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Suffering from recurrent chest pain. Pregnant. Done with EKG. What could it be?

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I am 29 years old. I am an active and healthy eater. I run, play tennis and do pilates and barre. In April 2011 I had an episode of "chest pain". I had blood work done and ekg and showed nothing. Dr said it was anxiety. I switched doctors and had a treadmill stress test with XXXXXXX injection. It showed nothing. My new doctor thought i might have a murmur so he sent me for an echo. The echo showed my heart healthy, but very slight MVP with slight regurgitation.
All was well and then I had another episode in November 2012 - Christmas 2012. My arm would get tingly and my neck was stiff and tense. I also saw my cardiologist and he did an echo and said if anything my murmur had improved and that the pain i was feeling was not heart related. I was not happy with this answer and went to a different cardiologist for a second opinion and he performed a stress echo. He said my heart looked great and was 99.9% sure my pain was not heart related. So I went to my MD & said he thought it was costrocontritis and a pinched nerve. I went to physical therapy and all seemed well. But then again mid February I was on a ski trip and started to feel the chest pain again. I thought maybe it from a yoga class I had performed the day before. But when we got home I called my md and he said it could be the cochstrocontritis again. He said we couldn't treat bc I am now 5 months pregnant. I tried calling my cardiologist to see if he would run tests, but he said he didn't need to see me because after the test he ran he doesn't think it is my heart. Well this problem is driving me crazy!!!!
Its now April and while my chest doesnt hurt, my upper middle back is hurting and my arms have weird pains in them and my neck is tense and feels strained. Sometimes under my rib I feel almost cramp like- where I want to be able to stretch it out.
What do you think the underlying problem is? I spend everyday on edge just so scared and worried that I am going to have a heart attack. Is there something the cardiologists are missing? Before I got pregnant in end Dec I weighed 120 at 5'2 and had blood pressure 120 or 116/60. My weight now is 128 and BP was 110/50 last appt. My cholesterol was 200 exactly and partly bc my good cholesterol was 85 or 90. Do you think I have a nerve or muscle I keep agitating that sends the weird chest pains and sometimes arm pain and tingling? Is there a better test I could have performed to see if it is my heart? I also went to the ER one night in December 2012 bc I was so worried bc my chest and arm flt weird and they did chest xray and ekg and said everything was normal. Please help. I don't want to suffer this anxiety anymore. It is causing me panic attacks and I don't enjoy the days with my children bc i'm so on edge trying to analyze every little pain or unusual feeling i get.
Now my jaw is hurting. Both sides at the bottom. It make me want to massage them. I haven't had my wisdom teeth taken out, do you think that is the pain in jaws? Or could it be heart related too?
Posted Sun, 28 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 3 hours later
Hi friend,
Welcome to Health Care Magic

You DO NOT seem to have Coronary Artery Disease (CAD).
If one can play tennis and do pilates, there CAN NOT be any significant heart disease!
CAD is very uncommon in women / till menopause...

Your pain does not suggest CAD / Pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on
Your symptoms do not suggest CAD.

Treadmill Exercise Electrocardiogram (TMT) – with XXXXXXX injection (thallium isotope) is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood is arriving at the heart muscle. If it is negative in you, there is NO CAD in you..

[CT angio is non-invasive study for the ANATOMY (structure) – and is done, only when the TMT is positive...
Of course, Catheterisation and coronary angiography is the gold standard for this but it is invasive / and should not be taken lightly / Not done unless there are specific pointers in other tests... You don’t have any leading clues... you don't need it]

Mitral Valve Prolapse (MVP) is often an incidental finding / more common in women / could not account for your symptoms /

X-rays of the spine may help / there could be nerve irritation and/or muscle spasm..but, should not be done, if you are pregnant...

The underlying problem is most likely Anxiety / centred around the heart / it is called Cardiac Neurosis. You may benefit from Psychological counselling...
Yoga – relaxation exercises, in particular – can help...
Beta blockers can help – they have several uses – anxiety, angina, pressure, irregular beats and so on...

Your good cholesterol is high / it protects against heart attack / only blessed people have this!

Relax / Forget it / Enjoy life - you have a long life ahead..

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Suffering from recurrent chest pain. Pregnant. Done with EKG. What could it be? 17 hours later
Thank you for your response. I am trying hard to not worry. Although, currently my upper middle back is hurting and i have on and off pain in my middle to left side of chest. Almost feels like a line that I could trace. I keep trying to punch my finger into the spot. And then sometimes my upper arm from the elbow to top of shoulder will also hurt. Could this be a pinched nerve? Should I go to ER or do I just keep telling myself its okay. Please help me understand why I keep having these symptoms.
Answered by Dr. Anantharamakrishnan 3 hours later

As you say, it sounds like irritation of a nerve root, as it is coming out of the spine...Examination / investigation of the bones of the neck and chest by a bone specialist (orthopaedician) and/or neurologist will solve the issue...

All the best
Above answer was peer-reviewed by
Follow-up: Suffering from recurrent chest pain. Pregnant. Done with EKG. What could it be? 39 minutes later
thank you. Last question for you. What do the tests that i had performed show? If there was a problem with my heart would the tredmill stress test with XXXXXXX the echo and then a stress echo and ekg show signs of problem? Do those tests miss problems? Thanks.
Answered by Dr. Anantharamakrishnan 1 hour later
HOLTER (ambulatory monitoring) shows irregular beats and silent (no symptom) ischemia.
ECHOcardiogram shows the heart valves / heart muscle (Cardiomyopathy) and heart function (Ejection fraction, wall motion abnormality).
TMT (Treadmill exercise ECG) shows Ischemia (reduced blood flow).
LABORATORY sows blood counts, sugar, electrolytes, kidney, and liver function, lipids and so on.

A test may have false positive results, at times... / False negatives are not usual / A single test may rarely mislead / several tests taken together will NOT / and in combination with history and physical examination, nearly foolproof... After all, we don't treat test results- we treat patient, as a whole..

They all together show you DON’T have significant heart problem...
Have a good evening...
Above answer was peer-reviewed by
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