Get your Health question answered in 3 easy steps

187 Doctors Online
Owl Image
MD
Dr. Andrew Rynne

Family Physician

Exp 18 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest remedy for persistent pain in chest

Answered by
Owl Image
Dr. Shailja Puri

Pathologist and Microbiologist

Practicing since :2006

Answered : 7059 Questions

Question
How do I rule out Angina?
Have had chest pain off and on for 3-4 years, Pain is quite concentrated behind breast bone. No sweating or nausea,
3 yrs ago - went to emerg - Troponin levels normal, EKG normal; Stress test - Normal.
1 year ago - still had pain - physician did stress test and Barium swallow. Both Normal, After pain it feels like soreness and scratchiness in my esophagus,
Physician thought it was due to stress.
I retired and went to 2 days a week in January 2014.
The frequency did lessen but I still get the pains.
.
Thu, 14 Aug 2014 in Hypertension and Heart Disease
 
 
Answered by Dr. Shailja Puri 3 hours later
Brief Answer:
Cardiovascular evaluation...

Detailed Answer:
Hello,

Chest pain can occur due to one of the following causes:
1. Ischemia of cardiac muscles- most common cause commonly called angina pectoris.
2. Gastro-esophageal reflux diseases (GERD): In GERD there is relfux of gastric contents into the esophagus. This causes burning sensation and also pain in the chest region which can radiate to shoulders and back.
3. Dissection of aorta: Dissection of aorta is usually an emergency, however, when the dissection is mild or when in its initial stage it can cause just pain in the chest
4. Esophageal causes: Esophagitis in the upper part of esophagus (besides GERD associated esophagitis) e.g. herpes or cytomagalovirus associated esophagitis.
5. Musculoskeletal pain: This can be associated with muscle associated or bone related disease.

Of these causes pain originating from heart condition - ischemia and dissection of aorta are classically reported as severe debilitation pain often associated with breathing difficulty and sweating. If you do not have this classical symptoms it is less likely to be from heart ischemia (angina). However we do not rule out angina pain based on symptoms alone.

Considering you had stress tests, ECG and troponin value as normal, if the pain characteristics hasn't changed from what it was few years ago (before tests), I would not include angina in my differentials now. But if the pain characteristics has changed, you will need to repeat the tests - stress test to assess the current status. Further a MRI of the chest region can also be done to know the status of blood vessels and muscloskeletal system.

Hope this answers your question. If you have more queries, I will be glad to answer.
Dr Shailja P Wahal



Above answer was peer-reviewed by
 
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,  
Lab Tests
Medical Topics ,  

Recent questions on Angina pectoris

doctor1 MD

my husband had a big operation on his ear 16 years ago he has had angina for 6 years just found out that he has had c o p d over the last 2 or 3 yeas and for the last few months his right nostril has been bleeding he has astma and it was his right ear aswell

doctor1 MD

I use Inderal la 80mg for an indefinite period of thirty years. It is now off the market. My doctor pur blokka 40mg prescribed. how many pills should I drink every day. the two weeks that I am on a drug, I m off balance, sometimes feel like I do to myself is not whistling in my ears, dizzy. I feel like I have a lack of oxygen, my heart s rhythm is not normal it time then I feel tired. Inderal la 80mg is prescribed for narrowing of arteries in my brain and heart, angina, migraine, heart rates and blood pressure ranging

doctor1 MD

I am 63, weight around 13stones 12, and usually have normal or slightly low blood pressure but my partner who has diabetes and other problems, used his blood pressure monitor on me earlier and it showed 165/89 and a pulse rate of 66

I will make an appointment with my doctor early next week but am concerned, as I haven't felt well for a long time, I have fibromyalgia and chronic fatigue syndrome and due to personal set up here, sleep during the day and am up all night. I am under a lot of stress both personally and financially and have ocd, I hoard. I cannot get the right help for this but currently having counselling. There is a lot of heart disease in both sides of my family, at least three people on my dad's side have/had pacemakers and my mother died from her third heart attack, and had angina. She became diabetic in her 60s and I am just the same body shape as her, apple shaped. Because of my constant tiredness I can't walk far or exercise but try to eat fairly well with lots of veg and fruit. I do eat the wrong things too but never much salt and I don't smoke or drink. I have been given vit d jabs twice in the last 18 months and have Adcal for the vit d too altho I don't take them every day now as I was concerned about heart problems connected with taking too much calcium.

Should I be worried? Could this be diabetes causing problems?



thanks

Liz W.

doctor1 MD

Hi Dr

I'm a 29 year old female...Recently I've been getting severe cramping on the left side of my chest which is travelling down my left arm & my back in line with my heart. There is a family history of heart disease in my family & most members on my father's side of the family have died due to heart disease. I've been reading on causes, symptoms etc of angina & I do have many of them. Upon having an ecg it read borderline ect with possible right bundle block i think.....& something regarding arterial enlargement sorry I could not be more specific as it now 2.34 am in south africa & i am experiencing this pain....so having been on the internet i came across this site...Is it possible for me to more info before I seek more medical advice as I do not want to worry my family....My mum has high blood pressure also...when i went to the hospital my bp was 176/109 pulse 120..

Any assistance would be highly appreciated.
Regards
Nivada Pillay

doctor1 MD

Is pain under my right shoulder blade likely to be gall stones? YYYY@YYYY

doctor1 MD

I get sharp chest pains that are relieved by burping. Can this be a sign of a heart condition?

doctor1 MD

I have had migraine headaches since I was 12 years old; I am now 65 years old. Everyone in my family has them, both maternal and paternal sides. We can trace them back to my great-grandmother. I have been using Imitrex since it came on the market....