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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Persistent Pain In Heart Area, Working In A Job Which Requires Physical Strength. Cause Of Worry?

I am 60 yrs old............work a physical job, getting pain over my heart area...........started at the end of work yesterday and is still persisting today...........last time i got this i went to ER and they couldn t find anything; since went to heart doctor and was told he d see me when i was 90............never lasted this long though. should i be concerned? am going for check up in a few weeks.
Tue, 19 Feb 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

You have not said of any characteristics of the pain – pain from the heart is oppressing, in central chest (and left), worse on effort, may radiate to shoulders and arms, associated with sweating and so on.

     If routine EKG is normal, the next step is stress test – TMT (Treadmill Exercise ECG) / preferably with thallium isotope – will be the ideal way to evaluate ischemia. This is to assess the physiology (function).
     If the test is positive, the next step is to see the anatomy. You may need catheterisation and coronary angiography with a view for possible intervention. Coronary arteriography is invasive but it is the gold standard for this. [CT angio is non-invasive study for the anatomy. If positive, catheterisation is necessary anyway.]

So, see your doctor, as early as possible.

Take care
Wishing speedy recovery
God bless
Good luck
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General & Family Physician Dr. Michelle Gibson James's  Response
Hi, thanks for using healthcare magic

Chest pain can result from problems in any part of the chest- the skin, muscles, bone, lungs ,heart and esophagus.
Cardiac pain is usually central though it can extend to the left side and the neck, tight or heavy sensation, usually brought on by activity and relieved by rest, associated with shortness of breath and palpitations. This occurs most commonly with increasing age, high blood pressure, diabetes,history of smoking, high cholesterol, inactivity.
To determine if the pain is cardiac in origin, you would need an ECG at least and possibly an Echo.
If the pain is constant, worse on movement of the arms and trunk , it may be due to inflammation of the joints in the chest where the ribs meet the sternum. This is called costochondritis and is treated with anti inflammatory pain killers.


I hope this helps
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Persistent Pain In Heart Area, Working In A Job Which Requires Physical Strength. Cause Of Worry?

Hi friend, Welcome to Health Care Magic You have not said of any characteristics of the pain – pain from the heart is oppressing, in central chest (and left), worse on effort, may radiate to shoulders and arms, associated with sweating and so on. If routine EKG is normal, the next step is stress test – TMT (Treadmill Exercise ECG) / preferably with thallium isotope – will be the ideal way to evaluate ischemia. This is to assess the physiology (function). If the test is positive, the next step is to see the anatomy. You may need catheterisation and coronary angiography with a view for possible intervention. Coronary arteriography is invasive but it is the gold standard for this. [CT angio is non-invasive study for the anatomy. If positive, catheterisation is necessary anyway.] So, see your doctor, as early as possible. Take care Wishing speedy recovery God bless Good luck