Brief Answer:
Your symptoms don't seem to be cardiac related

Detailed Answer:
Hello XXXXXXX

Thank you for asking on HCM!

I read carefully your question and understand your concern.

Your symptoms don’t seem to be cardiac related. I would exclude possible a coronary artery disease (based also on your previous cardiac tests).

I agree with you that a gastroesophageal reflux, could not be related to chest pain when measuring your blood pressure, so we can exclude this cause.

There are some other issues to take into consideration:

1- High blood pressure: what are your blood pressure values lately? You mentioned “high blood pressure”, but you didn’t report any values.

You should know that high blood pressure can cause chest pain.

I would like to explain what happens when your measure your blood pressure:
The pressure within the cuff is transmitted to the arm itself, and directly to the brachial artery within the arm. When the pressure within the cuff becomes greater than the pressure within the artery, the artery will collapse and blood flow will stop. This is how systolic blood pressure is measured.
In the case of the heart (a similar mechanism) when the systemic blood pressure is elevated (hypertension) that pressure is transmitted back to the cavity of the left ventricle. The increase in pressure is transferred to the heart muscle itself. When the transmitted pressure within the heart wall is great enough, it will cause the small coronary arteries within the muscle, that are branches and smaller in diameter than the surface coronary arteries, to collapse. This way blood flow within the muscle will be reduced and chest pain will result.

This doesn’t mean that you suffer from coronary artery disease. It only explains the mechanism of chest pain related to high blood pressure.

So I recommend monitoring your blood pressure (normally after 10 minutes of ceasing any physical activity). If higher values of blood pressure are I recommend consulting with your GP for the possibility of treating high blood pressure.

2- Your cervico-thoracic spine issue. It is known that the roots of the nerves traveling through the chest and arms lie in the cervico-thoracic spine. A disorder in this level could cause radicular pain irradiating in your arms and chest. This pain is typically exacerbated by physical exercise.
Nerves are like cords, they travel through the limbs and are fixed in some certain bone points or ligaments. When compression is applied in one point (like the arm cuff of the machine), tension is transmitted through all the nerve. So chest pain and back pain can occur, especially when the nerves are already tensed from an underlying spine condition.

I recommend performing a neurological examination and a cervical spine CT scan to exclude this possibility. Nerve conduction studies may be also helpful in this situation.

3. Fluid retention. It can be a cause of chest pain and high blood pressure.
Have you gained weight lately? Are you taking any ibuprofen or other nonsteroidals anti-inflammatory drugs?
Sometimes the overuse of these drugs can cause fluid retention , leading to high blood pressure and chest pain.

I recommend discussing with your doctor on the above possibilities.

Hope to have been of help!

Feel free to ask any other questions, whenever you need.

Best wishes,
Dr. Iliri

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Brief Answer:
I strongly encourage you to follow the recommended diagnostic issues.

Detailed Answer:

Hi XXXX!

As I mentioned above, it is necessary to perform a differential diagnosis of your pain. I know it is a bit confusing the idea of dealing with different aspects of chest pain (to exclude step by step on the round of several recommended tests).

Regarding your weight gain, I would explain that it will not affect too much your blood pressure if your renal function tests result normal.

You should be careful about paroxysmal bouts of hypertension, especially on certain anxious moments (as BP measurement may be).

I would encourage you to follow the above recommended diagnostic issues, as it could bring to a better understanding of your complain.

Wish you a pleasant weekend!

Regards,

Dr.Iliri

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