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Forum Name: Cardiology Symptoms

Question: Excruciating pain


 firemom31 - Thu Jan 13, 2005 10:38 pm

In the past 3 years I have had numerous episodes of terrible substernal pain. It always occurs in the early morning just after I wake up. I am short of breath, sweat profusely during these episodes. They last approximately 5-10 minutes. The pain is so severe that I cannot move, I can only try to stay very still and attempt to get enough air. Up until this last time, nothing has seemed to abate the pain until it goes away on its own. I had another episode last week and became very nauseated along with the other symptoms. When I began to suffer dry heaves the pain stopped immediately. I initially had thought it was some type of angina, but now wonder about hiatal hernia. Any ideas?
 Dr. Yasser Mokhtar - Fri Jan 14, 2005 7:13 am

User avatar Dear Firemom,

To decide what is the origin of chest pain suspected to be due to coronary disease, risk factors for coronary disease of the patient suffering from the chest pain and the characteristics of the pain are looked at. If the probability of this being of coronary origin is low, another diagnosis is looked at, if the probability is high, the patient is directly taken to coronary angio and if the probability is in between then a stress test is in order.

Being a female below 50 years generally means that you are protected from coronary disease. You are a smoker, you don't have diabetes or hypertension. You mentioned that your dad has cad but you never said when he developed it. i assume that you don't have high cholesterol or it was not checked.

Pain of coronary disease can occur the way you describe it but it does not have to wait till you wake up and then hits you, usually it wakes you up from sleep. The pain of coronary disease does not go away usually if a person has dry heaves.

So, you have one risk factor and your pain sounds atypical. So, most probably, this pain is not secondary to coronary disease. You mentioned in one of your previous posts that you have a history of ulcers, this could be behind the chest pain. Hiatal hernia can be another cause. You can try anti-acids and see whether or not the pain will improve.

3 years is long time to suffer from chest pain that you thought at one point could be from coronary disease. If you were never evaluated for this chest pain before, i would strongly urge you to be evaluated for it.

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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