Constant chest pain

Posted By  CCF Cardio MD SK on February 12, 1998 at 08:06:24:

In Reply to: Constant chest pain posted by Angela on February 10, 1998 at 13:33:40:

: I am a 31 yr. old healthy female (5'4", 130 lbs.) diagnosed with mitral valve prolapse a yr. ago.
  I am also on birth control pills and smoked on and off (socially)for about 10 years.
  I quit smoking 6 weeks ago.  I have infrequent symptoms from the MVP including increased
  heart rate, chest pains and trouble sleeping.  At the very worst, my left arm
  feels a little numb and I get an aching in my neck and around my left shoulder blade.
  However, over the past couple of days I have experienced a constant pain in my chest
  along with a dull pain shooting through my neck, shoulder and shoulder blade.  
  The thing that concerns me is that usually it stops by the next morning.  This
  has lasted for over 24 hours.  I am a big worrier, therefore I have already scheduled a
  stress test for tomorrow.  
  My father's parents both died of heart failure at around 50 years of age, and his brother has had two
  multiple by-pass surgeries (he's 60).  Recently my father (age 57) had angioplasty.  And
  my mother's father died at 61 of heart failure.
  Am I too young to have angina or heart failure?  I have heard of supposedly
  healthy athletes that die suddenly of heart failure.  How can this happen?
  Could MVP been a misdiagnoses even after I had an echocardiogram, chest x-ray,
  blood work and an EKG?  Should I see a Cardiologist instead of my family doctor?
  I also would appreciate any recommendations for liturature to become better educated.
  Thank you for your response.
  

[CCF CARDIO MD SK]

Dear Angela,
Mitral valve prolapse (MVP) is a specific diagnosis made with echocardiography. Though MVP is associated with chest pains, pain that last for hours is not likely to be from MVP. At your age, even with some risk factors for coronary artery disease, it is uncommon to see a significant coronary artery disease in women. After having said that, stress test is not unreasonable and will be particularly useful to rule out cardiac problems if it is negative. I think, you should discuss the need to see a cardiologist with you primary physician. Sudden cardiac death in the athletes is from completely different pathology. It is not from coronary artery disease. I am glad that you gave up smoking, keep it up!
If you are seeking a second opinion or further evaluation, an appointment with one of our cardiologists can be arranged by calling the Cleveland Clinic at [phone].
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your family physician(s).