Heart Health

[HAMMERHEAD]

Thank you for your time. I'm a 42 yr old male. I've had high blood pressure since my early teens. took meds to control it. I've had 3 stress test that all came back normal(one in 1998) (stress echo in 2001) (cardolite in 2003) all my ekg are normal. But i have chest pain most everyday back and arm pain. not always at the sametime. My blood pressure run about 122/70 on meds. would you suggest any other test or which direction should i take. My PCD say it's anxiety and treats me for that but I'm still cocerned that the PVC's and pain are some how heart related. On mt cardiolite test Doctor comments were. Heart function good,heart of normal size and thickness, EF function 54-59%. I"m overweight but working on that. What other test would you suggest at this point.Thank you

[CCF-M.D.-MJM]

Hi Hammerhead,

This is a common problem -- people with chest pain despite normal stress tests.  

Rarely we do a cardiac cath to make sure there is not coronary disesase, but also to reassure you that you don't have significant coronary disease.  It is true that anxiety can cause pain that meets the description for angina but the coronary arteries are completely normal.

What I usually advice people to do is maximize risk reduction (blood pressure, blood sugar, weight, don't smoke, eat right, cholesterol).  I will assume you don't have a strong family history of early heart disease since you didn't mention it.

Given your age and the negative stress tests, I doubt this is angina and if you already have a holter or event monitor and know these are pvc's, I wouldn't do much more.

you should know or have already had:
cholesterol screening
ekg
maybe holter monitor
stress test (done) -- I assume your symptoms haven't changed since your last stress test.

I hope this helps.

[HAMMERHEAD]

I forgot to say yesterday I had my yearly check up.EKG same for last 3 years total cholesterol 166 Triglycerides 236 blood sugar 102. My HDL was low about 34 I think. THANK YOU SO MUCH!!!!

[CCF-M.D.-MJM]

One piece of advice though --  your triglycerides are a bit elevated, your HDL is a bit low, and you mention you have hypertension.  you need to gain control of your health.  Make a commitment now to lose the weight and get yourself into better shape.  These are the risk factors that creep on you and go relatively unnoticed until it is too late.

good luck!

[HAMMERHEAD]

THANK YOU SO MUCH! I'M GOING TO GET ON A LOW FAT DIET AND START WORKING OUT BEFORE IT TO LATE.TKANKS TO ALL OF YOU AT CCF FOR YOUR ADVICE AND SUPPORT.

[upbeat63]

Just a thought, but have you tried chiropractic for your back and arm pain? If everything else is "normal" there might not be a cardiac reason for your chest pain, but rather a spinal or muscular problem which is often overlooked by "mainstream" medicine. These can refer lots of pain into the regions you have complaints, chest back and arm.

I guess if you've been checked out for everything else, it's worth it to try one more thing. Since they are "physical" medicine doctors, they might even help with an exercise program. Good luck on the weight reduction!

[smp48]

Hi everyone. From all the things I have read, I thought it was a concern when the valves were involved, I have coronary artery disease, also mitral leaflet thickening, and  mild  regurg, and 2+ regurge on tricuspid valve. I have daily chest pain. I had rheumatic fever as a child, and so far my dentist was the only one to tell me to make sure I get antibiotics before I get my teeth cleaned.Does this mitral valve need watching, and can these chest pains actually be something from my heart? I have been given no instrutions on what to do, to keep it from getting worse other than control my Blood pressure, and in the meantime I worry all the time about having a heart attack. I am 57 F non smoker 5'1" 128 lbs.