Dear shb203,
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 if your father had a
heart attack (and if yes how old was he then) before having his bypass surgery, whether you smoke or not, whether you excercise regularly and how much do you weigh. You mentionned that you are being treated for
hypertension and high cholersterol and since your mom is a diabetic, you are most probably prone to develop
diabetes (were you ever tested for
diabetes?).
Chest pain caused by heart disease usually has certain characteritics. The coronary
pain is usually a sharp
pain, but can be perceived by patients as pressure, burning or stabbing sensation. 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. So, the
vomiting, sweating that you had the first time can be related to the
pain, but unfortunately these symptoms are so non-specific and they are not an indication that the
pain that you had is of
coronary disease but just the
pain that you had might be severe.
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.
Your visit to the emergency department was a good step 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.
You are being treated for
hypertension by lopressor and lotrel but it looks that your blood pressure is not really well controlled. Where does it usually run?
We don't know which comes first, the high blood pressure or the
chest pain. High blood pressure as high as the numbers that you mentionned is a high stress on the heart and so you can feel some discomofort or
pain in the heart but the main problem is actually your blood pressure. If the
pain comes first and it is so severe, you can so
anxious and nervous that your blood pressure shoots up but it is rare that it reaches such high levels.
You have quite a few risk factors for
coronary disease. My suggestion to you is to discuss this further with your primary care provider and try to have your blood pressure controlled better and see whether this makes a difference in the occurrence of the
pain episodes. If this does not make any difference i think it would not be unreasonable to ask him/her if you could have a treadmill stress test with a nuclear scan to evaluate the reason behind your
chest pain.
Thank you very much for using our website
http://doctorslounge.com and i hope that this information helped and i will be waiting for your response.
Yasser Mokhtar, M.D.
