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Heart Disease (Expert Forum)
Chest pain and shortness of breath upon exertion
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Chest pain and shortness of breath upon exertion
by Iluvmals, Mar 31, 2006 12:00AM
Hello,
My husband is 45, does not smoke and not overweight. For 10 years now (it has gotten progressively worse), he gets chest pain, like an elephant standing on his chest, shortness of breath and some weird heartbeats. He had a cath 1 1/2 years ago and everything is fine. He has not recreated it on a stress test, in the past a holter said they saw some irregularities but nothing to worry about. He had a Nissen fundoplication for reflux last May. These symptoms are brought on quicker after he eats. Slow building up exercise, like for the stress hasn't done it. The Cardiologist says its not his heart cause the test results have been OK. I don't see how they can rule it out without witnessing an episode. If he pushes it and does not stop he will pass out. ( has once)
So, my question is.... Any ideas?????
Why can't they try the angina medication to see if it helps?
We are in the process of going to Mass General.
Anything specific we should ask for??
I think it may be microvascular angina or cardiac syndrome x, is that a possibility?
If you don't think its the heart, where would we go from here?
He has seen a pulmonologist and his lungs checked out fine.
Thank you very much, its nice to have someone help us all out when we're pretty much stumpted!!!!
Diane
My husband is 45, does not smoke and not overweight. For 10 years now (it has gotten progressively worse), he gets chest pain, like an elephant standing on his chest, shortness of breath and some weird heartbeats. He had a cath 1 1/2 years ago and everything is fine. He has not recreated it on a stress test, in the past a holter said they saw some irregularities but nothing to worry about. He had a Nissen fundoplication for reflux last May. These symptoms are brought on quicker after he eats. Slow building up exercise, like for the stress hasn't done it. The Cardiologist says its not his heart cause the test results have been OK. I don't see how they can rule it out without witnessing an episode. If he pushes it and does not stop he will pass out. ( has once)
So, my question is.... Any ideas?????
Why can't they try the angina medication to see if it helps?
We are in the process of going to Mass General.
Anything specific we should ask for??
I think it may be microvascular angina or cardiac syndrome x, is that a possibility?
If you don't think its the heart, where would we go from here?
He has seen a pulmonologist and his lungs checked out fine.
Thank you very much, its nice to have someone help us all out when we're pretty much stumpted!!!!
Diane
Doctor's Answer
by CCF-M.D.-MJM, Mar 31, 2006 12:00AM
Hi Diane,
I understand your frustration. It sounds like a difficult situation. I assume he had a negative stress test before the cath. The first thing I would do is an exercise stress test and try to catch the symptoms while on monitor. I can't say it isn't microvascular angina or syndrome X, but these are difficult to diagnose. Mass General is one of the best hospitals around. They should be able to help.
Usually causes of recurrent exertional chest pains are cardiac, but they should be relativey easily reproducible with equivalent exertion. If it occurs with variable levels of exertion, that makes it much less likely to be cardiovascular. It is often easier to say what something is not than what it is. If it isn't his heart or lungs, I am not sure what else it could be.
I hope this helps. Good luck when you visit Mass General. Thanks for posting.
I understand your frustration. It sounds like a difficult situation. I assume he had a negative stress test before the cath. The first thing I would do is an exercise stress test and try to catch the symptoms while on monitor. I can't say it isn't microvascular angina or syndrome X, but these are difficult to diagnose. Mass General is one of the best hospitals around. They should be able to help.
Usually causes of recurrent exertional chest pains are cardiac, but they should be relativey easily reproducible with equivalent exertion. If it occurs with variable levels of exertion, that makes it much less likely to be cardiovascular. It is often easier to say what something is not than what it is. If it isn't his heart or lungs, I am not sure what else it could be.
I hope this helps. Good luck when you visit Mass General. Thanks for posting.
Need very good interperters also.
Good Luck To You.
Thanks for reading. We went to Mass General today (we lucked out and got in early due a cancellation!)
The Cardiologist has ordered a Thallium Exercise test to check for Microvascular angina. Otherwise, he thinks his Acid Reflux surgery may have failed. He did say he has a fast heartbeat.
He has him trying some acid reflux stuff, and is going to try a beta blocker, my husband has the name of it, starts with n.
I guess we'll know more in a couple of weeks,
Thanks Again,
Diane