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Chest pain, tests normal, taking Rythmol and Torpor. Concerned about continuing throbbing pain

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Cardiologist, Interventional
Practicing since : 1998
Answered : 410 Questions
I am 65 yr old male- overall good health- exercise regularly- lipid profile- cholesterol 116, hdl 50, LDL 50, triglycerides-80. I have dealt with a fib off and on for 35 yes- I am under control with rythmol and torpor. had a stress echo within past year- results normal, I did 14 minutes with no issues. my question deals with chest pains I have been dealing with for the past 4 months or so. They are not related to exercise at all and there are no other symptoms. They are intermittent and throbbing in nature. I actually went to the er while on vacation back in October and spent 24 hrs- did all kind of tests ( blood, chest X-ray, egos etc)- results all normal- felt it may have been costchronditis. My concern is that they are continuing and I am starting to get concerned- any thoughts would be appreciated.
Posted Sun, 6 May 2012 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 3 hours later
I understand your concern.

Given that angina ( a manifestation of ischemic heart disease which typically presents with chest pain precipitated by exertion) can have an atypical presentation, I think you should be evaluated by a physician who can then repeat a stress echocardiogram or order a computerised tomography coronary angiogram (CT coronary angiogram). These investigations will help us rule out the possibility of ischemic heart disease ( a condition where the blood supply to the heart is reduced either at rest or under exertion).
Further, the possibility of an acid peptic disorder like gastritis needs to be considered. Apart from costochondritis, this would be one of the main possibilities to be ruled out in you. A consultation with a gastroenterologist with possibly an endoscopy and an empiric trial of proton pump inhibitors may be warranted.
I hope I have addressed your concern. I shall be available for follow up queries.

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Follow-up: Chest pain, tests normal, taking Rythmol and Torpor. Concerned about continuing throbbing pain 6 hours later
Thank you for your response-I have considered the possibility of atypical angina but what has steered me away from that thought has been the fact that I work out regularly on a tread mill and push myself pretty hard without ever having any issues-wouldn't that point to non cardiac involvement?
Answered by Dr. Prabhakar C Koregol 1 hour later
Thanks for getting back.

By and large, angina can be ruled out but there are certain types of angina like vasospastic angina which can occur very randomly without any major relation to activity. It would be useful to get this condition ruled out since the treatment of this condition is totally on a different plane.

I hope I have addressed your concern.


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