Get a second opinion?

I recently was admitted to the hospital after having chest pain. 44 yr. old female,overall good health,no immediate family history of heart disease.I do have esophagitis and sometimes muscular chest pain from a car accident 15 yrs. ago.(if I press on my upper middle chest it hurts at times, though the pain I had in the ER was different from this and hurt when I inhaled also)) I was on protonix back in January.
I had a thallium stress test. Did well on the treadmill, stayed on as long as they needed me to with no problems. EKG and all blood work and stress test were all normal.Released the next evening, told to get back on the protonix, the pain was probably due to excess acid and I have been going thru a tremendous amount of stress with my 3yr. old just being diagnosed with autism.
The cardiologist told me if something would of showed up they would of done a cath, but didn't think the risk was worth it now.
I am just wondering if a stress test would of been the most conclusive, and should I believe him that this is all due to esophagitis? Also, no other heart related symptoms with the chest pain(in neck or arms etc) They did give me 3 nitro pills, 4 baby asprin and a relaxant adavin(?) in the ER.
Thanks for your input!!!

[CCF-M.D.-RCJ]

Mom to Robbie,

Thanks for the post.  Sorry to read of your recent troubles.

A stress test is not a "conclusive test".  However, a 44 year old woman has a low probability of having coronary artery disease if she has no other risk factors.  If you couple this low probability with a negative test, then you now have a person who has a very low probability of having disease -- less than 1%.

Can I say that you don't have cardiac disease? No.  Can your doctor? No.  Can we say that a 44 year old female without risk factors and with a negative stress test has a very low probability of having disease? Yes.

I've used this quote from my grandfather now for the third time this month: "If you go to a barber, you are going to get a haircut."  I'm sure you're cardiologist would be willing to do the heart cath if it would ease your mind.  The reason he did not offer this to you the first time is that he thinks you are unlikely to have any benefit from the cath, but you still would be subject to the potential risks.

Whether or not you have esophagitis is another matter.  ER doctors frequently call cardiologists first when someone comes in with chest pain, but the bottom line is that cardiologists are not esophagus specialists.  I would recommend that you see your internist for further guidance.

Hope that helps.

[Dr. Erik]

Hello:

There is probably nothing wrong with your heart. Definitley get back on the Protonix. However, women get different symptoms than men sometimes with heart disease. Tests can also come up negative when there is really something wrong. This is rare but can happen. If it is really worrying you, get another opinion and even ask for the Catheterization if it will give you peace of mind. Good Luck.