Concerned for Husbands heart

[zil]

Hi.  I'm concerned for my husband.

33yo male.  High blood pressure.  Controlled with Altace.

Chest pains led to an ER visit, ekg, blood, x-ray, and stress test all clear they shot him with a nuclear material during the stress test 4 months ago.

He continued to have pains, including arms and jaw.  He occasionally wakes up in the middle of the night clenching his chest, but it goes away quickly.

He has an occasional PVC, 1-2 every 4-5 minutes.

He wakes up a lot with jaw pain and shooting pains in his arms, however it is generally not associated with any chest pressure other than those occasional cramp like pains.

He can jog for 1 hour plus without any chest pressure.

I lost a brother to sudden cardiac death so I"m extra sensitive to this stuff.  His internist seems to think it's just stress or neuromuscular.

Cardiolgist said his heart was fine, but didn't do much other than interpret the stress test, and listen to his heart for a few seconds.

I'm worried since he wakes up a lot with these jaw pains and quick chest cramps or his heart pounding.

Does this sound consistent with anxiety and stress?  Should he push for more cardiology testing (stress was clear, as was a ct scan).  Calcium score was zero, and it said he had a normal ejection fraction and all ateries were free of intraluminal defects (reading from the report)  would that include soft plaque?

thank you - worried wife

[hbp702]

Waking up with chest pain, but OK with exercise -- have him checked for sleep apnea ASAP.

[woodruff]

I agree about the C-spine possibility.  It's certainly worth looking into.

One other idea:  Waking up in the middle of the night, whatever the cause, isn't part of the normal program for a guy your husband's age.  I might just investigate a night at a sleep lab, because disorders of sleep cycles are not exactly rare.

[jan]

Another thing it may be is C-spine problems.  I was actually admitted to the hospital by my cardio, because of the heart attack like symptoms (pain in upper l. back, up neck and down arm).  My ekg was abnormal for some reason then too, but the pains really had them concerned.  It was all from my C-spine.  

[tickertock]

I am not a doctor but given his 64 slice was clean I would even be more reassured by that. I myself am a sufferer of PVCs & tachycardia(controlled with atenolol and cozaar) chest pains,occasional jaw and arm pain that is reproducible by pressing my chest. I do have costo and FM secondary to a CTD that I have. I have also been told that my jaw pain is probably related to anxiety and being high strung, alot of persons with anxiety and stress related problems tend to clench their teeth while sleeping and can be a common cause of jaw pain . Of course this might not be related to your husbands problems at all. I am only stating my personal struggles & experiences.

[ozark]

2 other things you might want to check out is esophageal spasms and a dentist to see if he's clenching his jaw at night.  just a thought  good luck

[zil]

Thank you so far.

Yes, he tried lots of GERD meds to no avail.

The CT scan was a 64 slice CT, with dye to watch the coronaries.  His calcium score was zero, and it said something about the inner lumen showing no stenosis. Again, I assume that is soft plaque they checked for, otherwise why not just get him a calcium score (even the co-pay's on that one were pricy!)

I guess I'm heartened that that particular test was clean along with a nuclear stress and that he can exercise without difficulties.

It's just when he wakes up with the clenching and jaw pain I feel awful for him and I worry.  It's affecting us both.  I may point him towards this site.

[momto3girls]

Hi Zil,

I'm so sorry to hear your husband is having health issues.

Is his chest pain re-producable if you press on it?  If it is that's a great sign that it's muscular.  I've been told by my own heart doctor that heart related chest pain is not palpable.  The reason I'm asking is that I too have chest pain that at times shoot down my arm and up my jaw.  I just recently realized that if I push down on the part of my chest that hurts, it shoots pain all the way down my arm.  It could be costochondritis which is an inflammation of the cartilage connecting the ribs to the sternum.  Mine hurts a lot at night too, depending on the position I'm sleeping in.  I've made numerous trips to the ER thinking it was my heart only to be told it wasn't.  BTW, I too am 33 years old.  

That is fantastic news about his heart tests.  If he can jog for an hour without chest pain, that would be very reassuring to me.  

I've also woken up in the middle of the night with tachycardia/pounding heartbeat that I'm told is most likely due to anxiety.  It's such a hard problem to sort out, but the fact he's had a cardio work-up and went to the ER at the time of an episode and still they found nothing, sounds good.  

I'd like to reiterate what anacyde mentioned, check the GI out as well.  Gerd can present very strangely in some people, so I'm told.  Some people won't even have the classic acid reflux.  Who knows.  Best of luck to you and your husband.  I hope the forum doctor will help to reassure you or point you in a better direction!  Best wishes (:

[Cleveland Clinic]

zil,

First, remember, your family history will have no effect on your husbands cardiac health.

With a low calcium score, a normal stress and the ability to exercise an hour, I would look at other causes of his symptoms and wouldnt not personally persue any further cardiac testing unless his symptoms changed. I would however make sure his blood pressure and other cardiac risk factors such as his cholesterol was under strict control.

Soft plaque in the CT scan can be seen as well as the study is of good quality.

good luck