Chest Pain

Chest pains and GI symptoms

Question: 

Hello, over a month ago I've started having times of significant discomfort with my digestion. They usually occur later in the day and I had several 'attacks' like that during the last month. The 'attack' starts with me feeling extremely tired and faint all this usually follows by one or several bowel movements. The discomfort might last for many hours and I usually feel 'aftershock' for days. About two weeks ago, but after all digestive symptoms started, I had a blood clot in my leg and have been on blood-thinners since then. And now I have some pain and tightness on and off in my chest. I was wondering if this all might be heart related. Could I have a heart-attack while on blood-thinners? What tests should I have to rule out a heart disease? Thank you!

Hi Alex,
I agree with you: your heart needs checking out! Your symptoms are indeed suggestive of angina, independent of your GI complaints. This is what you need to do:

chest pain after a stent

Question: 

my husband is 46 he has had 3 heart attacks and last week he had his 6th stent put in now 2 days ago he told me he feels a pinching in his chestand his right arm and shoulder hurts is this a sign of another heart attack he said every on has been different

Hi Lisa,
With his history, he should be re-evaluated again. His coronary artery disease was not cured with the stents!
Read more here:
http://www.cardiachealth.org/ca-blog/how-long-does-heart-stent-last-do-they-need
http://www.cardiachealth.org/app/
Hope this helps,
Dr T

Esophageal reflux and chest pain

Question: 

I had chest pain in left with some gastric problem.i went to a cardiac doctor and have the ECG .the doctor again carried out a post exercise ECG. He told that the former was not giving clear picture . hence the latter was done which was ok. He have  given esomaprazole tablets. What can be the cause.

Hi Manish,

You are being treated for GERD, but I cannot judge whether that is appropriate or not.
If you are worried you are at risk for heart disease check this link.

Hope this helps,
Dr T

Heart, Chest Pain or something else?

Question: 

Hi Doctor,

37 year old male, 6'0", 220 lbs. No family history of heart disease from anyone under 60.

I've been experiencing various symptoms of chest pain for almost two years. My first issue occurred out of nowhere - after a heavy meal I had chest pain which I shrugged off as indigestion. But it didn't go away and developed into a rapid heartbeat, shortness of breath, dizziness and cold sweat.

After that first episode, various symptoms have continued at irregular intervals. For two weeks following the episode I would have periods of dull/burning pain in the area around my heart, weak heartbeat, weakness and dizziness. Then it would mysteriously go away for several weeks, only to come back and alternate off and on with varying symptoms and intensity.

I saw my GP soon after the first episode and had normal EKG and normal BP. The diagnosis was muscle spasms, which didn't seem like it could be the real problem.

Since then the frequency and intensity have gone down, but when the pain flares up it is still quite intimidating.

I used to exercise regularly, but have recently become a father and haven't had the spare time to visit the gym. I've noticed, however, that symptoms seem to occur at night after I have found an open moment to exercise. I may go two weeks without issues, then find an open afternoon to jog a couple miles, and usually that night or the next I will have the chest pain and symptoms.

It also seems to coincide with spicy food. And I started to get heartburn pretty regularly around the time when I had the first episode last year. After spicy food I may get a burning sensation in my lower ribcage, and a tingling in and around my heart.

And the episodes almost always occur at night when I go to bed, which makes me think it has something to do with lying down.

So I'm not sure what to do. From everything I have been told, I shouldn't worry about it. But it just feels like something is wrong, and I don't want to find out too late.

Would like to hear your thoughts if any of these symptoms and circumstances point to possible conclusions, and if I should seek out a cardiologist on my own since my GP doesn't think it is a problem.

Thanks for your time.

Hi Tom,
Your chest pain symptoms are suggestive of GERD or gallbladder disease, both of which should be excluded.

Chest Heaviness and Left arm pain

Question: 

Dear Dr.
I am a 34 year old man having heaviness & tightness in my left chest towards the left arm. It actually started about a 10 years back not regularly but occassionally when I am too tensed. But from the last 2 years it occurs very frequently and even daily the whole working hours. One thing I have noticed is that it comes whenever I have too pressure in my work or when I am tensed. I do not have problem in my breathing, I do not have problem in doing exercises, walking or even sometimes running. I had undergone ECG check ups and the doctors had said everything is normal. But when the heaviness comes I feel like that my left hand side of chest and arm is going to get paralised or similar to that effect I am getting. It may remains for long hours and sometimes I feel too sleepy. I am worried that if it is related to any hear desease. Please do advice
 

Hi Gireesh,
A cardiac cause of your pain such Coronary Artery Disease has not yet been excluded.

An MI comlicated by AF and congestive heart failure

Question: 

Hi. My husband had his 5th heart attack on the 17th of Sept.
He said this one hurt more than all the others. Do you know what makes that happen? This one was on the back side of the heart if that makes a difference.

During the hosp stay, he was diagnosed with atrial fibrillation and congestive heart failure.

He is on Amiodorone and Lasix. He says every time he takes a deep breath he gets a pain in his chest.
I called his primary Dr and all UI got was "If it gets worse he can go to the hosp otherwise, you have an appt on the 12th (of December)
Can you tell me why he keeps getting the sharp pain? I worry about him.

Hi Joyce,
This sounds like a pleuritic type of pain. This can caused by a lung problem, but also by an inflammation following a heart attack, called Dressler Syndrome.

Whatever the cause, he shouldn't wait to see a doctor, so you must insist, go to a local ER or change to a doctor who is more attentive.

Mitral Valve Prolaspe and High Blood Pressure

Question: 

I was diagnosed with MVP as a child and have had no serious issues except for chest pain recently associated with sternal arthritis. I was just recently put on watch for high blood pressure, would my blood pressure readings be effected by my MVP? I am only 23 and would like to avoid being put on any meds this early in life.

Hi Hallie,
Most people with Mitral valve Prolapse (MVP) have no symptoms, however, those who do commonly complain of symptoms such as fatigue, palpitations, chest pain, anxiety, and migraine headaches.

Coronary Artery Disease on CT coronary angiography

Question: 

Dear sir,

My father is 74 years old, and experied some chest pain along with pain in left arm and jaw some 20 days back.we got a CT coronory angiography done for him and following results were found:
Calcium score: 2370
Dominant artery : RCA
LEFT MAIN ARTERY:Eccentric calcific plaques are seen in LMA not causing any significant focal luminal narrowing.

LAD: There is diffuse disease inproximal and mid LAD with multiple eccentric and concentric calcific and mixed plaques. Exact luminal assessment is difficult due to partial luminal obscuration and blooming artefacts of calcific plaques, however there appears to be significant 70 - 80% FOCAL LUMINAL STENOSIS in LAD at entry level of D1 origin.
Long segment myocardinal bridging is seen in distal LAD
Diffuse disease inD1 vessel with multiple calcific and mixed paques.D2 is small in calibre and normal.

LCA:There is a diffuse disease with multiple calcific plaques in proximal,mid and distal LCX 30 - 40% focal luminal narrowing

RCA: origin is normal. Diffuse disease in RCA and PDA through out its course with multiple eccentric calcific and mixed plaques.Approx 50 - 60% focal luminal narrowing in distal RCA and significant focal luminal in proximal PDA.

Kindly suggest how critical the situation is and can it be rectified with just medicines, because he does not want any invasive procedure.

Hi Tina,
These results show how far CT coronory angiography has come in diagnosing Coronary Artery Disease (CAD)! Your father has significant CAD, but treatment will depend on symptoms and other findings that requires further evaluation, including a stress test:

Chest pain and risk of coronary artery disease, Prinzmetal's angina

Question: 

I have been experiencing chest pain for several years. Went to the ER in 2006 with this pain. They admitted me because my EKG was abnormal but said that enzymes were normal. They first told me I was having an acute heart attack before doing the tests. Had a heart cath and it was negative for blockage. When I received copies of the hospital reports it was indicated that I had Angina. They didn't put me on any meds for that. I have had recurring pain since then. It usually starts in my right jaw, radiates to the neck and then to the chest and arm. I recently had another stress test, pulmonary function test and chest xrays. Still, no indication of heart problems except for the angina. This pain happens at various times, whether I am active, sitting, sleeping and especially happens if I get upset. The pain is relieved with nitroglycerin tabs. I really need answers. Is it simply Angina?

Angina is caused by insufficient blood supply to your heart, usually because of blockages in your coronary arteries. If you don't have blockages, you don't have angina!

However, there is a condition called Prinzmetal's angina, caused by coronary artery spasm. Prinzmetal’s angina is often diagnosed with an ECG (electrocardiogram or EKG) during an episode of chest pain.

Left side pain (shoulder blade, going into arm pit and chest)

Question: 

I had a miscarriage about 2 months ago, I spent 6 days in hospital as I was really poorly. I had chest tightness and shortness of breath, the did and ecg, radio active x ray, lung x ray all of which were clear. I'm still getting the same symptoms, including shoulder pain going into armpit and chest on the left side. I do suffer from a tremor could my pains be anxiety, muscle stress related. I'm really worried its a heart problem, I also get a tension feeling going up onto my jaw and forearm/wrist. I would really appricate some advice.

Chest pain has many causes, but the one that concerns me in your case is the possibility of pulmonary embolism:
http://www.cardiachealth.org/chest-pain
http://www.cardiachealth.org/chest-pain-symptoms-your-lungs
http://www.cardiachealth.org/lung-embolism

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