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Family history of heart disease. Chest pain, tightness in chest, high cholesterol. Should I take this seriously?

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General & Family Physician
Practicing since : 2001
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I am a 30 yr old female with a stong family history of heart disease. MY dad had his first heart attack at 38 yrs old. I have had high cholesterol for abou 5 to 6 yrs but the doc has never put me on anything. The last 2 days i have had mild chest pain and a sense of tightness in my chest. Since i have alot of anxiety I dont know whether or not to take this seriously. I am 5'6" and 170 pounds.
Posted Wed, 26 Sep 2012 in Hypertension and Heart Disease
Answered by Dr. Michelle Gibson James 1 hour later

There are certain factors which determine a persons risk for heart disease. When calculating the risk using high cholesterol a doctor looks first at whether the person has any evidence of cardiovascular or atherosclerotic disease such as angina, peripheral vascular disease,stroke or aortic anerysm.
The next step involves checking how may risk factors a person has, the risk factors that are considered of primary importance are age more than 55 for a female, heart disease in a male relative before age 55 or a female relative younger than 65, smoking history, HDL levels less than 50 in women, history of hypertension.

So a family history of significant heart disease at age 38 is important.
Chest pain can be related to any of the structures in the chest from the skin inwards.
Simple rashes like herpes zoster on the skin can cause significant chest pain.
Pain can also be related to costochondritis which is inflammation where the ribs XXXXXXX the sternum (the bone in the center of the chest). This tends to be a constant pain though the intensity may vary, it is aggravated by movement of the torso and in some cases breathing. In this condition when the chest is pressed ,it hurts. It is usually treated with anti- inflammatory medication like ibruprofen.
Pain can also result from the lungs in illnesses such as asthma (chest tightness, wheezing, shortness of breath), lung infection such as pneumonia (usually associated with fever,cough, loss of appetite), pleuritis (inflammation of the lining of the lung, associated with infection ,trauma or autoimmune disease.This pain is worse on taking a XXXXXXX breath and treatment depends on the cause )
Anxiety can also cause chest pain, it may also be associated with palpitations and shortness of breath.

Pain can also be related to the heart.It can be due to infection or inflammation of the heart, blockage of blood vessels (angina or heart attack).
Angina is chest pain due to reduced blood supply to the heart.It can feel like a squeezing, pressing pain. The pain is in the central chest, it can also be felt in the shoulders,neck and jaw. It is usually brought on by activity and relieved by rest.

A heart attack or myocardial infarction- it feels like a tight chest pain or a heaviness, it lasts at least 20 mins. Other symptoms are anxiety,nausea, sweating, shortness of breath, palpitations, feeling of impending doom,dizziness

Women tend to seek help later than men and symptoms may actually be a little different. We have typical symptoms or have more nausea, vomiting , fatigue, shortness of breath,abdominal pain,neck and shoulder pain.

Because of your dad's history of heart disease, the fact that you have high cholesterol, it is best that you seek medical attention as soon as you can.It is best that heart disease be ruled out by history, examination and investigations like ECG which looks at the heart rhymth . Blood tests may also be necessary.

I hope this information is helpful
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