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Forum Name: Ischemic Heart Disease

Question: Chest sore


 lmllml - Sun Jan 02, 2005 6:32 pm

I am a 31 yr old male. My father died of a heart attack at the age of 53. He had hypertension since mid 20's, diabetes, smoked from age 13, did not eat right, was overweight. I do not smoke, no diabetes, I run 3-4 miles 6 days per week. I weigh 222 lbs and am 6'2. I know that I need to lose weight. My blood pressure is normally 124/80 or so. Total cholesterol is less than 120 with hdl at 38. My question is, I have been having some chest discomfort for about 6 wks. I would not describe it as pain, more like an anxious feeling in my chest that is uncomfortable. It will last for 5-10 minutes and go away. Is more acute for 3 hrs or so after I eat. It seems to be worse at night. I went to the hospital last week as got that same kind of discomfort about 30 minutes after a 40 minute run. At the ER they took chest xray and ran resting ekg, all were normal. I followed up the my PCP the next day, He says that my C Reactive Protein is elevated but did not tell me exactly what number was. He is sending me to a cardiologist for possible stress echo. I also have had a panic attack 6 wks ago, these chest pains started after that experience when I thought that I was going to die. My chest felt tight although I had no radiating pain or shortness of breath. I had another panic attack last night that was similiar in nature. My chest was sore for a couple of hours after that. Is all of this likely cardiac related or could it be related to panic disorder? Also, if my dad had a heart attack prior to age 55 am I incredibly more likely to have one? How can you tell the difference between chest pain associated with a panic attack and chest pain associated with a heart attack?
 Dr. Yasser Mokhtar - Mon Jan 03, 2005 10:06 am

User avatar Dear Lance,

A family history of coronary disease is something that can not be changed and it is a risk factor for coronary disease and this means you have a higher chance of having coronary disease more than the poplulation with no family history of coronary disease everything else equal.

To determine whether or not chest pain is caused by coronary disease, risk factors for coronary disease for the person having chest pain and the characteristics of chest pain (as compared to the typical characteristics of chest pain orginitating from coronary disease) are evaluated and then it is determined whether this chest pain is or is not of coronary origin.

You are a male with a family history of coronary disease, these are your risk factors. No smoking, hypertension, diabetes or high cholesterol. You are a bit overweight but you exercise quite a lot which is a good thing.

Regarding your chest pain, it sounds kind of atypical.

Putting also in mind the normal ekg when you had chest discomfort after the run, i think that this is not related to coronary disease, but because you are a young and active peron and you get panic attacks (just to make things more confusing) and to put your mind to ease, i think that it is best to be seen by a cardiologist for an evaluation as your doctor suggested.

Usually, the chest discomfort associated with panic attacks is not the worst symptom that the person has during the episode and it is associated with a feeling of difficulty breathing and this is the feeling that gives the chest discomfort, sometimes these feelings are associated with apprehension or fear, Sometimes, this discomfort sensation could be associated with numbness sensation in the hands. Usually the patients affected by panic attacks are younger females.

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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