Angina for 28yo!?

Hi,

I'm a 28yo male, playing tennis 3x a week, 183cm, 72kg, BMI 21.5, not overweight at all, usually eat very healthy and I have never ever smoked. On the other hand, I do have a stressful sedentary job, stressful sedentary hobbies and a stressful attitude to life, and both of my parents have some heart trouble (tachicardia, atrial fibrillation), my grandfather went with aortal rupture, and I don't drink. And i've been somewhat of a weakling all my life, quite the opposite of an athletic guy.

I was feeling some palpitation and did an ECG. It showed flat T-waves. Like completely flat. Since then i've been feeling pain and pressure in the upper chest and it increases when I stretch out my left arm (move it to the back when horizontal). Overall i've started to feel worse (breathless after climbing stairs and so forth). Blood pressure was 125/80 I think.

The doctor sent me to an Echo test which will happen in a few days and probably will send me later to an ECG stress test, but won't say what could be wrong with me.

So right now I'm pretty stressed which doesn't help any and am imagining all sorts of medical conditions I could have from reading Wikipedia and Googling.

If somebody could name something benign that this could be it would be much appreciated and maybe will have some positive effect on me.

If not benign then at least something that will likely go away if I exercise, continue to eat well, take some medicine and relax more.

Best regards,
Janis.

[Forum-M.D.-MJM]

Hi Janis,
Cardiac chest pain does not increase with arm movement and reaching.  This suggests a musculoskeletal origin.  You have no risk factors for coronary disease and frankly are too young.  I can't tell you what the pain is from, but the likehood of this being cardiac is almost zero.
I hope this helps.  Thanks for posting.

[CollegeGirl143]

Have you had an ecg previous to the one showing flat t waves? I ask because you may find it important in determining if this is new, or if you've had flat t waves for awhile..  did your doctor end up labeling the ecg as abnormal? boarderline abnormal? Flattend t waves alone are nonspecific and need to be evaluated along with many other factors. Im sure the forum doctor will have some good ideas for you.

Be wary of what you read on the internet :) Take it all with a grain of salt.. Since you havent had all the nessecary tests yet (like the echo you're talking about) its impossible to know if these apply to you.. Stay positive until your echo!

[Janis Nazitis]

Yes, I've had a ECG 2 years ago when I also had some palpitation (IIRC - don't remember all the symptoms) and it showed normal T-waves. That time the doctor thought everything was OK and the symptoms disappeared.

This time the doctor thought the flat T-waves were abnormal and that I should refrain from physical activity until they run more tests.

[CollegeGirl143]

It sounds like you are on the right track to finding a diagnosis :) Ide wait until the other test results come in before stressing to much..Easier said than done i know, its one of the worst feelings in the world to think something may be wrong with your heart, of all things, and have to wait for other tests, but at the same time, nothing horrible seems to have jumped out at your doctor,  so thats something to be thankful for for right now :) Let us know how the other tests go!

[Al Dente]

Although it is rare for the young to have CAD, it is not impossible (remember the Army studies from Nam).  Family history is important and predictive factor.  

Young people in their 20's can have CAD, obstructive enough to cause problems.  I think MJM was pointing out the small chance, but it is a chance nevertheless (someone has to be that number out of the stats).

Lipid panels helps show a person's likelyhood for CAD.  If you've had grandparents, parents, siblings having early heart issues, then I'd get a thorough investigation done.

[Janis Nazitis]

Oh, MJM, I didn't notice your reply at first as it was right above the ad. That's very comforting to know about the probable musculosceletal origin.

Regarding lipids, I had had a blood test done 2 years ago and it showed low good cholesterol (though not a particularily high bad cholesterol). The doctor said I should try drinking small amounts of red wine more and I did for a a year or so and then I kinda gave up on it.

You've helped me a lot to become a bit more relaxed, and I really appreciate all your support, CollegeGirl, MJM and Al Dente.

[Janis Nazitis]

Yes, and I don't think any of my relatives showed early heart issues. The grandfather was probably in his 60ies (though very fit and the aortal rupture was very sudden and with no warning whatsoever - he had been running to catch a train) and my parents started showing some problems also only in their 50ies and serious problems only now in their 70ies.

[Janis Nazitis]

They did my echocardiography and all the findings were normal. The doctor did note my "middle wall" was think. Back wall thickness 1.1 cm, middle wall thickness 1.0 cm, EDD 4.2 cm, ESD 3.0 cm, EF 63%.

So that's good.

OTOH, I've developed a slight tingling in my left arm (all fingers).

I don't know what to make of that, but I'll have a "stress ECG" tomorrow morning.

[Janis Nazitis]

I did a velo-ergo, "Reached 175W, stress tolerance high, stress test negative, stress is limited by a submaximal pulse 173 bmp, BP 170/80 mmHg, trivial changes in ECG, adequate increase in BL and pulse".

I actually felt like I could handle the 200W level as well and was breathing through the nose all the time and not hyperventilating.

The doctor said I can carry on as usual and return for an ECG in 2 weeks to see maybe my T-wave has returned.

Thanks a lot for you help so far, it is much appreciated.

[truman]

Thanks for posting your test results.