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What Is The Cause And Treatment For Chest Discomfort?

Posted on Fri, 7 Feb 2014

Question: Hello, I am a 30 year old male from India. I face occasional chest discomfort for the last 6 months or so more so after eating. I was following few unhealthy lifestyle last few years with very occasional smoking , eatting fatty foods etc. From last year i lead a completely healthy life with 5 km walk every day , healthy eating and sleeping and quit smoking 1.5 years back. I have done 3 ECGs all normal and have done a Stress ECG as well , Stress ECG is absoltely normal as well, No ST Depressions, Blood Pressure Response Normal, No chest pain during exercise, Heart rate response normal , LV Function normal , Negative for Myocardial Ischemia METS of 13.5 . Troponin I is negative, CPK and CKMB is normal, Lipids is 162 Cholestrol, HDL of 39 and LDL of 106 and TGL of 113. Doctor said that there is no need of any Doppler or Angiogram and chest discomfort may be due to IBS. In this situation do you recommend i need any further cardiac testing like Angiogram or 2D Doppler ECg ? Thanks

Answered by Dr. Benard Shehu (49 minutes later)

Brief Answer: Please follow the answer below... Detailed Answer: Hi XXXX I read your query very carefully. Based on your histori and provided data there's little probability of ischemic heart disease. However I recommend to run the following examinations every year: - ECG - Cardiac ECHO - Stress test. Only if the following exams show any signs of induced myocardial ischemia (ischemic heart disease) than you should perform angiogram and /or angiography. Meanwhile I recommend to continue with healthy lifestyle and consulting a gastroenterologist to rule out gastrointestinal problems. Hope I answered to your query. Dr. Benard

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Benard Shehu (7 hours later)

Thanks Dr. Just a followup question. I haven't yet done a Cardiac Echo. Is it necessary to do so. ? My doctor told me it is not as Stress ECG and TMT was strong negative and BP Response and LV function was normal. Kindly refer the report attached Just some other stats I am 6ft tall and weigh around 70 kgs. I never had a problem while exercising but usually sitting or lying down after eating I am presently on medication for IBS and gastric irritations. I want to rule out any cardiac reasons for my chest uneasiness for last 6 months which feels like a pin pricking pain on the centre of chest and on the extreme left side Please advice. Thanks

Answered by Dr. Benard Shehu (3 hours later)

Brief Answer: Your symptoms indicate GI problems... Detailed Answer: Hi, Thank you for following up. I am glad to know that stress test resulted negative for myocardial ischemia. Please bare in mind that stress test is necessary to evaluate the function of the heart. Meanwhile, the cardiac echo is necessary to evaluate the anatomical properties of the heart. To my opinion, your symptoms are indicative for gastric problems. It will take time to be settled; however, within a month of starting stomach medications, you will notice the improvement. It is necessary to conduct a healthy lifestyle and diet regimen for better success together with a consultation with GI specialist. All the best! Dr.Benard

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (1 hour later)

Thanks Dr. Then i am not going for Cardiac Echo tests now. Please advice.

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer: You should do echo to complete cardiac check up... Detailed Answer: Hi again, The cardiac echo is necessary to see if your heart has had any anatomical changes (volume, valvules,etc). So, I recommend to do cardiac ECHO in order to complete cardiac check up. You should also follow the earlier advise on diet and lifestyle changes together with consultation with GI specialist. All the best! Dr.Benard

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Benard Shehu (22 hours later)

Thanks Dr. I will surely do that. In the meantime i have started gastritis medicines like Omeprazole and IBS medicines like Duspatalin Retard and i am feeling much better of my irritative symptoms

Answered by Dr. Benard Shehu (1 hour later)

Brief Answer: Glad you are feeling better.... Detailed Answer: Hi back, Thank you for following up. Glad to know that you are feeling better and I was of help. All the best! Dr.Benard

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

Above answer was peer-reviewed by : Dr. Vaishalee Punj