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Forum Name: Ischemic Heart Disease

Question: Potential Angina in an otherwise healty 34 y.o. male


 healthsmart - Sun Sep 02, 2007 5:38 pm

Hi, I am 34 years old, and 6 months ago had a gradual onset of chest discomfort (substernal), palpitations and just an overall tightness in my chest. Well, I got a complete workup (EKG, Stress ECHO, regular ECHO, Calcium CT scan (score = 0). My cardiologist could find nothing wrong with me.

My cholesterol is normal, and I do not have hypertension or DM. I do have GERD and I am on Prilosec for this. Both my mom and dad have hypertension and non-insulin dependent diabetes.

Well, I am having those pains again. Mostly on the left side of my chest, but sometimes all throughout my chest. It maily occurs when I am doing nothing, and I admit, I do tend to worry alot and am stressed out. In fact, the other day, I worked out on the treadmill for 15 minutes with no provocation of the symptoms.

My cardiologist 6 months ago cleared me, and told me not to worry about a thing, that it was probably GAD or my acid reflux.

Should I be worried. I mean, I got a full workup 6 months ago, and I now again have these symptoms?
 John Kenyon, CNA - Thu Sep 06, 2007 11:13 pm

User avatar Hello - This sounds like a classic Chicken and the Egg problem. If, indeed, your problem is anxiety-related, is it being cause by anxiety or is it simply producing anxiety? Or is it something else that could be treated, but is happening to someone who is already anxious by nature?

You've had a pretty comprehensive workup and have come out smelling like a rose. The symptoms have returned. Is this a problem? If you see it as one then it is. If it causes you anxiety and limits your enjoyment of life it's a problem. It also could be something totally unrelated to your heart (there's a lot going on inside one's chest). You do have GERD, which could account for some of this, but parts of it also sound like chest wall tenderness due to some inflammatory process. Since you cannot provoke the pain by exercise you have pretty well ruled out, along with the extensive medical workup, the heart as culprit.

That doesn't make it feel any less threatening, though, does it?

It would not be wrong of you to bring this matter to the attention of your GP once again. Perhaps, since it is a rerun now, he/she would be more inclined to explore more obscure causes such as costochondritis or some other non-cardiac cause, and help you to get rid of it or at least get comfortable with it.

You've been good with this. You deserve to be able to enjoy your life without undue anxiety and possibly without this pain as well (although pain alone is a lot easier to deal with than the anxiety is can cause).

Good luck to you.

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