CHEST PAIN FOR OVER ONE MONTH

[kami]

I AM A 25 YR OLD FEMALE WHO HAS BEEN EXPERIENCING CHEST PAIN FOR OVER ONE MONTH NOW. BECAUSE OF MY AGE MY DOCTOR KEEPS TELLING ME THAT IT IS NOT MY HEART, BUT I AM GETTING CONFUSED ABOUT THE RESULTS OF TESTS THAT HAVE BEEN DONE. I HAVE HAD 5 EKG'S AND 3 OF THOSE WERE ABNORMAL & STATED POSS ANTERIOR INFARCT, TOW OF THEM I WAS TOLD WERE NORMAL, BUT LATER FOUND OUT THEY MIGHT NOT HAVE BEEN. THEY THEN SAY THAT THEY MAY BE ABNORMAL ONLY BECAUSE I AM SO YOUNG AND THAT THIS DOES NOT NECESSARILY MEAN ANYTHING. MY CHEST PAINS ARE ON THE LEFT SIDE OF THE CENTER OF MY CHEST AND OFTER SPREAD TO MY LEFT ARM, BACK, AND SHOULDER (SOMETIMES THE NECK ALSO). AS THE PAIN INCREASES SO DOES MY DIFFICULTY BREATHING. ALSO MY FATHER DIED 9 YRS AGO WHEN HE WAS ONLY 45 YRS OLD (HE HAD A MI). I DO NOT KNOW WHAT TO DO NEXT & AM NOT VERY CONFINDENT OF THE DOCTORS I HAVE SEEN. IN ADDITION TO THAT I DO NOT KNOW WHAT MAY BE MISSED BY AN EKG, HOWEVER I KNOW THAT MY DAD HAD ONE DONE BEFORE HE DIED AND IT HAD BEEN NORMAL.  WHAT SHOULD I DO NEXT?

[Cleveland Clinic, MD]

Dear  Christine,

There are many causes of chest pain.  The one that doctors worry about the most is cardiac because it has the potential to be life-threatening.  Once this is ruled out the work-up can proceed at a more leisurely pace.

Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.

Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.

Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.

As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause.  A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.

[Sandy M.T.]

Dear Kami,
     I was having the same things happenig to me as well as 1,000 extra heart beats in a hour. My cardiologist sent me to another doctor for a second opinion. If you do not feel comfortable with your doctor's advise tell him/her how you feel and ask for a second opinion. Good Luck!!!!

[[e-mail]]

I am going for a thallium stress test tomorrow.  I have had a previous heart attack with damage to the left ventricule. How will they know  what is old damage or new damage. I have had previous tests done but in other facilites. Won't they have to compare to determine if there is new damage?? Or to say it another way, heart tissue died from my previous heart attack
how will they know what was from the first heart attack and what new damage may exist?  

Thanks so much
Brent

[[e-mail]]

I am going for a thallium stress test tomorrow.  I have had a previous heart attack with damage to the left ventricule. How will they know  what is old damage or new damage. I have had previous tests done but in other facilites. Won't they have to compare to determine if there is new damage?? Or to say it another way, heart tissue died from my previous heart attack
how will they know what was from the first heart attack and what new damage may exist?  

Thanks so much
Brent

[Cleveland Clinic, MD]

It would be useful to be able to compare the new to the old but there is still much information that can be gained from the study by itself.