Subject: Re: Chest Pain
Forum: The Heart Forum

Topic Area: Heart Attack

I'm a 46-year old woman, in general good health. Had a parathyroidectomy last September and have recuperated fully. I've had four or so episodes of unusual upper chest pain. It begins in the middle of my upper back between my shoulder blades, and is initially a squeezing, sharp pain. It hurts to breathe deeply, and the pain radiates up through my shoulders and into the front of my chest. It also radiates up into my neck and jaw; worse on the right side of my jaw. The episodes last maybe five minutes or so. During the episodes, my chest and neck feel full, like pressure from the inside out. Because of where the pain is, I am afraid it might be my heart, but during them I am not aware of arrhythymia or pounding heart. After the last episode -- yesterday -- I also had a great deal of painful belching. The episodes have ranged from first thing in the morning to late afternoon to late at night. I don't see a timing pattern. It's happened with both a full and empty stomach, so I also haven't be able to see a pattern in relation to food. I just returned from a vacation in the South Pacific, and ate many different local foods, so I've also wondered about parasites.

Although I have been diagnosed with hepatitis-C, I have no symptoms and no traceable viral load, normal enzymes, etc.

My family history does include heart disease -- my father has had angina and high blood pressure for many years, and both grandfathers had fatal heart attacks.

1. Can you give me any thoughts as to what might be going on?

2. Do you think cardiac involvement is likely?

3. Should I see a cardiologist?

Thanks very much.

paige

Dear Paige,
Yes you should see a doctor, at least a general internist if not a cardiologist and given your symptoms sound like they could be cardiac, you should go to an emergency room with the next episode. This is not a diagnostic forum, nor one where we "guess" what could be going on with a patient, a history and physical exam is absolutely necessary to evaluate a patient.

I hope you find this information useful. Information provided in the heart forum is for general
purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to
write back with additional questions. Good luck.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call
1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that
can be used to select the physician best suited to address your cardiac problem.

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