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Heart Disease (Expert Forum)
Angina or esophageal spasm?
Answered by
Cleveland - OH
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Angina or esophageal spasm?
by who_is_this, May 25, 2006 12:00AM
48 y/o nonsmoking slightly overweight female. Low total chol (144) and good hdl. Mild hypertension on Lisinopril and HCTZ. No other meds.
2-3 years ago had a stress test and stress echo after very mild bout of what I thought was minor chest pain, all ok at that time. I've pretty much dismissed any thoughts of problems since then.
Couple weeks ago while driving was hit with intense sternal chest burning/pressure that was so painful I felt I might pass out, but didn't. A burning "flush" type pain went up my throat to the lower part of my face. It took about 15 min for symptoms to abate while I contemplated calling 911. I chalked it up to bad heartburn and thought I'd go to the doc if it happened again.
Last week, it happened again while I was simply sitting down. Not quite as intense, but exactly the same severe burning in my chest, with the weird flush/burning up my throat to my lower face. This time, it only lasted 6-7 min and wasn't quite as bad. I didn't go to the doctor.
I feel as though I would be very low risk for any cardiac blockage, due to my low cholesterol, nonsmoking etc. Someone at work mentioned it could be an esophageal spasm. I hate to be an alarmist, in light of the good stress testing a couple years ago and low risk status. What is your take on this? Should I to to the doc and have another stress test? This happened at rest both times. I have zero problems during strenuous activities.
Or just take a wait and see approach? I don't generally ever have heartburn, but I suppose it could be reflux. Thank you.
2-3 years ago had a stress test and stress echo after very mild bout of what I thought was minor chest pain, all ok at that time. I've pretty much dismissed any thoughts of problems since then.
Couple weeks ago while driving was hit with intense sternal chest burning/pressure that was so painful I felt I might pass out, but didn't. A burning "flush" type pain went up my throat to the lower part of my face. It took about 15 min for symptoms to abate while I contemplated calling 911. I chalked it up to bad heartburn and thought I'd go to the doc if it happened again.
Last week, it happened again while I was simply sitting down. Not quite as intense, but exactly the same severe burning in my chest, with the weird flush/burning up my throat to my lower face. This time, it only lasted 6-7 min and wasn't quite as bad. I didn't go to the doctor.
I feel as though I would be very low risk for any cardiac blockage, due to my low cholesterol, nonsmoking etc. Someone at work mentioned it could be an esophageal spasm. I hate to be an alarmist, in light of the good stress testing a couple years ago and low risk status. What is your take on this? Should I to to the doc and have another stress test? This happened at rest both times. I have zero problems during strenuous activities.
Or just take a wait and see approach? I don't generally ever have heartburn, but I suppose it could be reflux. Thank you.
Doctor's Answer
by Cleveland Clinic, May 25, 2006 12:00AM
, May 25, 2006 12:00AM
who,
I agree, without a lot of risk factors the likelyhood for your symptoms are coming from cardiac blockages is on the lower side. There is no way a quick paragraph on a web site could even come close to a substitue for a quick look over from a physician that knows you. Any time ou develop new or concerning symptoms, you should seek medical care. Even though other causes of chest pain may not have the immediate consequences of a heart attack or unstable angina, they potentially could cause some problems if left unchecked. Talk to your doc.
good luck
I agree, without a lot of risk factors the likelyhood for your symptoms are coming from cardiac blockages is on the lower side. There is no way a quick paragraph on a web site could even come close to a substitue for a quick look over from a physician that knows you. Any time ou develop new or concerning symptoms, you should seek medical care. Even though other causes of chest pain may not have the immediate consequences of a heart attack or unstable angina, they potentially could cause some problems if left unchecked. Talk to your doc.
good luck
fwilson - I was very sad to see your last post because I know a lot of people who read this forum will be unnessasarily worried about it. It is true that PVCs can sometimes be an INDICATOR of more serious heart problems, but that does NOT mean they are dangerous in and of themselves. The people in the study you quoted had only a physical exam and holter monitoring, and just because they had no history of heart issues - they still may have had undetected heart disease. Anyone who has newly occuring PVCs or a increase in their PVCs surely must have further testing done to rule out an underlying condition. For example, they might have a stress test and an echocardiogram - or what ever the doc sees as appropriate given the persons risk profile. IF THOSE TESTS ARE NORMAL then the patient can be reassured that their PVCs are not indicative of a more serious condition and the PVCs are considered benign. From the abstract you posted, it did not appear that the study participants had gone through and RECIEVED NORMAL RESULTS from additional testing prior to the study's five year time frame. I think a non-scientist (many people on this forum)could easily read the abstract you posted and mistake correlation for causation. It is NOT the PVCs themselves that caused the negative events in the study participants, but rather, the underlying, albeit previously undetected, heart conditions. Yes, PVCs can be an indicator for heart disease but that doesn't mean they can't be benign in the absence of significant heart disease.
Love the name! Your symptoms are exactly the same as mine. Last week I ended up in the ER with same presenting symptoms, chest pain (cramping) and burning. This has happened to me at rest and while working out on treadmill. Well, to make a long story short, they discharged me and I didn't have a heart attack! (Always good to hear) This is such a great topic that I'm sure applies to a lot of people here on the forum, as you'll see by the people who post.
I would go to a cardio dr. for peace of mind, if nothing else. They'll probably repeat some of your previous tests and you'll feel much better. You sound low risk to me (: Also, I noticed that you were sitting both times you had this pain/burning. That sounds more like esophagus to me then. Most of mine is while at the computer (like now) and sitting down. I'm being evaluated for esophageal spasm too. Isn't it just so lovely that esophageal spasm can mimic angina? I wonder how many patients go to the ER with the same symptoms thinking, this is it, the end of the road for me! I was thinking of my husband and 3 little girls while in the ER and it turned out to NOT be my heart. I followed up with my cardiologist last week, have had another event monitor for a week and when I had symptoms, it showed up as nothing! Best of luck to you!
Andie, thanks for chiming in about fwilson's last post. I was very upset when I read it for the same reason's you were. Very helpful that you clarified what he was asserting! Hope you're feeling well! Best wishes (:
PAC/PVC's...I was told they were all benign in nature (via 24 hour holter monitor) They were not normal as I had an undetected heart attack that was missed. Finally ended in ER room with A-Fibs and Tachs and was brought back to NSR via IV.
I wore the event monitor for only a week. It looks very much like a holter only smaller. (Only 2 leads also.) Anytime I had a symptom, I pressed the button and it recorded the actual event and the 30 seconds before and after it. You can record up to 3 events at a time (on mine anyway) then you call this 800# and transmit it through the phone. They fax the daily results to your doctor and then your doctor updates you on what they found.
On mine, all they saw was sinus tachy and pac's, pvc's. Nothing new here! Main reason was to try and correlate my chest pain symptoms with the monitor. Good news was that it showed absolutely nothing as far as the chest pain was concerned. Very reassuring. I think it's a great tool but highly annoying! For instance, while my husband and I were intimate, I had to push the button! Not too romantic.
Anyhow, I know the event monitor is better than a holter in that you can wear it longer, shower and such and just record when you have symptoms. Niftly little gadget, isn't it? Is your doctor giving you one?