What causes recurring episodes of intense pain in chest with dilated pupils?
Patient: man in  mid 30s, periodic feeling of intense sternal chest pain, like squeezing when this occurs his pupils dialate with each heartbeatbegan appx 2-3 months ago went to ER on one occasion but by the time he got there the episode was overhe related his symptoms but was given something for gastritis none of the symptoms were evident at time he was seenepisodes continue to occur intermittantly, seemingly randomly Doctor: Thanks for your question on Health Care Magic. I can understand your concern. We should first rule out valvular heart diseases like aortic stenosis and aortic regurgitation because both of them causes intermittent severe chest pain and dilatation of pupils with heart beat. So first get done ecg, 2d echo to rule out these valvular heart diseases. If any of these is present than he needs surgical correction of valvular defect. If these reports are normal than sometimes stress and anxiety can cause similar symptoms. So ask him to avoid stress and tension. Don't worry, he will be alright but first rule out valvular heart diseases. Hope I have solved your query. Wishing him good health. Thanks.