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Heart Disease (Expert Forum)
Re: chest pain
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: chest pain
by CCF Cardio MD sc, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD sc on January 15, 1998 at 15:23:58:
In Reply to: chest pain posted by Marilyn Perkins on January 09, 1998 at 12:28:42:
: My husband will have chest pain once in awhile that is in the area where they tell you to do chest compressions.
It will make him sweat, but he doesn't get short of breath. Sometimes it hurts alittle in his chin for a few seconds.
The pains usually last several minutes then go away. They don't seem to be related to exercise because he can play some basketball
and never have any pain. Sometimes he can be sitting or just walking. He is 39 years old 5'10" and about 280 lbs. He does alot of sitting and
driving at work, and does not exercise. He has been to a Heart Doctor They checked the size of his heart with a ultrasound test. And tried to do a
tredmill but his bad knee gave out and they did not find anything wrong. They said his EKG was also normal. The pains come and go about once every
couple of months or so. He won't watch what he eats. He does not smoke or drink. Should we contact another Heart Doctor and have a Angiogram test done?
Should we go to an emergency room when this pain hits to see what his heart is doing? I'm afraid these are just minor heart attacks and one of them is
going to be a massive one. They don't seem to worry him enough to make him watch what he eats. Thanks for advice and listening.
______
Dear Ms Perkins
Although chest pain could be a marker for heart disease it is by no means specific. Chest pain could arise from any of the organs in the chest, including the lungs, esophagus and stomach, and chest wall muscles and tendons among other structures. A careful history and physical examination may help give an indication into the etiology but this rarely is it complete enough to be conclusive. Your husbands symptoms have both typical and atypical features, and due to his associated risk factors and sedentary life I agree that the next logical step would be to obtain a stress preferentially coupled with an imaging modality that would complement the ecg portion of the stress test. In your husbands case it appears that he was not able to achieve the target heart rate expected for a male his age because of his knee pain and as a result the test may be inclusive. When this happens the best thing to do is to repeat the test but instead of exercising, a medication is used to reproduce the physiologic effects of exercise without actually having to perform the exercise. Only in the rare case that this is also inconclusive and the history is still suggestive should a cardiac catheterization be considered. If a cardiac problem is excluded then I would start to consider other possible causes. I cannot over emphasize the importance of your husband trying to lose weight, enroll in a regular exercise program after the issue has been resolved and making sure that his cholesterol and blood pressure is completely under control. I hope that this information will be useful and that your husbands problem may be resolved. If you would like to ask any further questions or would like to have your husband seen by one of our cardiologists here at clinic please feel free to call 1-800-CCF-CARE to set this up.
Information in this forum is intended for general purposes only, specific diagnosis and treatment strategies should be reserved for physicians directly involve in patient care.
In Reply to: chest pain posted by Marilyn Perkins on January 09, 1998 at 12:28:42:
: My husband will have chest pain once in awhile that is in the area where they tell you to do chest compressions.
It will make him sweat, but he doesn't get short of breath. Sometimes it hurts alittle in his chin for a few seconds.
The pains usually last several minutes then go away. They don't seem to be related to exercise because he can play some basketball
and never have any pain. Sometimes he can be sitting or just walking. He is 39 years old 5'10" and about 280 lbs. He does alot of sitting and
driving at work, and does not exercise. He has been to a Heart Doctor They checked the size of his heart with a ultrasound test. And tried to do a
tredmill but his bad knee gave out and they did not find anything wrong. They said his EKG was also normal. The pains come and go about once every
couple of months or so. He won't watch what he eats. He does not smoke or drink. Should we contact another Heart Doctor and have a Angiogram test done?
Should we go to an emergency room when this pain hits to see what his heart is doing? I'm afraid these are just minor heart attacks and one of them is
going to be a massive one. They don't seem to worry him enough to make him watch what he eats. Thanks for advice and listening.
______
Dear Ms Perkins
Although chest pain could be a marker for heart disease it is by no means specific. Chest pain could arise from any of the organs in the chest, including the lungs, esophagus and stomach, and chest wall muscles and tendons among other structures. A careful history and physical examination may help give an indication into the etiology but this rarely is it complete enough to be conclusive. Your husbands symptoms have both typical and atypical features, and due to his associated risk factors and sedentary life I agree that the next logical step would be to obtain a stress preferentially coupled with an imaging modality that would complement the ecg portion of the stress test. In your husbands case it appears that he was not able to achieve the target heart rate expected for a male his age because of his knee pain and as a result the test may be inclusive. When this happens the best thing to do is to repeat the test but instead of exercising, a medication is used to reproduce the physiologic effects of exercise without actually having to perform the exercise. Only in the rare case that this is also inconclusive and the history is still suggestive should a cardiac catheterization be considered. If a cardiac problem is excluded then I would start to consider other possible causes. I cannot over emphasize the importance of your husband trying to lose weight, enroll in a regular exercise program after the issue has been resolved and making sure that his cholesterol and blood pressure is completely under control. I hope that this information will be useful and that your husbands problem may be resolved. If you would like to ask any further questions or would like to have your husband seen by one of our cardiologists here at clinic please feel free to call 1-800-CCF-CARE to set this up.
Information in this forum is intended for general purposes only, specific diagnosis and treatment strategies should be reserved for physicians directly involve in patient care.
