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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pain In Chest, Heaviness In Chest After Walking, Heaviness In Legs. What Is It And Possible Treatment?

Hi! 34 years male, weight 73 kgs, height 5 10 . For last few weeks have pain in chest , get tired in just little physical work, sweat more than normal, and specially while walking and climbing stairs feel heaviness in chest more with little breathlessness. My pulse rate also on checking is generally above 100 most of the time. Now before this started, I was in tremendous pain in my joints and was taking lots of painkillers. So, sweating and other things i ignored initially thinking maybe after joint pains it is side effects of those medicines. But slowly my symptoms aggravated, with heavy sweating in between. I went to doctor who ordered and ECG & ECHO. The ECG had little changes in lead 3 to which he was not too concerned as ECHO was perfectly normal. He asked me to wait and relax for few days and see If i feel any improvement. Now, even when I use to walk even less than 1/2 KM also, I use to sweat and also feel heaviness in my chest, a Cardic surgeon known to me, asked me for TMT to check. I was unable to do TMT properly as those heaviness and sweating was too much to bear. On consulting an cardiologist in the hospital, the doc said its more or less alright, and my symptoms are not related to cardic issue, but my known cardic surgeon wanted me to do Angio as he felt there are significant changes. Anyways I didn t go for Angio. The doc gave me cholesterol medicine as my level was high other than that no other medicine was given. I started with diet control and little walking but my symptoms are still the same, even after 15 days, infact not if I walk more I get swelling in my souls and legs feel very heavy. I get too tired and have nauseating feel sometimes. My Question is what is that I am having? What should I do? I consulted a senior doc showed him ECG/ECHO?TMT report to which he was slightly concerned on my resting ECG, ECHO he said was perfectly normal, and TMT he said may be false negative but not sure, he asked me to wait for few weeks, and if my symptoms aggravate than I should go for Angiography since my family has history of CAD. What Should i do? Should I immediately go for Angio? Are my symptoms related to Heart or is it panic attack? I don t have BP, Diabetes,I use to smoke and drink earlier but I quit all long back. What should I do, Please help me on this, Thanks in Advance.
Mon, 7 Oct 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

You need to be investigated for Coronary Artery Disease.

     If TMT (Treadmill Exercise ECG) suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. CT angio is non-invasive study for the anatomy. If positive, you will need catheterisation, anyway.

The treating doctor may suggest them depending on need, based on his assessment of the situation.

Take care     
Wishing all well
God bless
Good luck
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Pain In Chest, Heaviness In Chest After Walking, Heaviness In Legs. What Is It And Possible Treatment?

Hi friend, Welcome to Health Care Magic You need to be investigated for Coronary Artery Disease. If TMT (Treadmill Exercise ECG) suggests ischemia, it is an indication for further work up – because at times, there may be false positive or false negatives. The next step is TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. If there is a suggestion, the next step is to see the ANATOMY (structure) – undergo catheterisation and coronary angiography with a view for possible intervention. It is the only way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Coronary arteriography is invasive but it is the gold standard for this. CT angio is non-invasive study for the anatomy. If positive, you will need catheterisation, anyway. The treating doctor may suggest them depending on need, based on his assessment of the situation. Take care Wishing all well God bless Good luck