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Having on and off chest pain. Stress test and chest xray clear. Should I be concerned?

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33 yoa male, off and on chest pain for quite some time with past week being more often. Very mild pain. Had physical for work, stress test and chest X-ray all came back good 6 months ago.. No abnormal breathing, fatigue, sweating, nausea. Any idea or concern I should have?
Posted Thu, 11 Oct 2012 in Hypertension and Heart Disease
Answered by Dr. Anil Grover 2 hours later
Hi there,
Thanks for writing in.
I am a qualified and certified cardiologist and I read your mail with diligence.
TMT negative 6 months ago does have significance however, in the present context it does not exclude you having coronary artery disease. You have a risk factor for coronary artery disease that is hypertension. It is time that you get your profile for whole risk factors done and then let the doctor make a decision about chest pain. Personally, I do not think you have heart attack but there is strong suspicion of mismatch of blood supply to your heart versus the demand. That needs to be excluded, so certainly it is a cause for concern.
At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

Diabetes +/-
Stress* (Hypertension is stress in action!)
Obesity and Sedentary Life Style+/-
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

So you have some risk factors, hypertension is nothing but stress in action. I urge you to see a doctor who will help you complete your profile and make a value judgement. Even cervical spondylosis can cause such pain which has no relation to heart. As heart pain is serious issue we always suspect it and feel happy if we can tell you a definite no. Meanwhile if you have a question for me I will be only too happy to answer. Good Luck.
With Best Wishes.

Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
Follow-up: Having on and off chest pain. Stress test and chest xray clear. Should I be concerned? 20 minutes later
I have noticed that at times when the pain/ discomfort arises, certain movements seem to regenerate the pain. I'm generally am active person as I when I first began to experience this issue, I questionedh PCP which was probably 2 years ago now.. I shall check with my currant pcp to see of he feels I should be sent for further testing.
Also had 12 lead in past month with no abnormalities.
Answered by Dr. Anil Grover 1 hour later
Thanks for writing back.
12 lead EKG a month ago helps in excluding Myocardial Infarction (heart attack) which is not in the consideration at all; we are concerned with angina as a remote possibility (the mismatch I wrote in first email).
However your point pain related to musculo-skeltal movement leads us towards a diagnosis of cervical spondylosis. A rather benign condition when compared to diseases of the heart. I am not suggesting you seek an appointment with a cardiologist what I am stressing is see a general practitioner so that we assess your cardiovascular risk and at the same time find out the cause of this chest pain. Where simple analgesics and (if detected)care for cervical spondylosis will take care of. Good Luck.

Dr Anil Grover
Above answer was peer-reviewed by
Follow-up: Having on and off chest pain. Stress test and chest xray clear. Should I be concerned? 1 hour later
Thanks for the clarification.. And your help
Answered by Dr. Anil Grover 7 hours later
Pleasure is all mine. Thank you for interacting. Please close the query if you may now.


Anil Grover
Above answer was peer-reviewed by
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