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Forum Name: Cardiology Symptoms

Question: Chest Heaviness , goes away after a short rest


 RobinJPN - Tue Jan 13, 2004 7:27 pm

Dear Dr.

Every day for the past year or so I have been taking routine walks both in the morning for 40 minuets and in the evening for 40 minuets. Around 6 months ago I started to feel a sensation of heat in my head, like I felt flushed. This stopped eventually , however , right now when I walk I feel a heavyness in my chest , a sort of squeezing pain directly in the centre of my chest. This pain is also felt in my throat. After a short period of rest I feel no pain atall but even just doing the snow shoveling for 2 minuets makes it return.

I am a heavy smoker ( 30 cigarettes per day ) , and heavy drinker ( around 6 doubles of a 25% alchohol beverage ) in the evening only.

This pain seems to have come on at around the time it got very cold in the area I live. I am to understand that going from a hot environment like my living room , to an environment below freezing suddenly , will cause your heart to race. Could this be affecting the pain? The reason I ask this is because after around 35 minuets the pain seems to vanish or lessen whilst still walking. Could it just be my body's shock at the temperature change?

Thank you very much in advance for any advice you can give.
-rob
 Dr. Yasser Mokhtar - Wed Jan 28, 2004 9:10 pm

User avatar Dear Rob,

Thank you very much for using our website.

The pain that you are describing has some of the typical charateristic of pain of heart origin.

Getting the pain during exercise, having it in the center of your chest and feeling it in your throat, pain being squeezing in nature and the pain giong away after a short period of rest.

The thing strongly against the pain being of cardiac origin is the pain vanishing 35 minutes into walking.

You have certain risk factors for coronary disease. Being a male, smoking and drinking.

The most important factor though is having a positive family history for coronary disease and you have not mentionned whether or not you have a positive family history for coronary disease (a first degree male relative who had a heart attack before age 50 and/or a first degree female relative who had a heart attack before age 60).

Is the pain that you are having of heart origin, the answer to this is difficult and it can be yes and can be no.

Personally, i am inclined not to consider it of cardiac origin as you are young, have been exercising for almost a year now (why did you start to have pain now and if you had coronary disease it would have manifested itself a year ago when you started exercising, unless something came on which i don't believe is the case). And most importantly since the pain disappears when you are 35 minutes into walking (which wouldn't be the case if the pain was of heart origin).

So, what is causing this pain? My guess is that when you start breathing the cold air, i think you start having some sort of airway hyperactivity (like asthma) but not to a significant extent that makes you feel real short of breath but just enough to make you feel some chest tightness which is a common symptom in asthma secondary to inability to breath (as many patients will describe their shortness of breath as chest tightness).

This being said, however, i think it is worth your while to be checked by a doctor to make sure that the pain is not of heart origin as i said in the begining, it is difficult to say whether the pain is of cardiac origin or not as you have some risk factors and the pain has some features typical of heart pain.

The way to go most probably is by having an ecg treadmill stress test. If this is negative and you still have the same sensation each time you go out in the cold air then you ought to have a test to see whether you have asthma or not (called a methacholine challenge test). Or begin with the asthma test and then if negative go for the stress test whichever your doctor thinks is more convenient.

One more thing, although it is a remote possibility, is that you have coronary artery spasm due to the severe cold but this is usually associated with severe pain exactly as if you are having a heart attack and usually resolves with medications or if the cause of the spasm (in your case the cold) is gone, which does not happen in your case (you continue to walk in the cold but the pain improves).

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

Yasser Mokhtar, M.D.
 RobinJPN - Mon Mar 01, 2004 7:23 pm

Hello again!

I have recently taken a trip to the doctor and consulted him over the symptoms I was experiencing. After making this post , a few days later , I dicovered a spilt bleach container in this room where I spend 8 hours of my day. The doctor concluded that the bleach , mixing with kerosene fumes , was causing these chest discomforts. I had 2 x-rays done ( front and side ) and after a quick examination of these xrays the doctor confirmed that there was indeed nothign wrong with me. He suggested that my high blood preassure ( 164 / 100 at the time of examination ) was caused by my constant worry and constant reading of online medical journals. I would literally have nothing else on my mind but what "could" be wrong with me ALL DAY. So .. I have now been perscribed to a 2 week course of Sulpiride ( anti-psychotic ) and I must say it's going well. I can spend 1 hour on a tread mill at a moderate jogging pace and feel no pain whatsoever. I can walk my usual 40+40 mins a day in the cold and feel nothing.

Anyway , Another " since i made this post" things , I have also completely quit drinking and smoking which was , and still is , a challenge of will power. I have also stopped drinking coffee or any other caffene based product.

Here's to health! and thank you!

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