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ECG and BP normal. having bloated stomach, chest cavity and uneasiness, difficult to belch. Is it CAD?

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Practicing since : 1998
Answered : 1257 Questions
Hello Doctor
I am male 53 years
My resting ECG is normal and in past also it used to be normal. i have a echo done about 15 months back and it was normal
I dont have diabetes and my BP remains around 120-130/70-80
I got chest x XXXXXXX yesterday and it was normal
I got lipid profile yesterday and report is as follows:
Total cholesterol 173.2 mg/dl
HDL 35.5 mg/dl
LDL 112.8 mg/dl
VLDL 19.7 mg/dl
triglycerides 98.5 mg/dl
I do 2.5 km morning walk normal speed and 1.5 km walk after dinner. i do some yoga and light stretching exercise too
my height is 5 ft 9 in and weight 66 kgs
i generally remain active but dont do extensive sports or exercise
my work is full of stress and I am type A person from stress point of view
I am in travelling job and have frequent stomach upsets when i eat out regularly or when i eat heavily
i am binge eater and sometime eat as a stress buster. I am a vegeterain
i am a non smoker
i some time feel following symtoms:
a) heaviness and bloating above belly button and upto 2 inch above it
b) feeling of gas trapped in food pipe and difficult to belch
c) heaviness in chest cavity and un easiness
I feel relived by taking Digene and by walking
I am worried if I have CAD and need to go for TMT ot CT angiography test?
please advise

Thanking You

Posted Mon, 27 May 2013 in Hypertension and Heart Disease
Answered by Dr. Sukhvinder Singh 32 minutes later
Thanks for your query to us.

I would like you to clarify further on this issue.
1. When do you get these symptoms? Is it associated with running/ exertion/ using stairs? If they are associated with excessive eating ?
2. How long do they last? If there is variable duration, please write both maximum and minimum duration.
3. Do you feel any other symptoms associated with these complaints like shortness of breath/ sweating/ nausea ?
4. Do they definitely get relieved by walking?
5. Do you get any symptoms during your routine walk or your post dinner walk? Do you ever walk fast/ Run?

I will be glad to detail you on this issue, once I get more details.
Sukhvinder Singh.
Above answer was peer-reviewed by
Follow-up: ECG and BP normal. having bloated stomach, chest cavity and uneasiness, difficult to belch. Is it CAD? 9 hours later
Sir, I reply as follows;
1) These symptoms are common during the days when I have been eating heavily. These symptoms are not there when I eat less and eat non fatty food
2) My office is on 4th fllor. I get down the stairs regularly. sometime i go up the stairs too and i have only liitle high heart beat which becomes OK after some time
3) I dont really know if these symptoms are common after exertion
4) i have no observation on timing. sometime i feel pulptation for few seconds
5) mild shortness of breath. not sure about nausia and sweating
6) symptoms get relieved by morning for sure
7) I have no symptoms what so ever after my routine morning and post dinner walk. Rather I feel much better after walk. I have tried by walking even 4 km at a stretch at a sped of 4 km/hr
looking forward to your adice please
Thanking You
Answered by Dr. Sukhvinder Singh 27 minutes later
Dear Sir
Thanks for the details.

On the face of it, the heaviness in chest and uneasiness seems to be more of non-cardiac origin rather than cardiac origin. A pain which comes at rest (or after meals) but does not come on walking 4 miles or using 4 flight of stairs or on post -dinner walk is more likely to be non-cardiac in origin.
Because a cardiac pain, which is so intense or severe in nature pathologically, that it appears at rest should come at exertion/ walking. The basic mechanism of anginal pain warrants so. However in your case you mentioned that they got relieved on walking.
Symptoms which lasts for few seconds or less than minute are unlikely to be related to anginal heart disease.

My advise is to
1. Discuss these symptoms with a gastroenterologist. Even after his treatment if you do not get relief, you schedule a visit to a cardiologist.
2. Try to stop the binge-eating episodes. Discuss your stress related issues with a clinical psychologist and proceed as per his advise.
3. We do not recommend post meal/ post dinner walk. Ideally it should be on empty stomach and a leisure time activity (No tension/ No mobile phones/ no office discussion).
4. Increase the pace of your walking speed slowly to achieve somewhere near 7 km/hour (achieve this over a period of time may be in next 2-3 months). Aim should be to brisk walk for ~ 45 minutes in whole day. If you feel any symptoms while walking/running/exercising, do consult your cardiologist.
5. Your HDL cholesterol is marginally low but it will increase with exercise.
6. Do not worry much as stress and worries causes a large number of heart attacks in modern world. Yes they can be directly responsible for acute cardiac events.

Feel free to discuss, if there is anything else.
Sukhvinder Singh
Above answer was peer-reviewed by
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