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Pain In Chest And Neck. ECG And Blood Test Came Normal. Suffering From Anxiety. Can Arteries Be Blocked?
Question: Hi I've been getting chest pain and pain in my neck for the last couple of weeks. I've been to the ER twice and performed an ECG and blood tests and came back negative. I suffer from anxiety and have been referred to a psych . I'm a 42 year old male that had an angiogram in September 2009 which came back clear. Can arteries block up that quickly? Cheers Doug
Also I train with a personal trainer 4 times a week and the pain doesn't get any worse.
Also I train with a personal trainer 4 times a week and the pain doesn't get any worse.
Hi XXXXXXX Cheers!
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
Obviously, after those visits to ER you know a) the pain is not cardiac. Fact is:
Cardiac pain occurs due to mismatch between demand (of the heart) versus supply (of blood by coronary arteries). Typically pain is of two types one is Angina: It is reversible mismatch in favor of demand, typically by exertion and relief by rest. Pain is XXXXXXX squeezing, retro sternal radiating towards neck and left arm. Associated with rapid heart rate, rapid respiratory rate and sweating is usually associated.In exertional angina it is relieved by rest.
Other type of cardiac pain is that of myocardial infarction or heart attack. One has to XXXXXXX two out of three following criteria:
1. Typical pain as described above unrelated to exertion and usually lasting for more than 30 minutes.
2. EKG changes especially in ST segment suggestive of myocardial ischemia. Or changes occurring and changes called dynamic ST changes.
3. Associated with elevation of myocardial enzymes creatine phosphokinase myocardial fraction CPK-MB, Troponin T & Troponin I and serum myoglobin are various enzymes measured. So, you do not have typical chest pain related to heart.
You have talked about anxiety, I call that stress of Modern Life. Let us review your risk profile for coronary artery disease I will write a list for you, as you have not provided enough input to assess your risk.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, I take them as absent):-
A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension+/-
Smoking+/-
Stress*
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
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*or
Being a Man (as opposed to women) till the age 45*
You have identified few risk factors like stress, being a man and increasing age. We certainly can do something about your anxiety and stress. Please do this yogic exercise for ten minutes twice a day. Some term it as the progressive muscular relaxation which is used for non pharmacological treatment of blood pressure. This has opposite effect to heavy isometric exercise. Additionally, this is a great stress buster. It is called Savasana: corpse pose if literally translated from ancient Yoga Literature, which you can search on the net.
No yoga session is complete without the final pose – Savasana. The body needs this time to understand the new information it has received through practicing yoga. Even though Savasana is a resting pose, it’s not the same thing as going to sleep. You ought to be aware of your surrounding during the five to ten minute duration of final relaxation.
Instructions (as translated from ancient Yoga literature available in different language books: present translation is also available in net):
1. Come to lie down on the back.
2. Let the feet fall out to either side.
3. Bring the arms alongside the body, but slightly separated from the body, and turn the palms to face upwards.
4. Relax the whole body, including the face. Let the body feel heavy.
5. Let the breath occur naturally.
6. To come out, first begin to the deepen the breath. Then move the fingers and toes, awakening the body.
7. Bring the knees into the chest and roll over to one side, keep the eyes closed.
8. Slowly bring yourself back up into a sitting position.
Please write after two weeks how much benefit or lack of it you got from this simple exercise. If you have any query meanwhile you can write a supplementary.
Good Luck.With Best Wishes. One last thing, you are doing good by exercising with a personal trainer. Make me envious.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Thanks for writing in.
I am a qualified and certified cardiologist. I read your question with diligence.
Obviously, after those visits to ER you know a) the pain is not cardiac. Fact is:
Cardiac pain occurs due to mismatch between demand (of the heart) versus supply (of blood by coronary arteries). Typically pain is of two types one is Angina: It is reversible mismatch in favor of demand, typically by exertion and relief by rest. Pain is XXXXXXX squeezing, retro sternal radiating towards neck and left arm. Associated with rapid heart rate, rapid respiratory rate and sweating is usually associated.In exertional angina it is relieved by rest.
Other type of cardiac pain is that of myocardial infarction or heart attack. One has to XXXXXXX two out of three following criteria:
1. Typical pain as described above unrelated to exertion and usually lasting for more than 30 minutes.
2. EKG changes especially in ST segment suggestive of myocardial ischemia. Or changes occurring and changes called dynamic ST changes.
3. Associated with elevation of myocardial enzymes creatine phosphokinase myocardial fraction CPK-MB, Troponin T & Troponin I and serum myoglobin are various enzymes measured. So, you do not have typical chest pain related to heart.
You have talked about anxiety, I call that stress of Modern Life. Let us review your risk profile for coronary artery disease I will write a list for you, as you have not provided enough input to assess your risk.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, I take them as absent):-
A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension+/-
Smoking+/-
Stress*
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
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*or
Being a Man (as opposed to women) till the age 45*
You have identified few risk factors like stress, being a man and increasing age. We certainly can do something about your anxiety and stress. Please do this yogic exercise for ten minutes twice a day. Some term it as the progressive muscular relaxation which is used for non pharmacological treatment of blood pressure. This has opposite effect to heavy isometric exercise. Additionally, this is a great stress buster. It is called Savasana: corpse pose if literally translated from ancient Yoga Literature, which you can search on the net.
No yoga session is complete without the final pose – Savasana. The body needs this time to understand the new information it has received through practicing yoga. Even though Savasana is a resting pose, it’s not the same thing as going to sleep. You ought to be aware of your surrounding during the five to ten minute duration of final relaxation.
Instructions (as translated from ancient Yoga literature available in different language books: present translation is also available in net):
1. Come to lie down on the back.
2. Let the feet fall out to either side.
3. Bring the arms alongside the body, but slightly separated from the body, and turn the palms to face upwards.
4. Relax the whole body, including the face. Let the body feel heavy.
5. Let the breath occur naturally.
6. To come out, first begin to the deepen the breath. Then move the fingers and toes, awakening the body.
7. Bring the knees into the chest and roll over to one side, keep the eyes closed.
8. Slowly bring yourself back up into a sitting position.
Please write after two weeks how much benefit or lack of it you got from this simple exercise. If you have any query meanwhile you can write a supplementary.
Good Luck.With Best Wishes. One last thing, you are doing good by exercising with a personal trainer. Make me envious.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
.
Hi,
I would like to let you know this too. So I am writing again to you.
Yes, I read about your normal coronary angiogram in 2009. With your risk profile it can be confidently said they CANNOT BE 100% BLOCKED suddenly, so have no fear.
Regards,
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
I would like to let you know this too. So I am writing again to you.
Yes, I read about your normal coronary angiogram in 2009. With your risk profile it can be confidently said they CANNOT BE 100% BLOCKED suddenly, so have no fear.
Regards,
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks very much for that information,
It has eased my mind.
Cheers
Doug
It has eased my mind.
Cheers
Doug
Hi XXXXXXX
Thank you for your kind words.
You are welcome pleasure is all mine.
You may close the query now with appropriate comments.
Regards.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Thank you for your kind words.
You are welcome pleasure is all mine.
You may close the query now with appropriate comments.
Regards.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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