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What Causes Chest Pain And Shortness Of Breath?

Posted on Wed, 3 Dec 2014

Question: I have been experiencing chest pains and shortness of breath for almost a week. I've had 3 EKG's done and all are abnormal. The last two were done at the ER and the latest one also shows possible left atrial enlargement along with abnormal T wave while the other two just show abnormal T wave. I have an appointment scheduled with the cardiologist and I think I am driving myself insane. I am 38 years old and rather healthy but I do have a family history of heart issues. Should I be concerned?

Answered by Dr. Praveen (1 hour later)

Brief Answer:
Probably LVH.Nothing to panic.

Detailed Answer:
Hi dear.Thanks for giving me an opportunity to answer your query.

I have thoroughly read your query and completely understand your concerns.I were to suspect thickening of one of the heart chamber(left ventricle) which is responsible for pumping of blood to the rest of the body.Thus it might be due to early stages of left ventricular hypertrophy(LVH) which is the probable reason for ECG changes along with your symptoms of shortness of breath and chest pain.

However since the ECG findings have to be further evaluated I were to do a heart scan(echocardiography) for confirmation and plan further management.

Please donot panic since we have a good number of medications which can control the progression of LVH and can be appropriately managed when detected early.Heart issues need not necessarily be inherited.

I would be glad to know the reason for taking aspirin?Was it prescribed by your doctor?Do you currently take any other medication?
Do you have high blood pressures?
Could you please upload the scans of ECG?

Hope I have answered your query.Please feel free to ask for any further clarifications.

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

Follow up: Dr. Praveen (2 hours later)

Yes the aspirin was prescribed by the ER physician. I do not take any other meds and I di not have high blood pressure. I do have a consistently high heart rate usually between 90-96. It has been that range for years.

Answered by Dr. Praveen (20 minutes later)

Brief Answer:
ECHO as early as possible

Detailed Answer:
Thanks for sharing the information.You may continue the medication as prescribed by your physician.

Advise you to consult our cardiologist and discuss with him to schedule an echocardiography as early as possible.

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

Follow up: Dr. Praveen (4 minutes later)

If it is in fact LVH is it typical to continue to continue to be symptomatic. I don't even know at what point to go to ER anymore because the feeling does not go away. It comes and goes and even when not severe it is always sitting in the background.

Answered by Dr. Praveen (1 hour later)

Brief Answer:
ER when symptoms are troublesome even at rest

Detailed Answer:
Hi dear.

Symptoms of LVH depend on the thickness of ventricle and also on the nature of our activity.When the function of the chamber is compromised it becomes difficult for the heart to push the blood and this results in shortness of breath; when the thickness of the chamber increase there is relative reduction in the blood supply(ischemia) which manifests as chest pain.

Both can be improved by using medications (angiotensin receptor blocker) which not only improve the flow(by decreasing the resistance to blood flow) but also halt the progression of the disease.

Suggest you not to exert yourself and take rest(minimal activity) till you undergo proper evaluation.You may visit the ER when the pain hampers your routine in-spite of being minimally active.Have light meals.Avoid tea/coffee/stimulants.

Take care.Get well.

Note: For further queries related to coronary artery disease and prevention, click here.

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