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Suggest treatment for consistent chest pain and dizziness

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Posted on Mon, 18 May 2015
Question: Hi,
I am male, 35 years of age, work as a management consultant. I am having consistent chest pains, mostly on the left side, for last 4 months now. These pains are sporadic, usually of very short duration (ranging from 1/2 mins). The pains mostly come on a few points on the front side of the chest, below arm pit, left upper back. Occasionally (almost 30%) of the times, it comes on the right side as well. Plus i experience dizziness in the morning, sometimes a wheezing sound in my ear (mostly left).

I have done
- Numerous ECGs
- 24 hours Holter
- 2D Echo
- Stress Test
- CT Coronary Angiography
- MRI Brain
- EEG
All of these are normal. NUmerous blood test came normal like
- Lipid Profile
- CBC
- Blood Sugar
- Thyroid.

Only thing is my Vit B12 came very high. That may be because i took an Vit B12 injection a week back before testing.

My question is can this still be a cardiac pain?
doctor
Answered by Dr. Anantharamakrishnan (7 hours later)
Brief Answer:
Cannot be cardiac / normal heart

Detailed Answer:
Hi friend
Welcome to Health Care Magic

This pain CANNOT be cardiac.

     History of the pain is not in favour. Pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on. Your symptoms do not suggest Coronary Artery Disease (CAD).
     Function wise, the pain is not cardiac. Stress test (treadmill Exercise EKG - TMT) is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     Structure wise, the pain is not cardiac. CT angiography is non-invasive study for the anatomy – to see the ANATOMY (structure) – the way to directly ‘see’ the block, if any – and its location, extent, severity and so on.
     Holter has excluded silent ischemia and arrhythmia
ECHO has excluded issues of the valves, chamber walls and established good function

In summary, the pain has nothing to do with heart. It is muscular – from chest wall muscles. This is often due to spasm from posture or stress (Anxiety – Psychosomatic)

You will benefit from seeing an ENT (Ear Nose Throat) specialist - for tinnitus (ringing in the ears). The body's balancing mechanism is in the inner ear.

Good luck
God bless you
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Anantharamakrishnan (11 hours later)
Thank you Dr Anantharamakrishnan for your detailed answer. It helped a lot. Just wanted to clarify

- Can it be due to any blockage else where, like any blood vessel going into any muscles or other parts?

- Can it be due to heart spasms?

Thanks, XXXX
doctor
Answered by Dr. Anantharamakrishnan (16 hours later)
Brief Answer:
No heart spasm

Detailed Answer:
Hi

Heart muscle cannot go into spasm….
There is no blockage elsewhere / MRI has excluded any block in the brain vessels
Ordinary pain relievers and/or muscle relaxants will help, as and when needed.
Forget and enjoy the life / Have hobbies, go out to park or beach / Spend time with friends and family - that will relax....

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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Suggest treatment for consistent chest pain and dizziness

Brief Answer: Cannot be cardiac / normal heart Detailed Answer: Hi friend Welcome to Health Care Magic This pain CANNOT be cardiac. History of the pain is not in favour. Pain from the heart is oppressing, in central chest (and left), worse on effort, relieved by rest, may radiate to shoulders and arms, associated with sweating and so on. Your symptoms do not suggest Coronary Artery Disease (CAD). Function wise, the pain is not cardiac. Stress test (treadmill Exercise EKG - TMT) is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. Structure wise, the pain is not cardiac. CT angiography is non-invasive study for the anatomy – to see the ANATOMY (structure) – the way to directly ‘see’ the block, if any – and its location, extent, severity and so on. Holter has excluded silent ischemia and arrhythmia ECHO has excluded issues of the valves, chamber walls and established good function In summary, the pain has nothing to do with heart. It is muscular – from chest wall muscles. This is often due to spasm from posture or stress (Anxiety – Psychosomatic) You will benefit from seeing an ENT (Ear Nose Throat) specialist - for tinnitus (ringing in the ears). The body's balancing mechanism is in the inner ear. Good luck God bless you