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Forum Name: Cardiology Symptoms

Question: 3-Month recurring Chest Pain, Exercise worsens


 firecodes - Fri Feb 25, 2005 8:04 pm

I am a 33, male previously excellent physical condition, no medical history whatsoever, no family history, no drug use, stable life & low stress. My symptoms started 3 months ago. I am not sure what is related & what may be coincidental so I’ll provide it all. It all started with a non-painful pimple type rash across my chest & stomach - highly noticeable after hot shower. It lasted a week or so, then I had what appeared to be typical cold- runny nose, minor sore throat, etc. It went away within a week but an unusual chest discomfort developed - a continuous minor pressure in center of chest - sometimes left or right sided. This lasted months - during the time I also had intense bouts of nausea (no vomiting), intense headaches, and epididimytis (went away w/cipro). Any time I would try to exercise, about 30-60 minutes afterwards I would get intense feelings of needing to burp - but unable to or very little followed by the chest pain, headache and irritability.

I have had numerous tests: the only sign was abdominal ct scan showed light mesentery lymph adenopathy, otherwise chest x-ray & CT scan ok, treadmill EKG (no echo) ok, upper G.I. ok, scrotal ultra sound OK, blood tests ok including sed, parvo, & EBV. After 3 months of worsenting chest pain, the past couple weeks it has got better, but still intermittent pains, and every time I do moderate exercise they start up again - and the initial couple hours after exercise is incredibly uncomfortable with need to burp, headache & more significant chest pain all of which seem to last a couple days afterwards. Please help if you have any ideas, the stress of it all is really starting to wear me down. Thank you.
 Dr. Yasser Mokhtar - Sun Feb 27, 2005 4:49 pm

User avatar Dear Firecodes,

i can not tell you what is causing these symptoms but whatever it is, it sounds like a viral infection and i think it is regressing so, it is going to take its time and pass. Until then, i would recommend that you refrain from exercise as much as possible.

i would recommend that you have an echocardiogram if you have not had one.

This pain is not typical of atherosclerotic coronary disease, you don't have any major risk factors for coronary disease and you had a negative stress test which means that the chances of this pain being due to coronary disease is low.

Do you have this pain sensation after eating as well or just after exercise? Have you tried any reflux disease medications? Have you tried any medications that would make the stomach empty faster? Have you been seen by a gastro-enterologist?

Waiting for your update.

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

Yasser Mokhtar, M.D.
 firecodes - Tue Mar 01, 2005 12:44 am

Thank you Dr. Mokhtar for the prompt and thorough reply, that is more than I expected and I am thankful for it. In response to your follow up questions:

The pain does not generally come on or increase after eating. In fact I often feel the chest pain if have not ate for a long time. It is most pronounced lately after excercise, but also hits at different times. The only clear pattern is that it is almost always best in morning and gets worse by mid-day & lasts till bedtime, with excercise exagerating. One symptom that I forgot too mention is that I have developed an unusual cough in the last month or so too - it is dry, not painful, not hacking... it feels like something is irritated in lower stomach area that causes an involntary expulsion of air more than an irritation in throat causing a cough - if that makes sense. The cough does seem to be related to eating possibly, as it comes on most signficantly after eating, although I can have it at other times as well. I have never had any long term type cough before. H.Pylori?

Regarding heartburn, I did try a short period of pepcid (14 day) and later protonix (7-day) treatment in the early stages, but it did not seem to have an impact on the chest pain I do not have any of the traditional gerd symptoms sch as burning, bitter taste, regurgitation or difficulty swallowing. I thought about trying some GERD meds again now that many of the other symptoms have diminished. I have not tried any meds that make the stomach empty quicker, nor have i heard about this type of treatment.

I have not seen a GI doctor yet, nor have I had an echocardiogram. My doctor has referred me to a I.D. Specialist whom i have not seen yet (he too thinks probably started as something viral - although it is dragging on longer than expected).

Thank you again, if you have any suggestions based on the above new information I would be grateful. Otherwise, I can provide you an update after my I.D. consultation if you like.
 Dr. Yasser Mokhtar - Tue Mar 01, 2005 11:31 am

User avatar Dear Firecodes,

Thank you very much for the update.

An id appointment is a good idea.

Your symptoms sound to me more like gastro-intestinal symptoms more than cardiac symptoms.

i am not sure about the cough though.

Keep us posted about your id visit.

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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