Angina? Symptoms

[fallon09]

I have been having pain with exercise the last year or so. The pain sometimes feels similar to indigestion (starts in upper stomach) and other times is a burning pain that radiates to my right torso and arm. The pain is automatic if I have a couple of beers before doing anything strenuous. Like today, at the Patriots game, I had a couple beers and I could hardly climb 20 rows of steps to go to the bathroom without severe pain. (for some reason I remember this happening to me when I was much younger as well so if this is caused by CAD, then I have had it for a while. More concerning because it started within the last year is, when I have had no alcohol, the pain is more the indigestion type in the high stomach and comes on with intense exercise. I was a division 1 college athlete and never had any trouble with exertion. I have had two exercise treadmill tests which I passed with no symptoms (of course, I wish I had the symptoms so I would feel better about the good scores). The ETT's were also considered by the md's to be pretty conclusive because each time I got my heart rate to 210 bpm's or so with no symptoms or irregularities. I am a 30 year old male with hiatus hernia, elevated cholestorol 215 total but my HDL is low and my LDL is high, normal BP, 5'8'' 160 lbs (stocky build), both grandfathers died young of heart disease (55-60) but my parents and siblings are fine, I do not and have never smoked and I don't drink more than say 8 beers per week. Should I take my doctors word and not worry about this as they are confident that at my age and limited risk factors that my heart and arteries are fine? Any thoughts on this? Thank you for your help.

[Cleveland Clinic]

fallon,

Thanks for the post.

The patriots game this weekend was about enough to give anyone Angina unless you were from the West Coast.

That said, it is highly unlikely that your symptoms are cardiac in nature. The chronicity and your risk profile both argue this fact. It would be more likely to be GI in origin especially given the effect of alcohol on increasing the symptoms.

If you were a Division I athlete, I would strive to maintain a high level of fitness throughout your life and work with your physician to develop a plan to do this.

good luck

[fallon09]

I do have gerd, but it is under control with Nexium.  I never get heartburn at all on one pill a day.  I can eat anything without problems.  The thing that worries me is that it is ONLY with exercise that I have problems.  The other thing that worries me is that, on both stress tests, I didn’t get the symptoms that I usually get.  If I got the horrible pain in my upper stomach and had to stop exercising, and they told me my looks fine, then I would be satisfied.  Here is another tidbit that might help y’all give an opinion on this.  Day 1-8:30 am – I have the stress test and I go for 16 or so minutes with heart rate at about 210 bpm (over 200 bpm’s for some time) – I have no symptoms at all except obviously being exhausted – I pushed real hard to try to get symptoms but to no avail.  Day 2 – the very next day I go jogging and after just 3 or 4 minutes at a relatively slow pace, I get horrible pain that starts in upper stomach and then radiates and takes up my entire upper torso (feels very much like indigestion) and I also get short of breath (or so I think – it could be due to the general pain that I want to stop) and then as soon as I stop the pain subsides and I am fine.  My heart rate was probable around 150 or so.  Could it be that I just tolerate the stress test better for some reason or do these circumstances make it less likely that my symptoms are caused by CAD?  I am (or should say was) the youngest player on my adult hockey team and based on visual appearance, the most in shape, but after a couple of regular shifts, I can’t last 20 seconds without intense pain as described before and when I get off the ice, the pain goes away and I am fine.  It does seem to vary in degree of intensity.  Doctors don’t take me seriously especially in light of the negative tests, and I want to believe them so much, but I want a definitive diagnosis.  Thanks.

[PJmomrunner]

When you say "upper stomach," where do you mean in relation to your sternum?

[fallon09]

When I say upper stomach, I mean just below my sternum (vertically that is as if I were standing up), so it does not start where the heart is.  It originally led me to believe that my hiatal hernia was the cause because that is the location of the pain, however, in reading about angina it is said that occasionally the pain can be felt in the epigastric region which is where mine starts, also, why is pain ONLY with exercise.  As far as the gerd vs. CAD etc, I have had gerd since I was a teenager and I was on only zantac and had no problems at all exercising to very intense levels, now, with my gerd even more under control, I can’t and I do know what heartburn feels like and this is not heartburn.  My doctor thinks I have had a complete workup because he ordered the stress test.  I even went straight to cardiologist in Boston to tell him my symptoms.  First, he tried to tell me it was asthma, then he ordered a stress test which again came back, not only normal, but good as in excellent tolerance.  Of course, as mentioned, I had no symptoms during the test which worries me.