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Chest Pain When I Brisk Walk. ECG,echo Normal. LAD Show Proximal Stenosis. Taking Atorva,Clavix. How To Reduce Pain ?

Posted on Mon, 9 Jul 2012

Question: I am 57 and for the past two years I get pain in the chest (upper left side just below neck) while I do brisk walk. It subsides when I stop walking and also it subsides after walking for about half a mile even if I continue to walk. All my cardio test, ECG, Echo, stress thalium are all normal. I also did a coronary angiogram which has come insignificant as per the report. LAD shows proximal 30% stenosis followed by 40% stenosis in the mid segment Diaogonals normal and LCX - co dominant and shows 20% stenosis in the mid segment.
I also consulted a chest specialist who did a lung function test and was normal. Chest Xray normal.
My cardiologist has prescribed Clavix A 75 mg and Atorva 10 mg for cholestrol. I am also continuing on Amlogard for BP 2.5mg morning and 2.5mg evening. Also recommended I carry Sorbitrate with me. I am not diabetic. My chest specialist also did Vitamin D test which showed deficiency and I am taking 4000 units Vitamin D.
I also have back pain, slip disc for past 12 years. Otherwise I am healthy, 170 lbs and 5'8". I also have mild gastric problem.
Please let me know if there is anything else that would cause this pain and any suggestions.

Answered by Dr. Dr. Prasad J (14 hours later)

Hi,

Thanks for the query.

The details provided in the query are:
1. You been suffering with recurrent chest pain developing upon physical exertion.
2. Coronary angiogram reveals mild to moderate stenosis in the left anterior descending (LAD) and left circumflex coronary artery (LCX).
3. All other studies including nuclear stress test are unremarkable.
4. Chest pathologies are ruled out.
6. History of slip disc and back pain.

Based on the details provided, though coronary angiogram is not very concerning to warrant active intervention like stenting / angioplasty, the clinical presentation can be related to coronary artery disease. So I agree with your cardiologist to continue on antiplatelets (Clavix A) and antilipid (Atorva). Use sorbitrate if the pain recurs.

At this point it is important to maintain a healthy diet and lifestyle. Avoid all physical strain and mental stress. Regulate your blood pressures with proper and regular antihypertensive drugs.

Back pain and gastritis need to be managed independently. More often than not, both back pain and gastritis resolve with proper diet and lifestyle. I am not aware of the severity of slip disc from your query. Discussing with an orthopaedic if the problem is troubling you is suggested.

Hope this answers your query. Let me know if you need any more help.

Wish you good health.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Prasad J (11 hours later)

Thanks Dr XXXXXXX

Can I continue to walk? As I said I get pain for the first half mile and then it subsides. Other exercises like bike, and regular gym training does not give that pain. I think anything that has more pressure on the legs like bike does not give the pain. I will appreciate your thoughts on this.

Thanks

Answered by Dr. Dr. Prasad J (10 hours later)

Hi and thanks again,

There are certain exercise / activities such as brisk walking, climbing, cycling, swimming, treadmill, etc., which increase heart rate. These exercises are known as cardio exercises.

Though cardio exercise have various benefits on health, increased heart rate can precipitate chest pain (angina) by increasing the demand for blood flow. This is the likely explanation for sudden appearance of chest pain.

It is absolutely essential for patients suffering with angina and those having history of coronary heart disease to avoid such exercise. And follow the advice given by your cardiologist.

A healthy lifestyle and proper medication can keep your heart healthy.

Hope I have been helpful with my answers. If you are convinced with my answer and do not have any more queries, kindly close this discussion and rate it.

Wish you good health.

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar