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What Do Burning And Breathlessness During Strenuous Activity With Coronary Stents Placed Indicate?
Question: I have GERD as well as Coronary Artery Disease, I have had 2 coronary stents placed in the past. I get burning in mid chest whenever I start an activity, I also get Short of breath. If I take a sublingual NTG and rest for a few minutes the burning and SOB soon stops. I then can continue activity slowly. This has been going on for over one year. My doctors do know about it and have said it is not heart pain. What do you think it is?
Thanks, XXXXXXX Morar
Thanks, XXXXXXX Morar
Brief Answer:
History is suggestive of cardiac involvement.
Detailed Answer:
Hello Dear,
Thanks for choosing HealthcareMagic for your query.
I've gone through your details and I appreciate your concerns.
See thumb rule is that any pain responding to nitrates is angina unless proved otherwise.
Cardiac and gastric cause of chest pain often mimics each other however the immediate response to pain with nitrate is seen in the cardiac origin of chest pain only.
Pain due to gastritis or acid peptic disorder usually never responds to nitrates or rest rather it is relieved on taking antacids or proton pump inhibitor.
Your history is clearly suggestive of angina. Classical angina is a pain heaviness or burning sensation relieved by resting or using nitrates.
Few tests suggested are-
Stress thallium- As you are a post stent case stress thallium is best non-invasive scan for you. The sensitivity of this test is almost above 99%.
Cardiac cases are emergency cases while GERD is a chronic condition which usually never causes an emergency situation. Therefore initially rule out the functions of the heart. If stress thallium is normal treatment would be done on lines of GERD.
How does your cardiologist say that its non-cardiac despite having such classical signs?
Please also let me know what all tests were done by him to see the patency of stents?
Awaiting the details.
Regards!
History is suggestive of cardiac involvement.
Detailed Answer:
Hello Dear,
Thanks for choosing HealthcareMagic for your query.
I've gone through your details and I appreciate your concerns.
See thumb rule is that any pain responding to nitrates is angina unless proved otherwise.
Cardiac and gastric cause of chest pain often mimics each other however the immediate response to pain with nitrate is seen in the cardiac origin of chest pain only.
Pain due to gastritis or acid peptic disorder usually never responds to nitrates or rest rather it is relieved on taking antacids or proton pump inhibitor.
Your history is clearly suggestive of angina. Classical angina is a pain heaviness or burning sensation relieved by resting or using nitrates.
Few tests suggested are-
Stress thallium- As you are a post stent case stress thallium is best non-invasive scan for you. The sensitivity of this test is almost above 99%.
Cardiac cases are emergency cases while GERD is a chronic condition which usually never causes an emergency situation. Therefore initially rule out the functions of the heart. If stress thallium is normal treatment would be done on lines of GERD.
How does your cardiologist say that its non-cardiac despite having such classical signs?
Please also let me know what all tests were done by him to see the patency of stents?
Awaiting the details.
Regards!
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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