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Forum Name: Arrhythmias

Question: Lots of cardiac tests no reason for pains/irregularheartbeat


 Joshua24 - Thu Mar 31, 2005 12:10 am

Ive had high bp now for years, been on toprol xl 100mg once a day for the past two years. I have pvc's off an on, chest pains(mostly in the left peck area, not central to my chest very much, under my left arm on my side as well), pains in my left shoulder / arm and hand. I also have fast and irregular heart beats sometimes or very slow heart beats at times *due to toprol?*

Ive have all kinds of blood work, a holter test, numerous ekg's... a stress test, chest xrays and they have all come back fine, durring the stress test all pvc's dissapear and i expierence no chest discomfort from excersise of any type.

Still i have reoccuring pains on a daily basis. Just today, march 30th i had a dual isotope excersise stress test, the ekg/stress test portion according to the doctor that does them at the hospital here said yet again he saw nothing bad except my bp shot up to 220/120 when my heart rate reached 150 beats a min. The imaging process i have no results on yet.

I also suffer from bad nerves and anxiety....as well as chronic stomach problems and copd *minor asthma and chronic bronchitus*

Im not sure as to what is causing these pains, by my doctors orders im trying to walk daily and am working on not smoking anymore.

So if the last test i have comes back normal and there is nothing wrong with my heart, then what can be causing these pains? My family doctor seems to be clueless, and hes a US Military doctor *rank is that under a one star general* so ya think he would be pretty good at figuring things out, but not on this one i take it.

Can ya offer any advice??
 Dr. Yasser Mokhtar - Sat Apr 23, 2005 8:48 am

User avatar Dear Joshua,

You have 2 major risk factors for coronary disease, being a male and having hypertension. Your chest pain is atypical as compared to that of coronary disease. So, the probability that this pain be due to coronary disease i would say is very low to low.

Have you had an echocardiogram (ultrasound of the heart) to rule out a condition called mitral valve prolapse? This is a condition that is known to cause chest pain and palpitations and just needs to be watched.

In otherwise healthy young people who don't have heart disease, pvcs can be observed safely without worry or treatments. It is not unusual for healthy young people to have pvcs (and no cause is usually found). In the past, all pvcs were treated but not after a major study found that there is nothing to worry about in healthy young individuals without heart disease. You are already being treated for high blood pressure with a medication that should be controlling the pvcs. Did you have a holter while you were on toprol?

The pain that you are describing sounds to me like nerve pain more than anything else, i would recommend that you have an x-ray/ct scan of the neck to evaluate your cervical spine.

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

Yasser Mokhtar, M.D.
 Joshua24 - Sat Apr 23, 2005 9:41 pm

I saw a cardiologist with the praire capital heart center *st. johns hospital springfield illinois* and they ruled out anything wrong with my heart based on his physical evaluation and a dual isotope stress test.

my doctor thinks it could be my nerves or the copd that i have.

im still not sure, honestly i think its what my doc said or my stomach, because sometimes my stomach likes to really goof around with food coming back up or stomach acid coming up with out me realising its happening.

I take prevacid for the gerd i suffer.

so overall i do know what the cardiologist said, his name is Dr.Moses and he basically said he was very comfortable telling me that there was nothing to worry about except what you said, my weight and my bp.
 Dr. Yasser Mokhtar - Sat Apr 23, 2005 10:26 pm

User avatar Dear Joshua,

Thank you very much for the update.

There is nothing to worry about with the negative stress test.

If your cardiologist thinks it is indicated, i would like to recommend for you to have an echocardiogram.

Once more, i would like to emphasize that this pain sounds more like a neck problem to me, would you please, consider having a neck x-ray/ct scan done.

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

Yasser Mokhtar, M.D.
 Joshua24 - Sat Apr 23, 2005 11:23 pm

the dual isotope stress test did show an abnormality, but they cardiologist doesnt seem to be worried, and i do, or did, according to the doctor who removed my appendix, have a slight heart murmur*sp*

i will talk to him about the echocardiogram, and will see what my doctor thinks when i see him next about the neck xray/ct....cuz since you mentioned it, i remember now having to go for a neck ct once when i was younger because i fell off a trampoline*sp* and hurt my neck....i don't think anything was wrong, but i will talk to them about it.
 Dr. Yasser Mokhtar - Sun Apr 24, 2005 1:48 am

User avatar Dear Joshua,

Thank you very much for the update.

There is nothing to worry about. If your cardiologist thought the stress test was positive, you would have been told and went for a more definitive way of diagnosis like a coronary angiogram. Your probability of having coronary disease was low from the begining, so there is no need to worry.

Murmurs do not necessarily mean that there is serious heart disease, and cardiologist are more experienced in listening to the heart, so, if your cardiologist did not hear a murmur, then i would assume that there is no murmur. An echocardiogram would be a good test in case of a murmur as it will show the valves and where the murmur is coming from.

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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