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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Chest Pain And Tightness Of Chest?

my partner had a weeks history of chest pain and tightness of chest. Initial ECG showed T Wave inversion. The subsequent ECG's reverted to normal. He then had a TMT which again showed a period of T Wave inversion. A CT angiogram and echo were performed, both of which were said to be normal and showed no sign of blockage. Cardiac markers were negative. He is onle 22 very fit and healthy but with a family history of cardiac problems. What do you think is the next step? Thanks
Mon, 8 Sep 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM. In my opinion your friend may suffer from printzmetal angina. It is a variant of angina in which anginal pain is sudden due to coronary spasm. Its etiology is unknown but said to run in family. There is no sure shot diagnostic test for printzmetal angina. It is only clinical diagnosis. And spasm relieved by its on so patient becomes asymptomatic without treatment. So printzmetal angina is just a possibility since your angiography is normal. During attack ecg will shoe t wave inversion and once spasm is relieved inversion also go away.
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What Causes Chest Pain And Tightness Of Chest?

Thanks for your question on HCM. In my opinion your friend may suffer from printzmetal angina. It is a variant of angina in which anginal pain is sudden due to coronary spasm. Its etiology is unknown but said to run in family. There is no sure shot diagnostic test for printzmetal angina. It is only clinical diagnosis. And spasm relieved by its on so patient becomes asymptomatic without treatment. So printzmetal angina is just a possibility since your angiography is normal. During attack ecg will shoe t wave inversion and once spasm is relieved inversion also go away.