Chest discomfort (not cardiac)

[trubrit]

I am a 51 year old female who has had 2 heart attacks and a 5 vessel bypass surgery that failed.  My only options right now are to be treated with medicine and maybe later a heart transplant.  I continually get chest pain in the center of my chest (pressure) but my cardiologist says it is not cardiac related.  

Is it possible to have angina without changes on an EKG and with negative troponins.

Thanks

[CCF-M.D.-PPB]

Abslutely, especially if you chest pain feels like tightness in the center of the chest with associated shortness of breath or radiation to the neck or your arm, occurs more so with exertion or stress, and improves with rest or relaxation.  EKG or troponins are not very sensitive for detecting angina.  Symptoms that are reproducible as I described above are.  If you are still experiencing those symptoms and there is nothing to be done from an interventional or surgical stand point, then maximal medical therapy is indicated.  You should be on beta blockers, statins and nitrates at least.  Heart transplantation is never performed for angina, it is only offered in heart failure which based on what you have told me you don't have.  Also keep in mind, that sometimes, after heart surgery people experience chest pain related to the operation (sternotomy).  It typically feels like skeletal pain and is not reproducible such as angina is.  This type of pain is called non-cardiac.

[Jack54]

Do you ever try fast acting nitro to relieve this pain? If it helps or stops the pain, odds are it is cardiac related. I have read that nitro can help the symptoms of GERD.

Why do you say that your bypass failed and when did you have the surgery? If the bypass failed then you have good reason for having angina, right?

I sure hope that you can get things sorted out. Best of health to you  :)

Jack

[trubrit]

Thanks for the reply.  I carry nitro with me at all times.  I had my bypass surgery in May 2006 and in June they did an angiogram because of the chest pain I continued to get.  The angiogram shows that 4 out of the 5 had already occluded.  I knew that one had gone done, that happened about 30 minutes after surgery causing the second heart attack.  That was the one that did all the damage.  The bottom part of my heart no longer works (that is why they are considering heart transplant in the future).

Thanks

[Jack54]

All is very clear now. What an ordeal you are facing! My prayers are with you and I hope that you soon get a new heart. G-d bless you,

Jack