Chest Pains and PACs

Thank you for taking the time to answer my question.
I am a 27 y/o female. I'm 5' and 120 pounds. Cholesterol is 143. I smoked for about 10 years and I recently started the patch. Two years ago I began to experience chest pains 1-3x/week, particularly in the morning (90%), and often when the room temp. was cold. But, being outside in cold weather was not usually a trigger. The chest pain does not occur upon exertion. These pains could last between 5 mins and 5 hours. The pain level doesn't intensify during that time, but it does radiate straight through to my back. I went to the doctor and he treated me first with anti-inflammatories and then with digestive medications (e.g. heartburn, reflux). Nothing worked. One year ago, I also experienced a skipped heart beat. I went back to my doctor and he put me on a holter monitor for 30-days. The results showed that I was experiencing PACs, and doctor put me on Atenolol (half of a 25mg pill). I've been taking this for about two weeks and the PAC intensity is less but the frequency is about the same. I also had an echo done and it showed everything to be normal, except I had a slightly leaky valve and a minor heart murmur. What does mean?
1. If I do have a heart problem, would the holter monitor have showed anything abnormal if I hit it while I was experiencing the chest pains?
2. What type of testing should I request from my cardiologist and what should I be looking to rule out, based on my symptoms?    
3. Is there anything I can do between now and my appt. to decrease my risk of something serious happening?
Thank you, again!

[Cleveland Clinic]

Preslynn,

1. If I do have a heart problem, would the holter monitor have showed anything abnormal if I hit it while I was experiencing the chest pains?

The heart murmmer and leaky valve are common in some people.  If there isnt much leakage, there isnt much to worry about.  A holter would only show changes in your heart rhythm.  If the pains you are having were related to that, it would show up on the holter.

2. What type of testing should I request from my cardiologist and what should I be looking to rule out, based on my symptoms?

At 27, your risk of coronary atherosclerosis is miniscule.  That in addition to the quality of your symptoms.  I probably wouldnt really order that much else from a cardiac standpoint in you at this time.

3. Is there anything I can do between now and my appt. to decrease my risk of something serious happening?

No.  If you have recurrent symptoms that change form what you have been having, I would seek out medical attention. Howver, the fact that these symptoms have been ongoing for 2 years with no major sequlae suggest that it most likely isnt your heart nor will you have a major risk before your appointment.

good luck

[salis110]

dear Dr.
somehow I have  same symptoms, sometimes i feel dizzy but when i check my pulse it is normal as always for example it is 60 or little more or less.but sometimes it beats faster till 90-100 without any activity, at this period of beats i feel something happens in my chest, it is not pain or ? and after a short time (1 or 2 secs)i feel a heavy pulse and after that every thing goes ok but some anxiety.If casually through this event I check my pulse I feel an interrupt or skipping pulse.It makes me crazy.Also sometimes i feel pain in my chest bones dr.s siad they are due to ur anxiety.
I did echo which was ok and 24 hrs holter i had a period of 43 bpm during sleep at night and a 2.14 secs rest in hearts beat plus 2 rests less than 2 secs.
whats going on me? what are skips in my heart with odd feeling