Chest pains in a healthy diabetic

My brother is 34 years old with Type I Diabetes. He is healthy overall and runs/exercises regularly. He's had chest pain now for about 2 months, with changes in severity. He's been to the ER, his family dr, etc. He's had an endoscopy, stress test (scoring in 96th percentile), echocardiogram, CT scan of chest, xray of chest and heart cath. All came back fine. When he was at the ER, he was monitored for a heart attack, which came back negative. Along with the chest pain, he's had pain that radiates to his jaw and shoulder/neck, sweating and weakness. This has taken over his life. He worries about it constantly. The most recent bout ended up with him as a direct admit to the hospital to have all the tests done (ct scan, cath, etc.). The cardiologist determined it is not his heart. If it's not his heart, not a digestive problem either, then what can it be? He is not a hypochondriac by any means and has lived with diabetes since he was 16 years old. But we need to find out what is wrong with him. HELP.

With all the tests done, Coronary artery disease has probably excluded. There are other causes that not only include GE Reflux Disease (GERD), but also Esophageal spasm, which requires specialized testing probably not done in his case (symptoms can be very much like angina).. Another test to consider might be CTCA:

You can read more about chest pains, angina and heart disease here:
A stress test is a good way to test for CAD:
Check here for your risk of developing heart disease:

Hope this helps,
Dr T


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