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Pain in chest radiating to jaw. Endoscopy negative. Family history of heart disease. Concerned

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
good afternoon,
5 years ago i was told i had heart disease following stress test.......11 weeks later i had angiogram....this was negative thanfully.
however since that time i still have a crushing pain in my chest radiating into my comes on intermittently at different times of the day or night....i have recently had an endoscopy,,this was negative,i have been told to take pantoprazole..i still have the pain.
there is family history of heart disease,my mother,my brother and now my sister.
my cholesterol is 4,
thank you ....
Tue, 5 Feb 2013 in Hypertension and Heart Disease
Answered by Dr. Mayank Bhargava 29 minutes later
Welcome to XXXXXXX forum.

There appears to be least possibility of ischemic heart disease (IHD) because of normal coronary angiography.
Although you have positive stress test but normal angiography rules out possibility of IHD.
Considering symptomatology, there appears to be possibilities of prinzmetal's angina (occasional spasm of coronary arteries), muscle ache and pain attacks.

You should consult with XXXXXXX medicine specialist/ cardiologist and should go for thorough check up.
With normal endoscopy, possibility of gastrointestinal pathology also appears to be least.
As you have positive family history, you should take antiplatelets (clopidrogrel/ prasugrel & aspirin).
You should take low dosage of beta blockers, if systolic blood pressure is > 110 mm Hg.

You should also consult with psychiatrist for generalized anxiety disorders & panic attacks.
You should also take selective serotonin reuptake inhibitors (SSRIs).
Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
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