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Chest Pain After Thyroid Issues: Possible Causes & What to Do


Question
Hi, I know I cannot be diagnosed over the internet and plan on seeing my
doctor if it persists....I am just curious of what could be going on.

Let me preface this by telling you that I have an underactive thyroid that I am
being treated for.  Awhile, I felt like i was having a racing heart . I noticed it
was right around my period. I went for an EKG and they put me on a Holster
or Holter?(I think that is what it's called?)monitor.  The Ekg came back normal
. My monitor showed that my heart raced sometimes but not when I said it
did. Doc said everything was fine. I then switched off generic meds and went
to levoxyl. It did seem to help the racing. I still get it now and then but mildly.  
They also put me on atenolol because they said that should help too.  After
going through the testing..I kind of wondered if I just get some mild anxiety
here and there since it is in my family. What prompted them to test me is I
went to the er with a racing heartbeat .  They did tests in there too and found
nothing. They thought it was due to the allegra I was on and it didn't mix well
with my other meds.

I mention that so you know I have had my heart looked at.   So I have noticed
the past couple mornings when I wake up, I feel like I need to take a deep
breath. I kind of feel like I am not getting enough air. But then it goes away
quickly. I am allergic to many things(cats of which I have two)...but never been
diagnosed with asthma. Two of my three kids have asthma.  This morning I
woke up and felt that same way but this time the center of my chest hurt.  It's
in the center right.   It doesn't really feel like pressure...maybe a little bit. It
feels more crampy.  I got up and had some coffee and it started hurting again.  
I can't really tell what makes it worse. It seems when I move around it hurts
worse. If I reach up, it doesn't hurt, but if I twist I can feel it twang a bit. I
thought it hurt a bit when I breathe in ..but it doesn't seem to be doing that
now. It seems to be more with movement.

I have had bouts of heartburn..I get that once in awhile..but it hasn't been bad
lately..I took some tums just in case and also took some ibuprofen.  I feel ok
otherwise. I do have a bit of a headache..but have had that on and off for a
couple days (due to my period which is normal for me).   My glands in my
neck a tad sore and I do feel like I have some post nasal drip in my throat.

I was wondering if it could be asthma?  A virus?   Could I possible have pulled
a muscle while sleeping? Should I be worried about  a heart issue?  I am 38.

Answer
you have mentioned several appropriate causes throughout your description.

This isn't a heart attack.  (age, risk factors, etc)

Irregular heart beat... possibility.... 24 hour HOLTER monitors are OK but you don't have abnormal rhythms every day and they can be missed.   There are month long event heart monitors.

But first, I would look at the allergy/asthma, and the GERD/reflux possibilities.  

Reflux....  sometimes it takes a while to show improvement....

treatment....  if you are heavy, that makes it more likely.  Cigarettes and alcohol make this problem much worse.  Eat very little after 6pm... you want to go to sleep with a fairly empty stomach.  Elevate the head of the bed a little if you can.... not your head, but your head and shoulders via the mattress, to help gravity keep stomach contents in your stomach when you lay down.  
Take an acid suppressor like Prilosec, once daily on an empty stomach.  It doesn't stop reflux but makes the refluxing stomach contents less caustic.  You may have to do this for a month.

Allergies/asthma.... if the symptoms are not bad enough to feel short of breath or wheeze, then the diagnosis can be made with PFT's, ..... pulmonary function tests.  Having it at night suggests cats (if they sleep in bed with you) or house dust mite allergies... (those ALWAYS sleep in bed with you.)  

The muscle thing or virus should have gone away after a couple weeks max.