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Forum Name: Cardiology Symptoms

Question: Question about chest pain


 wendysease - Tue Dec 21, 2004 1:41 pm

I am a 34 year old obese female. I have lost about 50 pounds within the past year. I started having shortness of breath along with chest discomfort about 6 or 7 months ago. I was sent for a treadmill stress tests and blood work which all came back normal My cholesterol was borderline high being at 217. In July I had surgery for a hernia, and they did a chest ct scan because of a previous chest xray coming back abnormal for something they saw on the lungs. It came back normal, along with normal heart size.
I've had ekg's all normal. The shortness of breath kept bothering me so I got an appointment with a cardiologist in October. He did another ekg, a blood test to check for heart failure, and and echocardiogram. Everything was fine. He said that my heart looked healthly, and that I should live a long time heart wise. Well within the past week I've developed chest pains under my left breast, that sometimes makes my arm cold feeling. The pains are sort of sharp. Also, my neck has been going numb for the past few years. I had a carotid artery ultrasound almost a year ago for that and it came back normal. My question is, can this still be heart related, even though I keep getting back normal results on all tests. My father had a heart blockage that was found through the catherization. Please give me your advice. I hate to go to my family doctor about it because he always says that it's nerves. THanks
 Dr. Yasser Mokhtar - Wed Dec 22, 2004 6:39 pm

User avatar Dear Wendysease,

To consider whether or not the pain that a certain person gets is caused by coronary disease, doctors look at two things. First, the risk factors that this person has for coronary disease and second, the chest pain that the person gets and how typical are its characteristics in comparison to those of the chest pain experienced by patients who have coronary disease.

Regarding you risk factors, you did not mention what is your bad and good cholesterol. You also never mentioned if your dad ever had a heart attack and if so at which age? But i think that you are doing a great job by losing weight.

As to your chest pain, you only mentioned that you have pain under your left breast with some cold sensation in your arm, but you did not mention whether this pain goes anywhere else, how long it lasts, what brings it on, how does it go away, is it associated with any other symptoms?

If a patient has many risk factors for coronary disease and the chst pain is typical then the likelyhood that the pain is due to coronary disease is high and this patient goes to coronary angiography without even the need of going through a stress test.

If the patient has no or minimal risk factors, and the chest pain is atypical as in your case, then the chest pain is not due to coronary disease, and there is no need to even have a stress test because it is going to be negative, you already had a stress test and it was negative.

Obviously, I cannot rule out something as dangerous as a cardiac cause for your chest pain over the internet, but according to your description your chest pain is probably not secondary to coronary disease. Echocardiography can sometimes show other heart causes of atypical chest pain such as a condition known as mitral valve prolapse but your echo was normal.

Can this still be of heart origin? Anything is possible but this probability is extremely low.

Chest pain has so many non-heart related causes.

As regards to your shortness of breath, one very important cause was ruled out which was heart failure, but it has so many causes as well starting from being physically unfit to heart failure.

If you wish to, you can discuss being seen by a lung specialist with your doctor to see whether this shortness of breath is lung related.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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