Chest pain, tricep pain, PVC's

[PED]

35 year old male, 20 lbs overweight, cholesterol now under control.  Exercise frequently.

My concern is this.  When I'm under heavy stress, my chest gets tight and I will start to sweat.  Never happens during exercise (and I'm training for a triathlon), happens acutely during stress, and sometimes at rest.  I get various upper chest pains, and at times I get almost a cramp in my left or right tricep muscle.  

A year ago I passed a stress test with flying colors, but of course that was physical stress, at that same time I passed a 64 slice CT with no calcium seen.

Again, during physical stress the only, and I mean only pain I have gotten is occasional cramping in my left or right tricep during spin class, but my arms are locked in one position almost the entire time.  Rare jaw pain, but never, ever chest pain. (burp alot though)

So, seeing as how my chest pain and sweating come on during actue mental stress, and never physical stress...

1.  Can I be fairly assured that this is NOT cardiac related chest pain? I also get pvcs, but don't worry about them anymore.

2.  I guess my main question comes down to this.  If I had true cardiac chest pain, related to a blockage, or impending heart attck - wouldn't physical stress bring this on with the same symptoms at mental stress? (wouldn't spin class for 45 minutes at 80% plus of my heart rate bring it on as bad or worse than an argument with my boss?)

3.  Basic, but important question for me.  If it is not a blockage (which I also don't think it is), what causes the chest pain and sweating under heavy work stress?  Is that blood pressure constrictions? etc?  

Thanks, believe it or not I tend to believe that after 1+ years of this with a few tests it isn't a blockage/Angina, since I exercise without problems.  But I'm searching for why I get the pain (I know it's stress) but what is happening to me physically that causes it?

[Forum-M.D.-bkj]

PED,

Thanks for the post.

1. Can I be fairly assured that this is NOT cardiac related chest pain? I also get pvcs, but don't worry about them anymore.


Its pretty unlikely especially with your overall risk profile which seems to be fairly low.


2. I guess my main question comes down to this. If I had true cardiac chest pain, related to a blockage, or impending heart attck - wouldn't physical stress bring this on with the same symptoms at mental stress? (wouldn't spin class for 45 minutes at 80% plus of my heart rate bring it on as bad or worse than an argument with my boss?)

Yes it should. Again your overall risk seems low. That doesn't mean your not getting pain though so you should discuss your symptoms with your physician.


3. Basic, but important question for me. If it is not a blockage (which I also don't think it is), what causes the chest pain and sweating under heavy work stress? Is that blood pressure constrictions? etc? Thanks, believe it or not I tend to believe that after 1+ years of this with a few tests it isn't a blockage/Angina, since I exercise without problems. But I'm searching for why I get the pain (I know it's stress) but what is happening to me physically that causes it?


There are a lot of causes of chest pain which are not cardiac. GI symptoms, asthma, muscular and anxiety can all produce symptoms. I would discuss your symptoms with your physician.

best wishes

[Al Dente]

this is kind of a dilemma.  strictly speaking from my own experience, and from what my cardiologists say, people *generally* don't start feeling the effects of a blockage until it is >70%.  some people are more sensative.  i had ST segment depression with a 75% blockage--my cardio says he had a patient that had angina from a 50%.

unless there's a big lipid problem that runs in your family (for example both mom & dad) obstructive CAD is of low probability, but possible in the young.

some angina can be vasospastic in nature.  your exercise vs. stress question is not really an easy one to answer.  as you exercise, you build into the event.  a stress event, such as with a boss releases all kinds of stuff into your blood stream...your BP goes up, heart rate, vessels enlarge (or constrict).  some people get angina after exerercising, which is tough to track down why that happens.

i hope the docs can help.  good luck.

[DrTC]

Having same type of problem. Orthostatic hypo-tension with excess sinus tachycardia. Lately I can't seem to get my heart rate under 120 bpm. That is at resting. Other times it is up to 180 with no apparent cause. I know a lot is stress related because now I am having shortness of breath and chest pain. Short of taking anti anxiety medication is there something that can be done??

[EchoTech]

Go see a physician or cardiologist.  A resting heart rate should be 100 or lower, and definetly shouldn't shoot up to 180 for no reason.  They will be able to do some test to see if the wiring fo your heart is in good shape or not.

[rachelanne]

I am a 27 year old female, and I have been experiencing a bone ache in my tricep area, as well as heart palpitations in this past week.  I have  very stressful job.  Do you think this might be nerve pain as well as anxiety or related to my heart?

[EchoTech]

Your description is a too broad to really help you.  If you can move in some way to make the pain better, or if you can put your finger on the affected are a and increase the pain by pressing harder, generally, it is not cardiac, but more muscoskeletal.  I would recommend seeing a physician to help better delineate your symptoms  and they'll ask a lot better and helpfu;l questions than I know how to do.  

Good night and good luck.