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What Causes Chest Pain And Elevated Pulse Reading?

Posted on Thu, 5 Jun 2014

Question: Hi,
I have recently experienced some specific chest pain (located in a specific area of the chest) and it happened after exercising on the treadmill for 40 minutes. I ran 6.5 kms in this time, which is above my usual running range of around 5 kms and also it was a little faster.
My pulse was elevated at about 92-102 beats per minute even a couple of hours after stopping the exercise.
The pain in the chest is also felt when bending over in particular.
Other factors were that I had just got off an 8 hour flight the day before, which may have reduced the body's hydration levels.
Does this chest pain and pulse rate likely signify something wrong with the heart, perhaps some blockage and should it be investigated? Is it possible to suffer a minor heart attack while exercising but not be really aware that it has happened?

Thanks.

Answered by Dr. Benard Shehu (5 hours later)

Brief Answer:
Cardiac tests are needed...

Detailed Answer:
Hi there,

I have gone through your medical history carefully and understood your concerns.

Your pain has 2 characteristics:
- typical for heart problems (triggered by extreme efforts: treadmill, 8 hours flying)
- atypical- not related to heart problems. (localized in the chest and intensified when you bend).

So, the very first thing is to exclude heart problems through running cardiac tests:
- ECG
- cardiac echo
- stress test

If everything is ok, then, could be muscular-skeletal in origin.

Hope it was of help! Do write me back if you need further clarifications!
Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (38 minutes later)

Thanks Dr. Benard,

Just as a precaution I had blood tests and the ECG. The diagnosis was normal ECG and blood tests but muscle strain.

However, I can't understand why the ECG interpretation said that there was suspected left ventricular hypertrophy, probably abnormal ECG.

The only abnormal test was the CK/CPK which was 216 U/L compared to normal range of 38-174. Does this indicate a serious muscle strain or could this reading happen after normal exercise? Could the reading indicate a heart muscle strain?

Thanks.

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer:
Need to run other cardiac tests first...

Detailed Answer:
Hi back,

According to the reports of ECG you did, it might be related to muscle strain.

However, I highly recommend to run the other cardiac tests to get sure you do not have any cardiac issue.

Hope it helped!
Dr.Benard

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Benard Shehu (38 hours later)

Thanks Dr. Benard,

My understanding is that the blood tests indicated the muscle strain and the ECG could not really detect muscle strain.

I have done the stress treadmill and echocardiogram about 2 and a half years ago and they were normal. Should these be repeated again? Also, I am wondering if due to my high cholesterol readings (most recent totals 7.1 and 6.4 total with LDL 4.7 and 4.3) I should consider the CT calcium score test or CT angiogram as well?

Thanks.

Answered by Dr. Benard Shehu (11 hours later)

Brief Answer:
Please refer to the following answer...

Detailed Answer:
Hi back,

Thank you for following up.

As your last ECG was run 2 and half years ago, I think it is time you repeat the ECG and other cardiac examinations now. You should get annually cardiac check ups.

If other cardiac tests would report any abnormality, I advise to run CT calcium score test and CT angiogram. However, should wait for the results first.

Hope it answered to your query!
Dr.Benard

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar