24 yr old, angina?? heart disease

[cookienkikin]

i still have the chest pain everyday. it comes and goes throughout the day with just very little time where i wont feel it that bad, but even then it will be slightly dull. i had it again yesterday REALLY bad, and i started feeling dizzy, sweating, really hot,short of breath, and just like i was going to pass out, and the pain was in the same spot, left side of chest, left arm,and left hand. i checked my bp and it was 147/96 and pulse rate was 110. a few questions. 1.could i have angina,(blockages), that could be causing the pain but never actually caused a heart attack therefore none of the test that i have had have came to that diagnosis. 2.how is angina picked up on a test?  3.doesnt angina mean your likely to have a heart attack.  4.im VERY inactive, but i noticed when i ran on treadmill that i didnt have the chest pain, i just have it when at rest, and after i exercise. could i have unstable angina and not stable angina?? 5.i also drink alot of beer daily, i dont know how that would cause the heart symptoms that i have but is that possible?   Im just mainly curious about me possibly have angina(blockages) but never had damage to my heart therefore all the test are negative and there still might be something possibly wrong with my heart that could possibly lead to a future cardiac event. is there any further testing that i could have to possibly check for this or is there no need? maybe stress test with radioisotopes???????

[ed34]

I agree with everything grendslori has said. We have to remember also that whatever we put into our body, is what we should expect to get out of it. If we poison our bodies can we really expect to be healthy. To have an echo, ecg and stress tests which are normal will rule out heart disease. Could it be vasospasm? possibly but this is very difficult to diagnose without observing the event. If it is vasospasm, it often follows a 'trigger' event, and you can try to discover what that trigger is. In some it can be exercise, or some foods, alcohol, coffee, smoking, etc etc. The more information you can gather for a Doctor, the better. Perhaps the pain lessens if you take shallower breaths, or move into a different posture. To take your blood pressure/heart rate during the event is likely to be a false reading anyway due to anxiety. Most people will grab the pressure monitor thinking "oh God, it;'s my heart" and of course this will elevate all the readings. If you lay down and totally relax all your muscles and breath gently, does the pain lessen.
Many gastric problems give very similar symptoms to heart problems. In 2006 I was misdiagnosed as having a stomach disorder of some kind for a year, until I had a heart attack. My echo/ECG were normal during that year, and Doctors were sure my heart was fine. But it can be the other way round, we think it could be the heart, but it's the stomach. Chest pains for heart problems are quite unique and I now realise that after having endured so many. They are not anything like stomach pains, but I didn't know that at the time. Chest pains are like a sharp implement in your chest being constantly twisted. I'm sure you've felt a 'stitch' in your ribs when running, it's like that but 20 times stronger, much more intense. Changing breathing patterns, changing posture etc has no effect whatsoever. You feel nauseous with the pain and sweat heavily. Often there is a strange throat discomfort accompanying the chest pain, or lower jaw ache, like you have been chewing gum none stop for several days. The jaw hinge feels like it's locked and difficult to move. I've had those symptoms which have lasted for 30 seconds when I relaxed, making it stable angina, but I've also had them where they don't go away, requiring emergency Stenting. Another influence I've found is air temperature. When I breathed cold air, the symptoms would come on very quickly, whereas the summer months felt like I had a new body. I had vasospasm for a period of 3 months, this was brought about by having 5 long stents put into my left artery. With all the ballooning, it went nuts, opening and closing very fast. Calcium channel blockers put this under control for the three months and then it stopped, thank goodness. So, how did vasospasm feel?  I got the attacks at no specific times, there was no trigger. I would feel a kick in my chest, like a single flutter, then a wave of cold would go through my body, like a shiver. It felt like my heart had given a final beat and then stopped. Suddenly, two seconds later it would kick back in and beat fast for about 20 seconds and I could feel a strange fluttering sensation in my chest. Even though it felt like it was beating fast, it wasn't according to my monitor. After 20-30 seconds it would simply return to normal. I had these two or three times a day until I started calcium channel blockers.
Anyway, I hope my experience has some use in understanding what it feels like.

[inleedi]

Oh wow this whole thread is incredibly miss-informed. You do not need a build-up of plaque to have spasms. I have severe prinzemetal angina and I was diagnosed at age 23. I have squeaky-clean arteries because everyone in my family has died from the disease on my dad's side so we never cook with trans-fats, sugar or even salt.
You can't rule out blockage if you're inactive and eat poorly. Sort of like how they said kids can't get type II diabetes, but considering the crap we put in our bodies at faster and faster rates...
You need to get a treadmill, echocardiogram, ECG (multiple) and stress-echoed to check. End of story. Stop asking if anyone knows- demand them from your doctor. I had to go to the ER multiple times until I found a doctor willing to do those (non-invasive!) tests for me. They all (and some continue to) swear up and down no one in their early twenties experiences this. Well, then why did my grandfather have his first he-shouldn't-have-been-alive-but-thank-god-survived-heart attack (due to continued spasms due to prinzemetal angina) at age 30?

Get the ECG. Get the echo. Then, talk to someone that deals with young-adult cardiology- this is VIP!!!

[inleedi]

Oh wow this whole thread is incredibly miss-informed. You do not need a build-up of plaque to have spasms. I have severe prinzemetal angina and I was diagnosed at age 23. I have squeaky-clean arteries because everyone in my family has died from the disease on my dad's side so we never cook with trans-fats, sugar or even salt.
You can't rule out blockage if you're inactive and eat poorly. Sort of like how they said kids can't get type II diabetes, but considering the crap we put in our bodies at faster and faster rates...
You need to get a treadmill, echocardiogram, ECG (multiple) and stress-echoed to check. End of story. Stop asking if anyone knows- demand them from your doctor. I had to go to the ER multiple times until I found a doctor willing to do those (non-invasive!) tests for me. They all (and some continue to) swear up and down no one in their early twenties experiences this. Well, then why did my grandfather have his first he-shouldn't-have-been-alive-but-thank-god-survived-heart attack (due to continued spasms due to prinzemetal angina) at age 30?

Get the ECG. Get the echo. Then, talk to someone that deals with young-adult cardiology- this is VIP!!!

[erijon]

Read the site posted, not very interesting. Just another "cholesterol is not the problem" rant. Nothing to back up their position, just a reference to a study that indicates that there was an equal number of participants from a selection of the Framingham study with heart disease with and normal cholesterol levels. Again, this is not different than the " half of all people presenting at the ER with a heart attack have normal cholesterol levels" post. Really useless information as it does not account for the millions and millions of people that have normal cholesterol levels that don't have heart disease.

Just my opinion,

Jon

[cookienkikin]

so is it possible for me to have blockages with the normal test results that I've had??

[cookienkikin]

ok i have a few questions for grendslori and gonziii, grendslori-u said originally that pvcs and pacs are totally normal and can cause no harm at all, and now you say that pvcs, which are located in the ventricules, are dangerous and life threatning.  1.since i feel them and are symptomatic does that mean that they could be considered dangerous? 2.could they be dangerous considering i had normal ekgs,stress test, stress echo, holter monitor,and event monitor? 3.could it have been missed and something could be  wrong?4.does the pain that i feel (direcly over the hear) and left arm,neck,hand, and shoulder pain with normal test results mean i might have blockages that was missed? do them symptoms warrant anything along with the pvcs and pacs?5.are pvcs more dangerous than pacs?


gonziii- why do you think that the pacs and pvcs that i have are so life threatning with all my normal test results? why would you say that i might die from these? i feel like there is something wrong with my heart with all the symptoms that i feel, but i can run on the treadmill for 30 mins without any chest pain, it just comes upon me at rest. doesnt that mean i couldnt have angina or anything wrong with my heart? what makes you believe that something is wrong with my heart?

[grendslori]

You have a severe form of heart disease. If you read my posts above you will read a bit about my daughter who also had Hypertrophic Cardiomyopathy. Arrhythmias in this disease can be life threatening in about 2% of the population; however, irregular heart beats which are in the atrium are not life threatening if there is no underlying heart disease. Arrhythmias that are located in the ventricle, IF sustained, are life threatening. The treatments you are receiving are based on the the fact that your heart walls are too thick and need to be relaxed in order to beat properly. You would have angina due to the fact that your heart walls are too thick and the bloodflow is probably outstripped. Nitro helps to give some relief (although the headaches are a real pain, aren't they!) Oxygen can also be of some help. Hypertrophic Cardiomyopathy is a form of Diastolic Heart Failure.. Now one thing you must be aware of is that there is a form of Cardiomyopathy called Alcoholic Cardiomyopathy which is a form of heart disease caused by too much drinking; it's good that you have set goals for yourself to stop. Take care    

[gonziiii]

the dizziness, sweating and angina pains spreading to ur arms are typical signs of heart attack, i've never had those, lucky me but my caridologist prescribed some nitrates (isodil) that i always carry along with me, i usually take them when the chest pain becomes very sever and they work like magic...and if ur chest pain is relieved by nitrates then u really have a prob with ur heart which i am sure u do, c ur doctor immediately and ask him to consider off loading some of the burden on heart by giving ur norvasc, captopril and atenolol, these drugs can save ur life

[gonziiii]

I understand what u are going thru, i started having chest pains at the age of 13, i was later diagnised of rheumatic fever and treated but the chest pains didn't go away. they come and go, it didn't bother me though cos i was still playing football and doing all other things. u c doctors don't really know too much, they didn't know what was causing my pain, i passed all the tests, so my cardiologist suggested i shud try and ignore the pain and go on living a normal live, which i did. later on in life, when i was 18 i started drinking and smoking and i noticed that the pain usually comes about 4-6 hrs after alcohol consumption and the severity of the pain is directly related to the number of beers i consume, eventually my cariologist placed me on norvasc, captopril and moduretic, my condition improved and the angina reduced. it didn't go away totally cos i was still drinking, but whe i stopped drinking for a while the pain went away totally and i stoppd taking all thse drugs. later on i relapsed and went back to drinking heavily, 4-6 bottles of beer each day and eventually i started having irregular heart beats. ecg was normal but heart echo showed left ventricular hypertrophy and moderate cardiomyopathy, my cardiologist said i shudn't panick that my heart will be back to normal, i shud take my drugs and reduce my booze to not more than 1-2 bottles a day and if possible i shudn't drink for more than 3 times in a week, i tried to adhere to his insttructions and now i am a very stable at 34, the only prob is that the drugs are reducing my sexual drive, so i try to take the atenolol only if i drink or if i notice my bp is higher than 140/90. i noticed that the bp usually sky rockets when i drink heavily so that is the main prob, My advice for u is to get ur doc to prescribe some drugs that will reduce the work load of ur heart and if possible a beta blocker to control the irregular beats, i've had these irregular beats and i know how htey feel like, its scary, u'll think u are going to die, and  u might. My own plan is to give up smoking by the end of this yr so that i can gradually stop taking atenolol and eventually stop the norvasc, but i have a feeling i;m going to need bp drugs for some time to come,,, good luck and enjoy life...consider reducing ur beers to 1-2 bottles and u will feel al lot better, but u need something for the irregular heart beats cos they are dangerous

[grendslori]

HI Larry, I want you to know I am NOT trying to belittle the way you feel. I'm going to try and explain to you why I wrote the things I wrote so that maybe you will begin to understand where I'm coming from. You already know about my daughter, what you may not know is that I was an EKG Supervisor and ran a department in that field. I ran more stress tests than I care to mention! (I'm already a MULTI-Grandmother!)  Everyone on the planet has the right to feel the way they feel; they have the right to be scared because that is the human in all of us. I do believe that. The first thing you really need to understand is what causes angina; it is a lack of bloodflow to the muscle of the heart muscle. The Coronary arteries are located on the outside of the heart and supply the blood; if those arteries are blocked, you have angina as a result. It takes approximately 20+ years of eating junk foods to build up enough plague in those arteries to cause angina. Didn't you tell the OP that you were about his age of 24? You could have a genetic problem that causes the plague to build-up at a excellerated rate; you would be well aware to this through your bloodwork and through people in the family having heart attacks in their 20-30s. (I'm not talking about family members who die suddening as a result of arrhythmias which many people misjudge as dying suddenly from a  heart attack. (Arrhythmias kill suddenly, heart attacks rarely do). You wrote that you have pain on the left side of your chest; most adults know that the heart sits (or actually tips) to the left side of the chest; they assume that any pain on the left side of the chest is from the heart. True heart related chest pain is not located on the left side of the chest, Larry, it is across the entire chest and even is located in the middle of the back, between the shoulder blades, although that is seen more in women. True angina, when not treated DOES NOT STOP in a matter of minutes ( I believe you mentioned pain lasting up to 1-5 minutes) Most doctors will tell cardiac patients to wait and see if the angina continues for a half hour, if it does, go to the ER. Now having said that, stopping the activity should lessen the angina. However that is in patients with blocked arteries. You don't have blocked ateries; if you did, you would NEVER have had, not one, not two, but three NORMAL Stress Tests. Your doctor, who you are basically calling a jerk, is following the normal standard: do the EKGs, if nothing shows up, do the stress test ( which he would do with the symptoms you describe), maybe he would do an Echo as well and as you already said he did the Holter. A Cath is invasive and your symptoms combined with your test results do not warrent doing such a test because that test is there to determine the state of blocked arteries as well as checking the pressures of the heart chambers. Why do you feel you need a cath done? What do you think it will show you? I can tell you that the symptoms you are describing as far as exercise intolerances go would mean that you had a VERY SEVERE heart disease, literally dying from heart disease. My daughter was like that, she couldn't walk very far without chest pain and eventually she had chest pain sitting in a chair. To give you an example: her ventricular chamber walls were so thick she didn't have chambers really left anymore and muscle "bridges' were all growing through the chambers blocking bloodflow. She, in essence had not chambers left by the time she recieved her new heart. I'm not writing to make the comparison, I'm writing to let you know that with the symptoms you are claiming, any doctor would be expecting to see a very damaged heart. You are young, try not to throw away your life at this point, as you get older you will find your body doesn't work as well as it did when you were younger. ( I'm sure there are a lot of people on here who will tell you the same thing!) I also wanted to mention a couple of other things: PACs and PVCs are totally normal in the human heart. EVERYONE on the planet has them everyday of their lives; how they live with them and accept them determines how bad they become. I will never say I have not been in fear of losing my daughter at one time or another, but I can say for a fact that I have never been in misery as you put it; what I don't understand is why would anyone live in fear and misery when it has been proven that there is really no threat of wellbeing; people are capable of making their own hell, afterall, what is important is realizing you are making your own hell. The catacholamines you are putting through your system is playing havoc in your own mind.  .  

[LarrytheAstronaute]

I am very sorry about your daughter, but i believe every person has a right to be scared of death whether their symptoms are truly caused by a real underlying disease, yet undiagnosed, or simply in their minds. Yes my symptoms for angina DO make sense. You tell me if a person climbs a flight of stairs and their heart is racing and at the top of the stairs they get chest pains which last a minute or two, if a person walks a block and they develop chest pains that last 5 minutes or so should simply ignore these symptoms because they 'dont make sense'. Whether your bothered or not is of no concern to  me when i have to live every day with chest pains, pvc'c, exercise intolerance, etc. etc. EVEN if my symptoms are no more then severe anxiety, it does not you or anyone else the right to feel that only they are entitled to fear and misery simply because they are living with a diagnosed and real disease.

[ireneo]

That's good information to know. I've heard and read about e. spasms but wasn't clear how they felt. Sorry you go through that. Sounds painful. Thanks for explaining.

[grendslori]

How true!!! Esophageal spasms can be very painful! When that happens to me, I feel like my throat is swelling up really bad and I can't talk with it being hard to breath! Those spasms aren't fun!!

[ireneo]

I really like what grendslori had to say. The thought of vasospasms came to mind and now it's covered. I also thought of esophageal spasms that can be painful. Considering your alcohol consumption, I wonder if your stomach and esophagus are giving you fits rather than your heart.

I also have Raynauds (feet and hands get icy cold and turn white or bluish gray - ick). The past couple years I've had increasing chest pains that grab me. Treatment plan is to use a CCB (Diltiazem) that helps with Raynauds as well as the chest pain. We'll see. So far, so good.

I wonder if some of your symptoms could be an anxious response to your pain. That happens after awhile. A person will feel pain and the mind kicks in thinking the worst and other symptoms occur (dizzy, sweaty, wanting to pass out). I understand you want some answers. But so far you say all the tests are negative. I agree - if you had blockages and ischemia, I doubt you could run on the treadmill.

Whatever is going on, I hope you get some answers that will put your mind at rest.

[grendslori]

I was really bothered by the comment you wrote when you said you felt like you had no life and were going to simply die. Having lived, and raised a daughter who had severe heart disease, who was robbed of her childhood and her teen years and who had a transplant at 22, I can tell you what it is like to REALLY be dying from heart disease! From the description you wrote above, you are not dying from heart disease and the angina you are describing, doesn't make sense. I totally understand your retard doctor not doing the tests you want him to do. Young heart patients DON'T want tests done; they want to live a normal life like everyone else. I quit counting my daughter's hospitalizations when we hit the 48 number; the counting stopped, the hospitalizations didn't. Go and enjoy your life and try and stop worrying so much! If you had heart disease, you would not have been able to have three stress tests come back normal.

[grendslori]

I'm going to have a go and try and answer your questions:

1) could you have angina without having a heart attack? Yes, angina caused by spasms in the coronary arteries. You do not have to have blocked arteries for this to happen (I have this problem myself, I do not have blocked arteries) However, saying that you should alos understand that people like that, myself included, also suffer from Raynaurds where the blood vessels in my fingers also constrict. You haven't mention being diagnosed with something like Raynaurds.
2) How is angina picked up on a test? EASILY picked up on the EKG by changes in the actual look of the EKG Complex!!!
3) Does angina mean you are likely to have a heart attack? Not necessarily. A heart attack is caused by lack of blood flow to the heart wall muscle. It takes 20+ years of eating junk food to build up enough plague in the arteries to block them and cause a heart attack. Now there are some congenital forms of heart disease such as the Cardiomyopathies that can cause this to happen in young people where the heart walls are too thick and the blood flow is outstripped; those kids have true heart related chest pain due to constantly having heart attacks (if you had that problem, you would definately know it!)
4) Are you having unstable angina? I can tell you that you would not be able to run on a treadmill if you were having heart problems such as you are describing! The blocked arteries are there no matter what you are doing. Patients that have chest pain at rest are usually on Transplant Lists. They are classified as a Grade III- Grade IV heart patient and have SEVERE heart disease, in other words they are dying from the disease.
5) You drink a lot. I'm not going to get into the mess you are making of your liver as this is a heart forum, so I'll just tell you about what you COULD be headed for. It's something called Alcoholic Cardiomyopathy. Yes, you can destroy your heart by drinking too much; you might want to put your beer  mug down or your worse fears may become your reality.

Having said all of this, I don't think you really have a lot to worry about. Stress can do a real number on one's body so try and relax. A BP and HR that you describe can simply be a reaction to the stress you feel. If the problem is as severe as you descibe, go to the ER and have them check you over; that might make you feel more comfortable; keep in mind that we do not know you and therefore cannot give concrete advice on here.

[LarrytheAstronaute]

i am close to your age so convincing the doctors have been next to impossible about my symptoms and what they could mean. What tests have you had? My symptoms are very similar to yours, i have had 3 stress tests in the past year and a half, passed them all yet when i am alone and exercise i get pain on the left side of my chest, left arm shoulder, all the works. About the only thing i have not had is an angiogram, my doctor being the retard he is doesnt know the importance of a CT angiogram, he thinks its just another CT scan  that "wont show anything", and catherization is too "invasive". Right now my symptoms are so severe that if i am sitting and i get up my heart races and i get chest pains, climbing stairs gives me chest pains. All i can tell you is, pursue it further with your doctor, have your cholesterol checked, and talk about your family history if theres been any young heart attacks. I myself have no life right now, i keep thinking i am going to simply die any day, i just had a holter monitor and am waiting on the results. I think we both might be suffering from a severe case of anxiety, because it makes no sense to pass 3 stress tests yet be this misrable with chest pains over any exertion. Also do you have acid reflux?