ago after so many ER visits and then another about 5-6 years ago. All were fine.

EKG's have always been normal as has blood work when I did go to the ER. At my primary care doctor EKG's have also always been normal.

I have been in CBT and getting better but I have to say your post kinda opened a wound. The reason being my primary care doctor says I don't need a stress test and that the prior ones are good enough. She says given my age of 29 and risk factors there's just no reason for it. So far she's been right. Over the last 12 years the hundreds of times I have had chest pain I am not dead yet.

I guess now you have me a tad worried. My primary care doctor and her colleagues have been so convinced at times when I show up with chest pain they don't even think a EKG is necessary.

Hi there. I'm sorry it caused you worry to read what I had written. I was speaking largely in general terms - as I am sure you would be aware discussing medical situations, despite being medically trained, over the internet is not the best way to do things and I would hesitate to tell anyone that it is ok to sit at home and do nothing if they experience chest pain they are concerned about, it should be investigated at least once throughly.

It certainly does sound that if you are known to a cardiologist. have previously had negative stress tests and have had recurrent episodes of the same type of pain with negative ECG's then you have been worked up appropriately to exclude a cardiac cause. Your primary care doctor knows you much better than I ever can over the internet so I defer to their more expert opinion and interpretation of your recurrent presentations. Take solace in the fact that previous investigations have shown the pain to be non-cardiac in origin.

Wow, that's horrible, but I'm also upset you put it on robbiep. It's random advice on an internet thread titled "Just had a heart attack" under a comment "Can someone with some medical experience write about what are exactly the warning signs for a heart attack?".

That sounds like there was more than ample warning about the subject matter. If it's triggering, you might not want to seek it out?

It could be a tense ribcage muscle. If you stretch and the pain changes then it's probably a muscle.

It is that at times. But sometimes not.

I suffered serious anxiety and panic for a couple of years. Called 911 several times, thinking it was a heart attack. My wife, who is a doctor, humored me through these episodes, though she knew what was going on. One day, as I came to her again and proclaimed I was having a heart attack, she said, "You know, if you're standing up, you're pink, and you're telling me you're having a heart attack, you're probably not (having one)." That calmed me down. Over the next year, I learned to "fix" my anxiety, and now only rarely feel a wave of panic coming on, and even then, can get it under control.

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