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Treatment for chest pain and tightness - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Have been having chest pressure and tightness (seems as if someone is pulling my chest muscles) on the left side for the last couple of days accompanied with a mild Shortness of breath, which occur at any time of the day and goes away. Have been diagnosed with a myocardial bridge around 6 months back (no blockages) in the LAD and am taking beta blockers for the same.My last stress test was done around 25 days back on 2nd June and was negative for ischemia with excellent exercise tolerance. This was done because I started getting pains on my left jaw. My cardio said at that time it could be anxiety. Sometimes, I do get relief when I take betablockers (bisoprolol) for some time, as if someone has lifted a weight of my chest. What could be the cause of the chest pressure? Is it because of any issues in the heart or could it be because of someother reasons? Also, if not related to heart, why do I get relief with betablockers
Doctor :   Hi
Doctor :   I am Dr.
Doctor :   let me read your query
Doctor :   I need a couple of minutes
User :   Hi,
Doctor :   May I know your age, occupatinn, height and weight?
User :   My age is 41. I am working as a CEO of a company. My height is 5' 7" and weight is 79 kgs.
Doctor :   Ok
Doctor :   As said rightly by your doctor, anxiety can be good reason for the pain or pressure in the chest
Doctor :   Stress test is gold standard to rule out a ischemia of the heart
Doctor :   Betablockers act as antianxiety drugs
Doctor :   Betablockers also have a good property of delaying the cardiac cycle ( myocardial bridge) is treated
Doctor :   tus
Doctor :   Thus
Doctor :   Hello are you tyhere
Doctor :   Did you follow?
User :   I feel really anxious whenever I get chest pressure. A week back, I used to get chest pains on walking. Doc told me it is due to a muscular pain and suggested me to apply either volini or take a combiflam.
Doctor :   Did it get relieved?
Doctor :   by the volini or Combiflam?
User :   How long can muscular pains continue in the chest? Have been having these since last November. As a result of which I had undergone a stress test, 2D Echo and CT Angio. Stress and 2D echo were normal, where as the CT Angio revealed a myocardial bridge in the mid segment of the LAD with significant narrowing of the lumen on systole. Does myocardial bridge cause these pains? What does significant narrowing mean? Is it more than 75% etc.
User :   Volini did give me some relief.
Doctor :   If volini gives relief for the pain, it mostly is musuclar
Doctor :   Muscular pains can be long term and keep bothering the person once in a while
Doctor :   Now coming to the severity of the narrowing
Doctor :   I think this is a question to Cardiologist, Interventional Cardiologist
Doctor :   Myocardial bridging can cause the chest pain
Doctor :   It is pressure like, cannot be pin pointed
Doctor :   It is associated with sweating, increased heart rate
Doctor :   You can ask the questions to a cardiologist on our panel
Doctor :   He is the best person to reply
User :   But, is this really worrisome? My cardiologist, who is an interventional cardiologist says this is nothing to worry as more than 30% people have MB. Also, after looking at the CT Angio he says narrowing is nothing to worry about as most of the blood is supplied during diastole. However, there is some reduction in diastole also.
Doctor :   WWW.WWWW.WW
Doctor :   He is true
Doctor :   MB is in many people
Doctor :   as rightly said, unlike other organs, heart gets blood supply during diastole and its requirements are met during the blood supply during diastole
Doctor :   I am not sure what is critical stenosis in terms of percentages
User :   I had written earlier to the cardiologist on your panel. His response also was the same. Nothing to worry as MB is fairly common and does not cause too much problem.
Doctor :   Ok
Doctor :   Did you try to exercise and is there any loss of exercise capacity?
User :   There is definitely a loss in exercise capacity after I started taking bisoprolol.
Doctor :   ok
User :   I used to walk at around 6.5 kmph on the treadmill. Nowadays, have been able to do around 5.5 kmph only. Also, have been told to reduce the speed.
Doctor :   In terms of time or heart rate
User :   I can walk around 40-45 minutes. My exercise schedule is : 10 mts in my building ground, 20 mts on the treadmill and about 15 mts barefoot on grass. My heart rate goes up to 120 odd in the treadmill. I can see some offshoots for a second or so to around 160 or 180, but have been told this is because the machines are not reliable.
Doctor :   Actually the heart rate that you are going is perfectly normal
Doctor :   How frequent is the pressure in the chest?
Doctor :   I assume that your blood pressure is below 130/85
Doctor :   after 10 minutes of relaxation
User :   I have been feeling pressure in the chest for the last 4 days only. I feel slight heaviness on the chest once it starts. My pressure is normally around 110/70 with a heart rate of 72-73 after 15 minutes of relaxation.
Doctor :   Absolutely fine
Doctor :   Is the pain spread over the left side of the chest or is it pin point?
User :   it is generally on the left side, just around the breast bone or near the center of the chest.
Doctor :   Can you pin point or wide area about your palm size?
User :   Not the size of a palm.
User :   May be size of my fingers around 3-4 inches
User :   with a width of around 3-4 inches also
Doctor :   Ok did you check with a Gastroenterologist in person if this is a problem with the Oesophagus
Doctor :   Less likely but just to be sure
User :   I do have a small hiatal hernia. Had done a endoscopy a year back.
Doctor :   Ok
Doctor :   Is the pain more towards stomach or towards the throat
User :   i also have moderately severe oesophagitis with schatzki's ring.
User :   Pain is more towards the throat.
Doctor :   Do you have problem with swallowing food or chewing food?
User :   no
User :   PAin is rather in the direction of the throat rather than towards the throat.
Doctor :   Relation of pain with respect to the food
User :   Nothing that I have observed.
Doctor :   When was the last time you observed the pain prior to this episode?
User :   This is the first time I felt pressure. But generally been having chest pains off and on. I start feeling shortness of breath when my heart rate climbs beyond 75
Doctor :   As said the chest pressure could be because of MB
User :   my session is ending. I will chat again.
Doctor :   Anxiety
Doctor :   I think the betablockers
Doctor :   are the best
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