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Forum Name: Valvular Heart Diseases

Question: Chest pain and DVT


 cynthiaw4 - Tue Jan 06, 2004 8:51 pm

Hello,
I've been having chest pain for a couple weeks. I told my doctor and he did a ekg it came out as abnormal consistant with septal infarct. he sent me to the ER and they did nothing. After that my neck swelled up. Aftet 2 day's it went down. I'm still having sharp chest pain's under my brestbone and in my chest. like a burning feeling. What could this be? He's sending me to a cardioligist but the appontment isen't till march. Also I have had DVT's? Could I have a blood clot in my neck??
 Dr. Tamer Fouad - Sat Jan 24, 2004 5:38 pm

User avatar Cynthia,
Please visit this link for more information on our site regarding chest pain and the possible causes.

pain/chest.htm" class="postlink">Click here!

It seems you may have a condition known as a hypercoagulable state and should be investigated as to the cause of your developing DVT and septal infarction at such a young age (33).

A visit to the cardiologist cannot wait till March.
 Dr. Yasser Mokhtar - Sun Jan 25, 2004 8:06 pm

User avatar Dear Cindy,

Thank you very much for using our website.

Chest pain is usually worrisome for coronary disease. Coronary disease has factors the presence/absence of which can usually predict fairly well the probability of the person complaining of chest pain having or not having coronary disease.

These risk factors include family history, smoking, hypertension, diabetes, high cholesterol, sedentary life style and obesity. You did not mention your family history and whether it is positive for coronary disease (first degree male relative with a heart attack before 50 years and/or first degree female relative with a heart attack before 60 years) and whether you smoke or not, whether you excercise regularly and how much do you weigh.

Chest pain caused by heart disease usually has certain characteritics. It usually occurs on exertion, lasts for a few minutes and is relieved by rest. Its location is usually behind the breast bone and can move to other places like the left arm, the back or the neck. If severe enough it can be associated with nausea, vomiting and sweating.

Its character is usually a sharp pain, but can be perceived by patients as pressure, burning or stabbing sensation.

You did not mention under which circumstances do you usually get the pain, how long does it last and whether or not you have any associated symptoms.

The answer to all these questions makes it most of the time easy on the physician to decide the origin of the chest pain and whether it is cardiac in origin or not (from the heart).

Obviously if the only source of chest pain was the heart, it would have been very easy for doctors to diagnose all patients who present with chest pain, but there are other sources and the symptoms are sometimes vague enough so that doctors resort to other resources to try to diagnose the source of the pain.

And here comes the role of investigations such as ekg and others. An ekg showing septal infarct in females is sometimes not specifice as the placement of the leads on the female's chest is sometimes not accurate because of the breasts. And you did not mention whether the infarction on the ekg was acute or old.

Your doctor did the right thing by sending you to the emergency department and my guess is that they thought the pain that you are having is most probably not heart related and that is why they did not admit you to the hospital. And you did not mention what they thought was the reason behind the chest pain.

Your history of dvt (deep vein thrombosis) is very pertinent to the development of chest pain. Of the causes of chest pain is pulmonary embolization which is travelling of a blood clot from veins in the legs and pelvis to the blood vessels of the lungs and this is common in patients who either have or had dvt before.

However, you did not mention what were the circumstances under which you developed dvt as dvt is somewhat expected in patients who have had surgery, or had a prolonged illness and had to remain in the hospital in bed for a while and were not given prophylaxis against dvt or if you have taken contraceptive pills for a while (particularly if you were smoking at the same time) and then you developed dvt and you had to stop them. You also did not mention what are the treatment that you received and for how long. If you had dvt under such circumstances then most probably there will be no need for you to be checked for a hypercoagulable state at this time.

Once more, thank you very much for using our website http://doctorslounge.com, i hope that this information helped and waiting for your response..

Yasser Mokhtar, M.D.

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