Chest pain - not heart attack

Posted By  CCF CARDIO MD sc on January 13, 1998 at 09:37:54:

In Reply to: Chest pain - not heart attack posted by polly on January 09, 1998 at 09:43:20:

: My sister and I have both been having similar symptoms.  We are
  mid-early 50's and have both had heart attack/disease ruled out.
  Symptoms are chest pain/pressure.  Mine is always on the right side,
  feels like right lung is going to explode.  The pressure may last anywhere
  from a few seconds to 1/2 a day or longer.  Sometimes the pain radiates
  up through neck, lips tingle, once a tingling in center of back.  As I
  said we have both had every test available to rule out heart attack/disease.
  For nearly 2 years, I have kept a log of everything I did and ate just
  before the pressure started, some patterns show up, but not consistent.
  Any ideas?

[CCF Cardio MD sc]

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Dear Polly
Your problem is unfortunately a very common one. Chest pain notoriously associated with heart disease can arise from a number of different conditions and organs present in the chest and even remote from the chest. A clear and careful detailed history on the character, location, duration, precipitating and alleviating factors of the pain is an extremely helpful guide but is not complete as a definite diagnosis may still be missed. Although your symptoms are not typical for heart disease I agree with your doctors in investigating for the possibility of heart disease. If the investigation was exhaustive with an imaging stress test and an echocardiogram to rule out structural heart disease, it might be time to start looking at other possibility of our etiology while at the same time reassuring yourself that the likelihood of you having a serious cardiac condition is very remote. I suggest that you look into the possibility of a gastrointestinal problem or a disorder of the tendons, or nerve endings  at the chest wall level. There are a number of possible treatment modalities for the variety of conditions that give rise to chest pain and I would not focus on the heart for all the answers.
I hope you and your sister get to the bottom of this and find some well needed relief. If you have any further questions or would like to come to the Cleveland Clinic to see one of our cardiologists for a second opinion please feel free to call 1-800-CCF-CARE for an appointment.
Information in this forum is intended for general purposes only, specific diagnosis and treatment strategies should be reserved for physicians directly involved in patient care.