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Over weight , chest pain, EKG negative, - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Dear Doctor, i am a 44 yr male ,slightly overweight at 86 kgs, have not had coffee, tea, cigarettes or hard drinks till date, but have sometimes got some pain in the complete chest area which is replicated by pressing on the area which are tender to touch. have a history of cervical sponylytis. have done ecg-have born RBBB, 2d echo with colour doppler normal and had stress EKG dne in 2007 which was negative. My doctor says not to worry as these are more muskuloskeletal pains and not related to heart. I can walk for an hour covering 5.2-5.7 kms and also walk briskly on treadmill but have no crushing pain in the chest or tightness, except that slightly deep breathing as bcos of my wt. I had also done holter test where they founf some pauses but doctor says its asymptomatic since i did not have the usual light headedness/dizziness symptoms etc., Do i still need to fear for artery related blockage and is it so rapid that if it was negative 5 yrs back, it can become blocked more than 50% in 5 yrs and lastly, my sugar and cholestrol, tryglyceride levels are within normal values except that due to excessive eating of sweets due to festivities, the fasting sugar has gone upto 137 whci i am controlling now with no intake and walking for half an hour 5 days a week
Doctor :   Hi
Doctor :   give me couple of mins to read your query.
User :   hi doc, pls go through my details above and answer
Doctor :   I did read your query
Doctor :   can i ask you some relevant questions now?
User :   sure do
Doctor :   ok, may I know your weight?
User :   as i mentioned 86.3 kgs
Doctor :   sorry I mean height
User :   height is 5'6" where ideal wt should be below 71-72kgs max
Doctor :   yes, your aware of it, that is good
Doctor :   I would want to know when was the fasting blood sugar done?
User :   had reduced to 80 kgs but went up as stopped walking due to hip injury for 4 months
User :   fasting sugar done a week back, do it once every two months with accu check active at home
Doctor :   ok
Doctor :   when was the last cholesterol test done
User :   a week back, total was 203, LDL-98, and tryglyceride was 111
Doctor :   ok
Doctor :   fine , may I know if anyone in your family had similar problems ?
Doctor :   any history of diabetes, heart problems, high blood pressure?
Doctor :   are you with me?
User :   father and mother have blood pressure problems and mother additional arrythmia problem--no cardiac related blockage problem only that father now at 83 is on pacemaker as he used to have syncopes and blactout problems-implanted9 yrs back
Doctor :   are you with me?
Doctor :   ok
Doctor :   how is your blood pressure?
User :   yes i sent you an answer
User :   my pressure is usually in band 130/80-86 max
Doctor :   apart from this , any medications you have been taking?
User :   i have no medications as such
Doctor :   ok , i will summarize my opinion to you now
User :   only that had taken atocor about a yr back as suggested by cardiac physician when cholestrol was at 230 but from then on controlled with diet and exercise
Doctor :   since you have had your blood tests and other cardiac tests , which turn out to be normal
Doctor :   you need not fear of any blocks
Doctor :   for now
Doctor :   but since you have some risk factors which includes family history and some cholesterol changes before and a slight increase in fasting blood sugar, you need to be alert now
User :   just a querry- can spondylytis cervical pain radiate to left arm till elbow and along front of chest more towards the collar bone area
Doctor :   I do not see the chest symptoms as angina or related to blocks, I feel it is the uneasiness you have due to the weight gain
Doctor :   yes , it can radiate
User :   also- for knowledge sake- after how much % block does one start gettingangina pains and are they severe
Doctor :   I will suggest that you keep a check on the fasting sugar and post prandial as well
User :   can missed or extra beats give you a higher feeling of heart beat
Doctor :   and if there is sustained increase in sugars in the same range of 137 as well , you need to see doctor for medicines
Doctor :   the pain may or may not manifest , even with severe blocks, some people will not get any pain.
Doctor :   generally more than 50 or 75 percent blocks start with symptoms of shortness of breath, chest discomfort , etc
User :   yes , he too suggested that he will repeat test after a month and then decide with glucomet1mg to start with but doesnt want to give now having slight fear that level might go down too much
Doctor :   I would also suggest you keep a track of blood pressure as well
Doctor :   yes, as i told keep the readings with you
User :   pressure has never gone beyond 140/90 till date even in worst conditions
Doctor :   and then see the doctor , initially some fluctuations in sugar is expected but they do settle down
Doctor :   blood pressure , sugar and cholesterol need regular reviews
Doctor :   atleast every 6 months lipid profile needs a check
Doctor :   120/80
Doctor :   is the pressure we expect to maintain
Doctor :   please try and lose weight
User :   will do so
Doctor :   Im glad your walking daily
Doctor :   control more on your diet
Doctor :   diet and exercise put together will work
Doctor :   this is very important, that you take care of the three risk factors.
Doctor :   if they are wel under control , we can prevent blocks
Doctor :   as your stress test was normal, do not worry much
Doctor :   but if doctor says, even a stress test may be repeated
User :   I am trying all but rate very slow- morning 100 gms sprouted mug, 1 cup milk, 1 apple and an egg occassionally or only two idlis, afternoon one chapati, night one chapati with fish and dal and vegetables try and take in 1500-1700 caloroes max
Doctor :   did you follow my suggestions?
Doctor :   I hope I answered your questions.
Doctor :   you could subscribe for our diet plan
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