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Can chest pain, hiatus hernia and nausea be indications of heart problem?

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Cardiologist
Practicing since : 2004
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Hello, i m male 32years old 1.71m 77kg, dont drink or smoke, eat verry healthy since a couple of month, do only light sport (when my symptom allow me too) and as i get unconfortable and quickly out of breath with more intense exercise. I ve been experiencing chest pain since 5 years now and it seems worsen gradually. I generally feel a squeezing pain on the left side just under the breastbone that can radiate to the back, it often wake me up during night and can be felt also many mornings, symptoms last from one to three hours (sometimes more) , during those crisis i feel nauseous, my stomach makes a lot of noise and i force myself to burp a lot as to provide temporary relief to the pressure, my BP is good during episode and i XXXXXXX t have arytmias or fast/ slow beat. I had ecg, echo and stress test and it all came back ok. Got endoscopy which reveled small hiatus hernia and some verry light gastrisis. Lung test ok. Im living a vivid nightmare because of those pain and have horrible nights and morning, sometimes days... Since no stomach medecine seems to provide relief and since according to stomach doctor the endoscopy report doesn t justify all those symptoms , i was wondering if there is still a chance Cardiologist(s) could have missed congestive heart faillure, unstable angina or prinzmetal angina? THANK YOU ps : while some food or big meal can worsen the symptoms, food is not usually the trigger.
Posted Sun, 16 Feb 2014 in Hypertension and Heart Disease
 
 
Answered by Dr. Benard Shehu 1 hour later
Brief Answer: I suggest to run cardiac ct angiography... Detailed Answer: Hi XXXX, I read your query very carefully and understood your concern. Based on the data you provided your pain is atypical for cardiac disease and the cardiac examinations (ECG, ECHO, stress test, Holter) has shown this. The pain is typical for hiatal hernia and gastro esophageal reflux disease GERD. The probability that cardiologist has missed heart failure is zero, because Echocardiography has a high sensitivity and is impossible to miss diagnosis. Meanwhile the possibility that stress test missed diagnosis is very low, so I suggest running cardiac CT angiography which is a more specific noninvasive examination. Hope it answered to your query! Dr. Benard
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Follow-up: Can chest pain, hiatus hernia and nausea be indications of heart problem? 27 hours later
Thank you for the prompt answer, i will try to schedule MRI as i had an allergic reaction to XXXXXXX in the past (related to another problem), is quality of MRI decent enough for CAD?? One last question: out of context and on a range from 0 to 10 for each conditions , what would you estimate the chances an individual suffer from an episode of unstable angina or prinzmetal angina without having any type of rythm or blood pressure disorders during attack? Regards, XXXX.
 
 
Answered by Dr. Benard Shehu 10 hours later
Brief Answer: MRI is decent enough for diagnosing CAD... Detailed Answer: Hi XXXX and thank you for following up. I would like to say that MRI is decent enough for diagnosing CAD. So i recommend to schedule as soon as possible to rule out your concern. The possibility that you have CAD (unstable angina or Prinzmetal angina) without having any type of rhythm or blood pressure disorders during attack is very low and on a range from 0 to 10 I would give 0.5. Hope it answered to your query! Dr. Benard
Above answer was peer-reviewed by
 
Follow-up: Can chest pain, hiatus hernia and nausea be indications of heart problem? 1 hour later
Thank you for your verry precises answers to my concerns. Have a great day!
 
 
Answered by Dr. Benard Shehu 10 minutes later
Brief Answer: Glad to know I was of help! Detailed Answer: Hi XXXX, Very glad to know that my answers were of help to you! Have a great day you too! Dr.Benard
Above answer was peer-reviewed by
 
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