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    What causes exertion while climbing stairs despite having normal stress test?

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Posted on Fri, 3 Jun 2016 in Heart Attack
Question: doctor I think I have angina. I had a stress test in january and was given the all clear, but I continue to have symptoms.basically I feel OK until I excert myself. walking up stairs, carrying messages, running for the bus. anytime I excert myself I get ys severe burning pain in stomach it feels like really bad heartburn.gaviscon and other antacids don't talke the burning away.it goes away after several minutes of rest.I asked a cardioligist for an angiogram and he said no. please give advice as I'm really worried
doctor
Answered by Dr. Meriton Siqeca 48 minutes later
Brief Answer:
I also do not think angiogram is necessary

Detailed Answer:
Greetings and welcome to HCM. Thank you for your question. I understand your concern.

If I recall right, I addressed your issue also about five to six months ago.

Especially in young ages, such as yours, angina is very specific and it presents a severe chest heaviness or tenderness which is triggered by exertion, radiated to the jaw, left shoulder and arm, and is discontinued when the exertion is ceased. Therefore, having a negative stress test, also having in mind that the coronary artery disease does not progress in this fast way, I really do not think that this is angina. At a maximum, just to exclude the coronary origin of a problem, another stress test is indicated. I am an interventional cardiologist, and I would also not refer you for a coronary angiogram.

As I recall to have said from our last communication, I think this is a gastric (stomach) problem, which is no more dominated from simple antacids. Maybe a 28-day course of protein pump inhibitors (PPI: omeprazole, esomeprazole) should be tried, to try and supress these symptoms.

I hope to have been of help with my answer. If you have follow-up question(s), I am happy to help.

Kind regards.
Dr. Meriton
Above answer was peer-reviewed by : Dr. Deepak
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Follow up: Dr. Meriton Siqeca 17 minutes later
I have spoken to you before doctor. I am on esomeprazole and a recent endoscope showed esophagitits. I'm just worried that it could be my heart. my stress test in january was checked by a cardioligist when i was there and he said it looked normal.
doctor
Answered by Dr. Meriton Siqeca 1 hour later
Brief Answer:
A negative stress test indicates no coronary artery disease

Detailed Answer:
Hi again and welcome back.

I recall that you had another test at the time we had spoken. Its good that the test was repeated on January. My opinion remains that these are not clues of a coronary artery disease, since the symptoms are not typical. I, personally, would refer you to a coronary angiogram if the symptoms would be typical, regardless the stress test results. Even though you have been on esomeprazole, the endoscopy resulted on oesophagitis. This means that even if it was cured once, it may recur, if you continue to get exposed to caffeine, alcohol, tobacco, grilled and spicy food, pickles etc. Therefore, I think this is not coronary artery disease.

I hope my follow-up answer is helpful.

Regards,
Dr. Meriton
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Answered by
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Dr. Meriton Siqeca

Cardiologist

Practicing since :2009

Answered : 773 Questions

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