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Forum Name: Cardiology Symptoms

Question: ? unstable angina ?


 carol2007 - Sun Dec 31, 2006 3:49 pm

Hello. I am a female, morbidly obese, and almost 40. I have not been hospitalized before, or had any diagnosed diseases. My last check up was about 3 years ago, and my cholesterol, triglycerides, blood sugar, insulin, and blood pressure were all normal. About 2 weeks ago I began having chest pains, in the center of my chest. Other than a few lighted headed moments (I think more from panic than shortness of breath) my only other symptom was a hollow feeling in my chest, and a tingling. The pain lessened when I moved around or bent over, and increased when I sat down or layed down. After reading several posts here, I got worried that this sounded a lot like unstable angina. The posts I read said the angina is unstable if it comes on quickly and for the first time, and if it gets worse when resting or laying down, and this fits my symptoms.

I was going to go to the emergency room last night, but then last night the pain just went away. I got a feeling of numbness in my chest, and a slight tingling, and a feeling of being full, like I'd just eaten (but I hadn't). I went to sleep without any chest pain, and woke up without it. Over time today though I've felt strange (hard to describe). Slightly light headed (but could be from stress or mild panic), kind of hollow feeling, some tingling in my breasts or center of chest, and a few times a slight pressure pressing down on my chest, with just a few moments of pain here and there, but nothing as bad as before.

Does this sound like unstable angina? If the pain is gone should I not worry, or should I still go on to the emergency room. From what I've read, it could be chest wall pain or pain from chest muscles (I did sit in one position for a couple of weeks before Christmas, working on craft items for school, for several hours each day), or it could be a hundred other things. Any help or advice or information would be greatly appreciated. This has me really scared.
Thank you,
Carol
 John Kenyon, CNA - Tue Jan 02, 2007 12:51 am

User avatar Hello Carol - Last things first: anterior chest pain that is new and suspicious, such as you describe, needs to be evaluated whether it has stopped or not. While this may well not be related to coronary artery disease, it could be. There is no advantage to waiting to see what might happen next.

I do believe you have some good insights into what's going on and that the lightheadedness might well have been due to anxiety; most people experiencing unstable angina will rightly feel some degree of anxiety. If it is only anxiety, perhaps combined with some other, less serious problem, great. But if not, watiing will only make correction of the problem more difficult and add to the risks.

One thing you've described, the fact that the pain lessened when you stood up and/or moved around does not sound like unstable angina, which may begin at rest, but will only become worse with exertion. Also you noted the pain got worse when you sat or lay down. Two rather likely causes of this are a) sliding hiatal hernia and b) an inflammation of the sac enclosing the heart (pericarditis). The latter is painful especially when lying down and is relieved by sitting up and leaning forward.

What seems most likely is anxiety over the possibility of heart disease, combined wth a sliding hiatal hernia, but there is only one way to be certain and that is to have a competent and thorough cardiac workup. I would strongly recommend you have this done at the earliest opportunity and if the pains should return that you get yourself to an emergency department for more prompt evaluation. Even though it sounds more like a non-cardiac problem, there is no way to be certain of that without a hands-on exam. Women are more inclined to have atyipical cardiac presentations anyway, so I would encourage you to put your fears to rest and/or get on the right track to resolving a more serious problem and not wait for it to flare up again.

When in doubt, always err on the side of caution.

Please let us know how things go. Good luck to you.
 Dr. A. Madia - Thu Jan 04, 2007 8:28 am

User avatar Hi Carol,

You definitely do not have unstable angina. So get the thought out of your mind.

Even then you must go to the hospital and get a thorough medical including ECG, Stress test, Echo-Doppler and full blood biochemistry.

A barium swallow or endoscopy to rule out hiatus hernia also in a must.

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