Chest Discomfort

[Jangel]

I am a 36 year old woman in general good health but could stand to lose about 20-25 pounds. I do aerobic exercise 3-4 times a week , though I haven't been doing my regimen for the last month as we just bought a house and I do not have time.
About 2 years ago, at the time of my wedding, I began experiencing some discomfort in my chest - mostly left side under, on the left and right side of my breast that is sore when pressed. After experiencing more stressful things in my life, I was diagnosed with GERD. Since then, I have had 3 EKGs, a Pulmonary Function test and a Stress Test, all of which were normal. I was told that the chest discomfort was due to GI problems or a muscular source. A few months ago, after a miscarriage, the chest pain became more pronounced. I went to the ER, EKG was normal and they attributed it to esophagal spasms and/or anxiety, and said the normal stress test ruled out cardiac source of the chest pain.
Since then, I still feel the discomfort, and sometimes it feels like a tightness as well.
I have recently started .025 mcg of Levoxyl for mild hypothyroidism but am not on any other meds.
My overall cholesterol is 220, but my HDL is good at 68 and LDL is good at 125.
I am still concerned that it is cardiac as my father died at 56 during triple bypass surgery.
Again, I have always had a clean bill of health at every annual physical, but do have frequent headaches and some occasional dizziness, as well as indigestion and GERD.
My doctor doesn't seem concerned, but could the chest pain be cardiac in nature? I am very anxious. Thank you.

[CCF-M.D.-RCJ]

Jangel,

Sorry to read of your symptoms.  No lab test, physical exam finding, EKG, or stress test can completely rule out that your chest pain is cardiac.  Darryl Kyle, a 32 year-old pitcher with the St Louis Cardinals, just died without warning; presumably from a heart condition.  It's a dangerous world.

You have two options. You can decide to live with the very, very low possibility that your pain is from your heart, or you can proceed with more invasive tests, such as cardiac catheterization.  You'll have to decide how much risk your willing to take to relieve your anxiety.  The national risk of death or other adverse event with cardiac catheterization is about 1 in 1500.

Hope that helps.

[Jangel]

Thank you for your reply. It sounds as if the Cardiac Catherization is more risky than having a very low, low possibility of heart problems. Your reply has eased some of my anxiety.

[Mamachan]

I am a forty-six year old lady who has multiple disabilities, is sedentary, and who weighs 180 lbs at five foot six inches in height.  I, too, have chest pains.  I have had these pains since about 1997, and they occur one or more times per month.  They usually begin with pain in the center of my chest, about the area of the breastbone, and they intensify and radiate into my jaw, and after three to eight (or ten) minutes, they have subsided.    They are very consistent in their manner of behavior, although occasionally the pains begin in the jaw, and radiate to the center of my chest.  Anyway, last October I had one of the pains, and I went to the Emergency Room, not knowing what to expect.  They admitted me, and they kept me in the hospital for two days and gave me an echocardiogram and a thallium stress test.  These only showed some regurgitation in my mitral valve and my tricuspid valve.  I already knew about the mitral valve.  Ever since about 1985, I have taken a beta-blocker for MVP.  My doctor believes that it is GERD or a muscular problem.  I don't think it is GERD, as I take Nexium every day, and it does not feel like something gastric, and why would GERD cause pain to radiate to the jaw?  Perhaps the pain is musculo-skeletal, since I have Reflex Sympathetic Dystrophy (RSD) from an injury to my right forearm, and this RSD causes muscle spasms and trigger points and myoclonus and vascular constriction and vascular spasm.  Maybe the RSD also causes chest pain and jaw pain from muscular disorders.

It is confusing.  I, too, don't know if I should pursue testing or believe it is just GERD.  The truth is, it feels like something cardiac.  But who am I???  I am no expert...just the one to whom it matters if it really is cardiac.  

I would appreciate any comments on what I have written and any comments from the person with the original post.

[Addie]

I too have had chest pains since April.  I called a gastro doc and they did an EGD and found grade 1 esophagitis. They then did a CT scan and it showed dilation of the liver.  They also did an MRCP and MRI of the abdomen and this showed no dilation but a hiatal hernia but small to medium in size.  They want me on Nexium, i think for the rest of my life...but I do not think I want that forever.

Anyway, i am very concerend that this could be heart related and not all GERD/reflux.  I called a cardiologist's office after I saw the Oprah show the other day about women and heart disease and how women are not taken seriously.  One lady had to beg for an EKG at the age of 29 and was having a heart attack.  Oprah herself has had a heart catherization but it was normal.

When i called for an appointment for my chest pains, i was not able to see the doctor for 2 weeks.  Now, what does this tell you. I think if I were a man, they would of worked me in.  

My sister has a stent.  My father died suddenly at the age of 39 of a heart attack?  Mother died of heart problems but at age 77.

I make myself sick, worrying about whether my chest pains are heart related and not reflux.  I know I aggravate the condition but I cannot beggg someone to see me. Then I worry if I am going to a good/nice cardiologist.  Never an end to this worry.  I do know that when I finally see someone and get the necessary test, I will be relieved, either way, and will feel better.

I told my husband at times it is hard to be a female for the stigma many docs place on us.

Good Luck to all of you.

[emeraldone]

I had chest pains from drinking Crystal Light (aspartame).  Is that part of your diet?  It took about 6 weeks after stopping using the product for the chest pains to totally cease for me.