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Dr. Andrew Rynne

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Have borderline hypertension. Getting chest pain. Medical test normal. Should I consult cardiologist?

DOCTOR OF THE MONTH - Jan 2013
Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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Hi,
I am 55 y/o male, non smoker with borderline hypertension (treated) and no family history of heart disease. For the past month I have felt left-sided chest pain with radiation to left shoulder and sometimes arm. This pain is dull and lasts any where from 30 seconds to 5 min. It occurs mainly during rest and sometimes when I feel stressed. No sob, nausea, nor sweating.
Last week I went to local ER and resting EKG was normal with normal labs and chest x-ray.
An exercise stress test was also normal. They discharged me from the ER and said it was non-cardiac chest pain; however, I worry because the pain keeps coming back.
Should I ask to see a cardiologist and request a CT coronary calcium scan?
Fri, 1 Feb 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Mayank Bhargava 1 hour later
Hi XXXXXXX,
Welcome to XXXXXXX forum.

Presence of heart disease appears to be least with normal EKG and stress test.
Stress test is very specific and any sort of obstruction in coronary arteries may be detected during test.
There may be possibility of non cardiac chest pain (arising from chest muscles, esophagus, neural disorders) and panic attacks.

You should consult with XXXXXXX medicine specialist/ cardiologist and should go for thorough check up.
You should go for coronary angiography and CT coronary calcium score.
CT coronary calcium score gives details of calcium deposition in coronary arteries.
Coronary angiography evaluate the percentage of obstruction in coronary arteries.

If all these investigations are normal then you should consult with XXXXXXX medicine specialist/ psychiatrist for panic attack.
You should take proton pump inhibitors along with muscle relaxants for relief of symptoms.
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava

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