Continued Chest Pains

[Toneman]

I'm a 48 yr old male that started having mild chest pain 13 months ago and went through a complete cardiac workup with an echo, thallium stress and blood work all came back normal.

I went back to the family doctor who put me on a PPI for GERD that resolved most of my symptoms but the mild chest pain continued. I also had a recent ultra sound of my abdomen due to some elevated liver enzynmes found during my annual physical. Liver was fine but they found what they called a significant amount of sludge and gravel in my gallbladder.

I had my annual cardiac work up with my cardiologist last week and repeated the echo, thallium stress and bloodwork from last year, all of which came back normal agian yet the mild chest pains continue.

My cholesterol numbers are total 199 HDL 40 LDL 83 TRI's 380. My blood pressure is controlled at 115/60 and I have no family history of early onset CAD. I walk 2 miles a day at my target heart rate or even above without any problems or symptoms. I am 50 lbs over weight and have lost 30 lbs in the last 4 months. Also, I do not smoke.

I know the accuracy of a thallium stress test is 85% and my cardiologist does not want to do a cath based on my recent test results and the lack of any other symptoms. She feels the risk is greater than the likelyhood of finding anything significant.

Am I at a point that I should stop worrying about this being cardiac related and move on?

These pains are fairly mild and don't affect my daily life too much but are a constant worry and concern.

Any input would be greatly appreciated.

Jon

[Cleveland Clinic]

Jon,

Thanks for the post.

Am I at a point that I should stop worrying about this being cardiac related and move on?

I wouldn not pursue too much more of a work up in someone with your demographic beyond what has already been performed. Im not sure what to tell you. If you continue to pursue the issue, someone will eventually cath you, but its probably not the right thing to do with your lack of risk factors, atypical symptoms, and completely negative noninvasive evaluation. Instead of asking me the above question, you need to ask it to yourself. If the answer is "no" then perhaps you need to figure out what is driving the excessive anxiety and stress.

Good luck

[PED]

Well, if it makes you feel any better I'm 35 with the same complaints.  My cholest is a bit higher than you (230) ldl 145.  My BP runs in the 120's/130's.  I'm only about 20 lbs overweight and exercise regularly.

Went through the same as you.  Thallium ECG stress in December- fine. etc..

Still having random chest pains, went for GI work-up.  GI scope showed some reflux and erosion, but nothing major.  Max doses of PPI's anyways.

Anxiety over all of this landed me on Xanax (low dose).  In addition started on 2 bp meds, lipitor, nexium, zantac.

I honestly was feeling worse and worse the more meds loaded on.

Gall bladder pain for sure.  

My GI then turned into a mess, and I had muscle cramping from lipitor (also some GI effects).

I've started to pull myself off the meds slowly. (other than lipitor which I was told to stop asap)

I'm SLOWLY starting to feel a bit better GI wise.  

I guess I tell you all of this because I think I turned myself into my own visious cycle...

Chest pain- anxiety - GI got worked up - loaded up on meds for all - felt worse GI/ no change cardiac fears - more tests - no more answers - throw more GI Meds at it - gall bladder pain - more worries - more anxiety - more xanax etc....

So.  I have a new approach.  6 months ago I felt pretty good other than some shooting pains and chest pain.  No question I was under a LOT of stress at that time. GI was fine.

So, I'm pulling back on all meds. Lipitor is done (going to keep eating healthy, maybe try niacian in time).  Tapering off of Xanax (I think even at a low dose daily for 3 months I got a slight physical addiction).  Slowly pulling back on the PPI's (rebound effect was horrid after stoping 80mg nexium cold turkey).  Went to 40, to 20 prilosec, and working just toward zantac.

Now, I still have a big fear about my heart and that is a big (most) of the anxiety now.  I'm going to push for a 64 slice CT scan (3D).  If they won't give me a referal, I'm going to a center in NYC that will do it for 1200 bucks.

I honestly believe if I get a all clear on my heart, and wean off these damn meds I'll feel better and better.  Bottom line is last July I felt great.

Once I clean my system out of all the meds.  I'm going to talk to my IM about a low dose of something for the BP and maybe try niacian, and go back to OTC stuff for heartburn.  I'm convinced I hosed up my whole system.

Try not to fall into the trap I did.

[giggles92756]

Please just be happy and relieved that all you cardiac tests were normal and take that as a clean bill of health heart wise. The reason I say this is because I was in the same boat as you and I continued to investigate and someone did do a heart cath on me. My arteries were perfectly clear however he dissected an artery in the procedure sending me for emergency double by-pass surgery which failed a few weeks later. I am only 49 years old and I am now trying very hard to stay off the heart transplant list. I would give anything to go back knowing what I know now and I would NEVER have gone through the cath. Take your negative heart tests as a blessing and just start to love life because in a moments time your life can drastically change for the worse, I'm living proof!!!!

[tickertock]

Thanks for sharing, like Dr. RCJ used to say on this forum when he use to reply to questions if you go to the barber you're gonna get an haircut, maybe everyone should think twice about pursuing invasive actions when every other tests points in the opposite direction,I will acknowledge there are exceptions to rule. But do the benefits ouweigh the risks, well from your post , you're living proof it's mostly best to take no/negative for an answer. Good luck, best wishes and I hope things go fine for you.

[Toneman]

Thanks everyone, I appreciate the comments. It sounds like it's time to move on and put this behind me and look in another direction.

Again, thanks!

[LukeL]

Like the doctor said eventually you will find a Dr. who will perform any test on you for any number of reasons. It seems you know about the accuray rate of the tests but you also forget that all tests have false positives which can result in more redundant and dangerous procedures being done. I had a VQ scan done because of a slightly elevated result on blood work which I didn't need in the first place.

Just try to move on and look for another cause of your chest pains like stress and anxiety.

[Mantels]

I recently had chest pains. I had a stress test 3 months ago and aced it.

I had heartburn and the doctor gave me Prilocec and an OTC anti heartburn.

Had an EKG that looked normal.

Finally decided that chest pains ARE NOT normal. Had a cath done and had a 100% blockage in LAD.

Get it checked! Don't delay.

[Mantels]

also with TRIG at 380, you need to re-evalute your diet.

Incedently my thallium stress test went over 20 mimutes.

Get the cath., it is no big deal.

[jmike1_]

Doctors usually know best, but thought I'd throw out for you that I also had chest discomfort (not pain, just pressure) and discomfort in my shoulder.  Did well on all tests, and the doctors were convinced that it was not cardiac.  The difference between us is that I have high cholesterol and a family history, but I work out quite often and am young (38) and don't smoke.  Ends up, after pushing the doctors to do a heart cath, I had 80% blockage in my LAD and had angioplasty and 3 stents put in.  My recommendation is to listen to the doctors, but also understand that you know your body best and if you know something is wrong, you should continue to push your doctors until they find out exactly what it is.  Until they do the invasive procedure, their recommendatin is a highly educated analysis - but not fact.  I'd never recommend an unecessary invasive procedure, but I'm glad that I pushed and got treatment.  I wouldn't recommend going straight to a heart cath, but I'd ensure they find out what IS wrong.  Chest discomfort is nothing to put off.  Take care and best of luck.

[blueangelz]

A while back I had "pebbles" in my gallbladder and that left me with a low grade chest pain. I had a few episodes of the "pebbles" passing and that was one of the WORST pains I have ever had. After I had it removed it has helped alot. All my chest pains now come from anxiety..lol. That could be a big part of your pains though. Good Luck to you!!

[natalie31]

Hi! I am a 17 year old very athletic and in shape female who has been experiencing increased chest pains. I call these episodes "attacks" and have been having them since I was 10 years old. After the attacks, I experience weakness and fatigue. It hurts to breathe, therefore, I usually don't breathe, which really doesn't help the situation but stops the pain for a few seconds. The pain is the worst thing I have ever felt and is increasingly getting worse. There is no set situation that causes them cause I have had them in the middle of a basketball and in the middle of the night and they last anywhere from 20 minutes to an hour and a half. My parents have taken me to 3 different cardiologists and a neurologist and I have had countless tests, including a stress test, tilt table test, too many EKGs to count, 2 ultrasounds, and many more EEGs as well. Each doctor has said there is something wrong but they can't seem to find it, especially when my last EKG was abnormal. (In order to get a normal reading, I had to hold my breath!) I have also been checked for anxiety and stress disorders, all of which I have been cleared because I am well-oriented and pretty much stress-free. I am very tired of doctors and hospitals and tired of getting no answers and the pain just keeps getting worse and it feels as if it is wearing on my body because every attack is a little longer. I have run out of options, and money! If anyone has any suggestions, please let me know!!!

[princess21]

hi. im a 20 year old female and i am experiencing the same exact chest pains as natalie31 but these spains can last for a few minutes and occur a few times a day to having the pains constantly all day. It hurts to breathe so i can only do quick breaths and these pains interrupt my sleep. I went to a doctor and she told me that i was absolutely normal. If im absolutely normal then i wouldn't be having these horrible chest pains? Some of the women in my family have MVP but my doctor said that i don't have that. My mom told me that its stress but i personally don't feel that stressed out. I would really like to know what these pains are and what they are caused by so i can treat them in any kinda way.