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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Chest Pain And Functional Heart Murmur

My 16 year old daughter has been experiencing chest pain here and there for the last 8 - 10 months. She was diagnosed with a functional heart murmur after having pneumonia at the age of 8. The chest pain would happened when she was engaged in physical activity - skating, running and power walking. In May she experienced a very severe episode where she suddenly had a stabbing pain in her chest, could not breathe and she felt nauseated. She had been training on previous runs at a distance of 7 - 10 km and this time she did not even make it to 5 km. I took her to see the doctor and she was referred to a Pediatrician.The Pediatrician was worried about how her heart handled stress so she referred her to a Cardiologist. She saw the Cardiologist at the end of August where she had an echo cardiogram and a short EKG. The Cardiologist did not feel that she needed to have a stress test done as he felt it was just respiratory because a couple of the incidents involved a noise maybe a whistle noise with her breathing. Just this week she has had two more episodes but they were different this time. She is a cashier at a grocery store and she went to bend over to pick up an empty milk crate when it suddenly felt like someone had grabbed her whole heart and was squeezing it so hard and it also felt like her heart was no longer beating. She was unable to move until the feeling had gone away. I am not sure exactly how long it lasted - maybe 5 - 10 seconds. A day or two later she was sitting at home watching tv when the pain happened again only this time it felt like someone was just squeezing the bottom portion of her heart. She unfortunately did not inform me until the following day each time so I could not take her into the emergency department to see the doctor to have an EKG done and maybe some blood work. She has an appointment to follow up with the Pediatrician this coming week. She is a very physically active girl. She has figure skated since she was 5, trains for the marathon every year since she was 10 and she participates in miscellaneous sports activities. She is 16, weighs 128 lbs, is 5'4" and has never had any major health problems. She has had the normal cold and flu and she gets the occasional migraine. I have made some inquires in the family histories this fall. My father has a heart condition - his heart skips beats. He is 65 and was diagnosed at the age of 45. My sister has a heart murmur. Heart aneurysms run on my father's side of the family. I am just wondering if you have any ideas or advice for me. Thank you.

Concerned Mother
Mon, 16 Jun 2014
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Critical Care Specialist 's  Response
Hi,
As you have already consulted a Cardiologist, and Echo has already ruled out structural heart disease, and over all her age is 19, too small for Ischaemic heart disease, so in a summary, I also think there are least chances of cardiac chest pain. You must focus on muscular and psychosomatic pains, which is very common in females of this age. Around 8 out of 10 patient of this history that presented use had pain of muscular or psychosomatic origin. Pulmonary causes should be ruled out too.

Feel free to contact, if you have further queries.

Regards
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Suggest Treatment For Chest Pain And Functional Heart Murmur

Hi, As you have already consulted a Cardiologist, and Echo has already ruled out structural heart disease, and over all her age is 19, too small for Ischaemic heart disease, so in a summary, I also think there are least chances of cardiac chest pain. You must focus on muscular and psychosomatic pains, which is very common in females of this age. Around 8 out of 10 patient of this history that presented use had pain of muscular or psychosomatic origin. Pulmonary causes should be ruled out too. Feel free to contact, if you have further queries. Regards