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What Causes Chest Pain With Family History Of Heart Disease?
Question: I am 34 year old woman 5'5 with BMI of 34,(although you cant tell). I dont have a family history of heart disease and I have not been diagnosed with high blood pressure or diabetes. I have been having chest pains off and on for the past 3 months. most recently been having abdominal pain and pain on the right side as well. I went to the ER twice EKG normal, chest xray normal and blood work normal. What is causing my chest pains? could I still have heart disease?
Brief Answer:
BMI is quite high
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
My understanding is, based on the information provided above the risk of development of ischemic heart disease in you is a bit low, because you are non-diabetic, non-hypertensive and don't have a positive family history.
However, your BMI is quite high. Have you checked your lipid profile? If yes, please attach the scanned copies of the investigation reports.
I think the pain may be due to functional reason and may be related to anxiety, depression, regional pain syndrome etc.
So, for the time being my recommendations are-
1. Salt restricted (<5g/day), fat restricted (oil<2 tablespoon/day) high fiber diet rich in green leafy vegetables and citrus fruits.
2. Daily exercise or yoga or brisk walking for 30 mins (STOP exercise in case you develop breathing difficulty, unbearable palpitation, black out or chest pain).
3. TMT should be done to rule out ischaemic heart disease.
4. Have relaxation sessions for 30 min./day
5. A vitamin supplement rich in antioxidant and vit. B should be started.
6. You should consult a local psychiatrist to rule out any anxiety, depression or any mental illness.
Hope you are satisfied with my answer. If you have any further query related to this, please write back. Please also attach all investigation reports in any follow up query.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik
BMI is quite high
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
My understanding is, based on the information provided above the risk of development of ischemic heart disease in you is a bit low, because you are non-diabetic, non-hypertensive and don't have a positive family history.
However, your BMI is quite high. Have you checked your lipid profile? If yes, please attach the scanned copies of the investigation reports.
I think the pain may be due to functional reason and may be related to anxiety, depression, regional pain syndrome etc.
So, for the time being my recommendations are-
1. Salt restricted (<5g/day), fat restricted (oil<2 tablespoon/day) high fiber diet rich in green leafy vegetables and citrus fruits.
2. Daily exercise or yoga or brisk walking for 30 mins (STOP exercise in case you develop breathing difficulty, unbearable palpitation, black out or chest pain).
3. TMT should be done to rule out ischaemic heart disease.
4. Have relaxation sessions for 30 min./day
5. A vitamin supplement rich in antioxidant and vit. B should be started.
6. You should consult a local psychiatrist to rule out any anxiety, depression or any mental illness.
Hope you are satisfied with my answer. If you have any further query related to this, please write back. Please also attach all investigation reports in any follow up query.
In case you have any new query in future, you can directly ask me questions @ http://www.HealthcareMagic.com/doctors/dr-kaushik-sarkar/68460. I will try my level best to help you.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for your response. I have attached a few lab reports from my recent visits over the last few months
Brief Answer:
Report not found
Detailed Answer:
Hi, thanks for posting. Unfortunately, I couldn't find any reports attached with your query.
Sorry for your inconvenience.
Please call the customer service of HCM and mail all your reports in the email id specied by them at the earliest tagging my name.
I will definitely reply back as soon as I get them.
Regards,
Dr. Kaushik Sarkar
Report not found
Detailed Answer:
Hi, thanks for posting. Unfortunately, I couldn't find any reports attached with your query.
Sorry for your inconvenience.
Please call the customer service of HCM and mail all your reports in the email id specied by them at the earliest tagging my name.
I will definitely reply back as soon as I get them.
Regards,
Dr. Kaushik Sarkar
Above answer was peer-reviewed by :
Dr. Shanthi.E
Here are a few of my labs from the past few months. As I said, I panicked and been to ER room several times. EKG normal chest exray normal but my mind is saying doctors dont know what they are talking about.
Component Results
Component Standard Range Your Value
WBC 3.5 - 9.9 x(10)3/uL 7.5
Rbc 3.70 - 5.00 x(10)6/uL 4.56
Hemoglobin 12.0 - 15.0 g/dL 12.9
Hematocrit 36.0 - 45.0 % 39.5
Mcv 78.0 - 100.0 fL 86.6
Mch 27.0 - 33.0 pg 28.3
Mchc 32.0 - 36.0 g/dL 32.7
Rdw 11.5 - 14.5 % 13.7
Platelets 150 - 400 x(10)3/uL 277
Mpv 7.4 - 10.4 fL 8.5
% Neutrophils 45.0 - 74.0 % 48.9
% Lymphocytes 15.0 - 44.0 % 40.1
% Monocytes 2.0 - 12.0 % 8.5
% Eosinophils 0.0 - 6.0 % 1.6
% Basophils 0.0 - 2.0 % 0.9
Abs Neutrophils 1.7 - 6.4 x(10)3/uL 3.7
Abs Lymphocytes 1.5 - 3.5 x(10)3/uL 3.0
Abs Monocytes 0.1 - 0.9 x(10)3/uL 0.6
Abs Eosinophils 0.0 - 0.7 x(10)3/uL 0.1
Abs Basophils 0.0 - 0.1 x(10)3/uL 0.1
The above 20 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
Component Results
Component Standard Range Your Value
Creatine Kinase (Ck/Cpk) 38 - 234 U/L 124
Ck-Mb 0.6 - 6.3 ng/mL 0.7
Ck-Mb Index 0.0 - 3.0 % NA
Troponin-I 0.00 - 0.03 ng/mL <0.03
0.03 ng/mL represents the 99th percentile of the upper referencelimit (URL) defined in a population of apparently healthy adultswith no known diseases of the cardiovascular system or otherserious acute or chronic disorders. This Beckman Coulter
Troponinassay demonstrates a total CV <10% at the 99th percentile URL.The above 4 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
lucose 70 - 99 mg/dL 86
Normal (Fasting) 70-99 mg/dlPrediabetes or impaired glucose metabolism (Fasting) 100-125 mg/dlDiabetes Mellitus (Fasting) >125 mg/dl on two occasions.Diabetes Mellitus(Non-fasting)>200 mg/dl with appropriate symptoms
Urea Nitrogen 5 - 26 mg/dL 16
Creatinine 0.44 - 1.10 mg/dL 0.78
Egfr-Nonafrican XXXXXXX 60 - 300 mL/min/1.73m2 >60
Egfr-African XXXXXXX 60 - 300 mL/min/1.73m2 >60
eGFR Reference Range: >60 mL/min/1.73m2
Sodium 135 - 145 mmol/L 138
Potassium 3.5 - 5.1 mmol/L 3.6
Chloride 95 - 110 mmol/L 109
Carbon Dioxide 22 - 32 mmol/L 23
Anion Gap 7 - 16 mmol/L 6
Calcium 8.6 - 10.5 mg/dL 9.2
Protein-Total 6.1 - 8.3 g/dL 7.8
Globulin 2.1 - 4.3 g/dL 3.9
Albumin 3.4 - 5.0 g/dL 3.9
Ast (Sgot) 15 - 45 U/L 24
Alt (Sgpt) 10 - 54 U/L 19
Alkaline Phosphatase 35 - 115 U/L 53
Bilirubin-Total 0.0 - 1.3 mg/dL 0.4
The above 18 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
Component Results
Component Standard Range Your Value
Glucose 70 - 99 mg/dL 99
Normal (Fasting) 70-99 mg/dlPrediabetes or impaired glucose metabolism (Fasting) 100-125 mg/dlDiabetes Mellitus (Fasting) >125 mg/dl on two occasions.Diabetes Mellitus(Non-fasting)>200 mg/dl with appropriate symptoms
Urea Nitrogen 5 - 26 mg/dL 13
Creatinine 0.44 - 1.10 mg/dL 0.78
Egfr-Nonafrican XXXXXXX 60 - 300 mL/min/1.73m2 >60
Egfr-African XXXXXXX 60 - 300 mL/min/1.73m2 >60
eGFR Reference Range: >60 mL/min/1.73m2
Sodium 135 - 145 mmol/L 136
Potassium 3.5 - 5.1 mmol/L 3.5
Chloride 95 - 110 mmol/L 106
Carbon Dioxide 22 - 32 mmol/L 22
Anion Gap 7 - 16 mmol/L 8
Calcium 8.6 - 10.5 mg/dL 9.0
Protein-Total 6.1 - 8.3 g/dL 7.6
Globulin 2.1 - 4.3 g/dL 3.6
Albumin 3.4 - 5.0 g/dL 4.0
Ast (Sgot) 15 - 45 U/L 18
Alt (Sgpt) 10 - 54 U/L 15
Alkaline Phosphatase 35 - 115 U/L 49
Bilirubin-Total 0.0 - 1.3 mg/dL 0.7
The above 18 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
08/07/2014 1:58 AM
Ordered By:
XXXXXXX XXXXXXX MD
Result Status:
Final result
Back to the Test Results List
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Component Results
Component Standard Range Your Value
WBC 3.5 - 9.9 x(10)3/uL 7.5
Rbc 3.70 - 5.00 x(10)6/uL 4.56
Hemoglobin 12.0 - 15.0 g/dL 12.9
Hematocrit 36.0 - 45.0 % 39.5
Mcv 78.0 - 100.0 fL 86.6
Mch 27.0 - 33.0 pg 28.3
Mchc 32.0 - 36.0 g/dL 32.7
Rdw 11.5 - 14.5 % 13.7
Platelets 150 - 400 x(10)3/uL 277
Mpv 7.4 - 10.4 fL 8.5
% Neutrophils 45.0 - 74.0 % 48.9
% Lymphocytes 15.0 - 44.0 % 40.1
% Monocytes 2.0 - 12.0 % 8.5
% Eosinophils 0.0 - 6.0 % 1.6
% Basophils 0.0 - 2.0 % 0.9
Abs Neutrophils 1.7 - 6.4 x(10)3/uL 3.7
Abs Lymphocytes 1.5 - 3.5 x(10)3/uL 3.0
Abs Monocytes 0.1 - 0.9 x(10)3/uL 0.6
Abs Eosinophils 0.0 - 0.7 x(10)3/uL 0.1
Abs Basophils 0.0 - 0.1 x(10)3/uL 0.1
The above 20 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
Component Results
Component Standard Range Your Value
Creatine Kinase (Ck/Cpk) 38 - 234 U/L 124
Ck-Mb 0.6 - 6.3 ng/mL 0.7
Ck-Mb Index 0.0 - 3.0 % NA
Troponin-I 0.00 - 0.03 ng/mL <0.03
0.03 ng/mL represents the 99th percentile of the upper referencelimit (URL) defined in a population of apparently healthy adultswith no known diseases of the cardiovascular system or otherserious acute or chronic disorders. This Beckman Coulter
Troponinassay demonstrates a total CV <10% at the 99th percentile URL.The above 4 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
lucose 70 - 99 mg/dL 86
Normal (Fasting) 70-99 mg/dlPrediabetes or impaired glucose metabolism (Fasting) 100-125 mg/dlDiabetes Mellitus (Fasting) >125 mg/dl on two occasions.Diabetes Mellitus(Non-fasting)>200 mg/dl with appropriate symptoms
Urea Nitrogen 5 - 26 mg/dL 16
Creatinine 0.44 - 1.10 mg/dL 0.78
Egfr-Nonafrican XXXXXXX 60 - 300 mL/min/1.73m2 >60
Egfr-African XXXXXXX 60 - 300 mL/min/1.73m2 >60
eGFR Reference Range: >60 mL/min/1.73m2
Sodium 135 - 145 mmol/L 138
Potassium 3.5 - 5.1 mmol/L 3.6
Chloride 95 - 110 mmol/L 109
Carbon Dioxide 22 - 32 mmol/L 23
Anion Gap 7 - 16 mmol/L 6
Calcium 8.6 - 10.5 mg/dL 9.2
Protein-Total 6.1 - 8.3 g/dL 7.8
Globulin 2.1 - 4.3 g/dL 3.9
Albumin 3.4 - 5.0 g/dL 3.9
Ast (Sgot) 15 - 45 U/L 24
Alt (Sgpt) 10 - 54 U/L 19
Alkaline Phosphatase 35 - 115 U/L 53
Bilirubin-Total 0.0 - 1.3 mg/dL 0.4
The above 18 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
06/26/2014 5:25 PM
Ordered By:
XXXXXXX BENSON, MD
Result Status:
Final result
Component Results
Component Standard Range Your Value
Glucose 70 - 99 mg/dL 99
Normal (Fasting) 70-99 mg/dlPrediabetes or impaired glucose metabolism (Fasting) 100-125 mg/dlDiabetes Mellitus (Fasting) >125 mg/dl on two occasions.Diabetes Mellitus(Non-fasting)>200 mg/dl with appropriate symptoms
Urea Nitrogen 5 - 26 mg/dL 13
Creatinine 0.44 - 1.10 mg/dL 0.78
Egfr-Nonafrican XXXXXXX 60 - 300 mL/min/1.73m2 >60
Egfr-African XXXXXXX 60 - 300 mL/min/1.73m2 >60
eGFR Reference Range: >60 mL/min/1.73m2
Sodium 135 - 145 mmol/L 136
Potassium 3.5 - 5.1 mmol/L 3.5
Chloride 95 - 110 mmol/L 106
Carbon Dioxide 22 - 32 mmol/L 22
Anion Gap 7 - 16 mmol/L 8
Calcium 8.6 - 10.5 mg/dL 9.0
Protein-Total 6.1 - 8.3 g/dL 7.6
Globulin 2.1 - 4.3 g/dL 3.6
Albumin 3.4 - 5.0 g/dL 4.0
Ast (Sgot) 15 - 45 U/L 18
Alt (Sgpt) 10 - 54 U/L 15
Alkaline Phosphatase 35 - 115 U/L 49
Bilirubin-Total 0.0 - 1.3 mg/dL 0.7
The above 18 analytes were performed by JMMC-Walnut Creek Campus1601 YGNACIO VALLEY RD.,WALNUT CREEK,CA 94598
General Information
Collected:
08/07/2014 1:58 AM
Ordered By:
XXXXXXX XXXXXXX MD
Result Status:
Final result
Back to the Test Results List
Back to the Home Page
Brief Answer:
TMT required
Detailed Answer:
Hi, thanks for posting your reports.
Please don't worry. Your reports are absolutely fine. Cardiac enzymes and Baseline ECG are also within normal limit.
So, possibly of a myocardial infarction can be safely excluded.
However, you may undergo Treadmill test (TMT) just to confirm that you are not having an ischaemic heart disease and consequent angina.
If that is excluded, please follow rest of my advices mentioned in the previous answer.
You may also start taking suatained release Levosulpride before breakfast. This would fight any gastroesophageal reflux.
in case you have a normal TMT report, please also start some anti anxiety medication consulting your local physician or psychiatrist.
For any further questions, please write back.
AND PLEASE DON'T WORRY.
Regards,
Dr. Kaushik
TMT required
Detailed Answer:
Hi, thanks for posting your reports.
Please don't worry. Your reports are absolutely fine. Cardiac enzymes and Baseline ECG are also within normal limit.
So, possibly of a myocardial infarction can be safely excluded.
However, you may undergo Treadmill test (TMT) just to confirm that you are not having an ischaemic heart disease and consequent angina.
If that is excluded, please follow rest of my advices mentioned in the previous answer.
You may also start taking suatained release Levosulpride before breakfast. This would fight any gastroesophageal reflux.
in case you have a normal TMT report, please also start some anti anxiety medication consulting your local physician or psychiatrist.
For any further questions, please write back.
AND PLEASE DON'T WORRY.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I scheduled a consultation with a cardiologist for next Tuesday. I am trying to be rational and not worry because I dont think I ever had my cholesterol checked so I don't know if it is high or not and I am a little over weight especially in my belly area after having a baby 20 months ago so I meet 2 risk factors... I dont know whats involved in a stress test but I am fearing the worst
anxiety 34 year old
anxiety 34 year old
Brief Answer:
Walking in treadmil is done
Detailed Answer:
Hi, stress is another name of TMT. You just have to walk in a treadmill and the ECG will be recorded.
Alternatively, Dobutamin stress test may be done after administration of the said medicine.
So, I don't think you need to be anxious at all for these tests.
Your belly area may not be that solely because of obesity. Abdominal muscles become lax after childbirth. Please have a tummytucker and wear the same.
If you are satisfied with my answer please close the thread and rate my answer.
For any further information, please write back.
Regards
Dr. Kaushik
Walking in treadmil is done
Detailed Answer:
Hi, stress is another name of TMT. You just have to walk in a treadmill and the ECG will be recorded.
Alternatively, Dobutamin stress test may be done after administration of the said medicine.
So, I don't think you need to be anxious at all for these tests.
Your belly area may not be that solely because of obesity. Abdominal muscles become lax after childbirth. Please have a tummytucker and wear the same.
If you are satisfied with my answer please close the thread and rate my answer.
For any further information, please write back.
Regards
Dr. Kaushik
Note: For further follow up on digestive issues share your reports here and Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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