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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes sudden chest tightness while playing?

Answered by
Dr.
Dr. Sameer Maheshwari

Cardiologist

Practicing since :2010

Answered : 814 Questions

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Posted on Fri, 4 May 2018 in Hypertension and Heart Disease
Question: i had chest tightness when playing tennis. went to e.r . ekg and echo results were normal/ bp was 150 /85 and troponin was 0.4 then .14 and 8 . ct calcium score is 1, please advice my next steps
doctor
Answered by Dr. Sameer Maheshwari 23 minutes later
Brief Answer:
Can do stress tests

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer cardiologist.
As your echo, ECG and cardiac enzymes are normal & CT calcium score is low your chances of having a coronary blockage is low.
Still i will recommend you to have a stress echo done to rule out possibility of having a future cardiac event. It is a good test with normal report means 85-90% chance that you do not have any blockage and risk of getting it in future is low.
So you can go for that test.
I will be here if you need any further assistance.
Thanks and take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sameer Maheshwari 23 minutes later
Hello Dr XXXXXXX

' As your echo, ECG and cardiac enzymes are normal'

just to clarify cardiac enymes ( tropponin ) was high ( .4 . then .53 and 8.0 ) Please advice. Thanks
doctor
Answered by Dr. Sameer Maheshwari 23 hours later
Brief Answer:
You have a rising Troponin trend

Detailed Answer:
Hi,
Welcome back.
The Troponin results you have quoted is in rising trend ( I am sorry I didn't see that 8 in last).

So Chest pain with positive Trop I is considered as a cardiac event. Echo and ECG can be normal.
Further investigation needed is Coronary Angiography because stress testing is contraindicated in patients with positive Trop I.

Coronary Angiography is a day care procedure and is 100% sensitive for diagnosing any blockage.
Hope this helped.
Thanks & take care
Above answer was peer-reviewed by : Dr. Kampana
doctor
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