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Pain in the chest while exercising. ECG normal. Suggestions?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
Hello I am a male, 59 years old with a normal ECG just taken a few months ago. I get a prickly pins and needles feeling centered over my heart when I do some vigorous exercise or cleaning tasks but not always. I can jog for 15 minutes with no problems though...
Posted Fri, 4 May 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 19 hours later

Thank you for your query.

I understand, from the details that you have provided, that you are a 59 year old gentleman with hypertension and dyslipidemia and that you have atypical chest discomfort occasionally following strenuous exercise.

Even though your resting ECG is normal, it would be appropriate for you to undergo a stress test to see if there is any likelihood of blockages in your coronary arteries.
The stress test can be in the form of a treadmill exercise ECG test, a stress echo test (exercise or pharmacological), or a nuclear stress test.

If the stress test is positive, you will need a coronary angiogram to guide further management.

If the stress test is negative, it is unlikely that the pain that you are experiencing is of ischemic origin. You will then need to be evaluated for other causes of chest discomfort like musculoskeletal causes, inflammations of the coverings of the heart or lungs, neurologic causes, acid peptic disease, etc. Non-coronary cardiac causes of chest discomfort like left ventricular hypertrophy (due to hypertension), mitral valve prolapse, etc., also need to be considered.

I hope this clarifies your query. Feel free to contact me for any further specific answers.

With regards,
Dr RS Varma
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