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What causes moderate to severe chest pains ?

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Practicing since : 2002
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Hello. Femal age 54 5'6" 200lb. normal echocardiogram two weeks ago. no stress test taken. problem with water retention in legs. small mass has been detected in the area of the thyroid. been having chest pains from moderate to severe - pain stretching across the chest and up to the neck. is it possible to have heart disease when echo comes back normal?
Posted Thu, 3 May 2012 in Lung and Chest disorders
Answered by Dr. Robert Galamaga 20 minutes later
Hello and thanks for the query.

I am sure you have been dealing with quite a bit of stress and anxiety in trying to figure out what is the real cost of the symptoms you have been having. Your question regarding echo cardiogram and determination of heart disease is a good one. Let me provide you with some information and reassurance here.

You have had a nickel cardiogram which shows how what well the function of the heart muscle is doing. The echocardiogram does not however show how the small blood vessels of the heart are functioning. Generally when there are blockages in the coronary artery this will lead to abnormalities in the echocardiogram. I would probably bet that you do not have any significant heart disease given the fact that you have had a normal echocardiogram. It might not be a bad idea for you to have a stress test performed at some point in the near future.

Is stress test will help your doctor understand if your heart can pump adequately with an increase in demand which the exercise will create. This is generally down on a treadmill. If you are unable to walk briskly on a treadmill the doctor can do a special test which does not require actual exercise but does require medication which will perform a stress test on your heart when it is given intravenously.

Regarding the symptoms you describe with pain across the chest and into your neck there is another possibility which could be contributed to this. Generally when patients have your Teishen of the lining of the esophagus or even the stomach. It can create symptoms which Maine league one to think it might be a cardiac type of pain when in fact it is a gastrointestinal type of pain. What I would recommend that you do for the time being is a trial of Prilosec which can be a fiend over the counter. I would recommend that you take this twice daily with your meals at breakfast and then dinner and evaluate how your symptoms progress over the next two weeks. If your pain is related to irritation of the stomach or esophagus it will slowly resolve overtime. I am very confident that since you have happy echocardiogram and the results are excellent that you do not have a significant degree of heart disease. I am more inclined to think that your symptoms are related to esophageal reflux.

Again I thank you for submitting your query. I hope my response has been both informative and adequate. If you have additional questions. I am available to address them.


Dr. Robert.
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