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SHORTNESS IN BREATH AND CHEST PAIN
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SHORTNESS IN BREATH AND CHEST PAIN

I am a 48 year old male that has exercised vigorously for the last 25 years (marathons and daily workouts etc) and am very body conscience. I weigh alot (244lbs but have 8 % body fat so alot of muscle on a 6'2" frame).  I have been diagnosed with beneign muscle facsicualtion and cramping disease a few years ago which I take neurontin for which seems to keep the extremity burning and facsiculations to a mimimum and every year seems to get better with that particular disease.......however 2 years ago I started to cramp severely around the chest. ribs and upper stomach area which has never been successfully linked to the beneign disease or anything else. I also found out a couple of years ago that my trigylcerins(spellling??) were way out of wac (600 to 1000) and probably were that way for 5 years!  I take lopid to keep it in check with an excellent number now!  Two years ago other symtoms (symptoms) came on strongly but irregularly....... I started bouts with breathlessness just walking up the stairs and the feeling of fullness under my sternum and middle chest esp the diaphram and esophogus (upper back of the throat and swallowing difficulty sometimes) area............ eating really exaggerates this problem!  Bending over after a meal is very uncomfortable and adds to the breathlessness issue!  I still exercise on a regular basis.....most of which is aerobic and have some discomfort during exercise sometimes and other times not. If I eat something before exercise it really feels full and like I can't take a full breath. I do not have any other symtoms (symptoms) of heart disease like pain in the arms and/or light headedness or sweating with these other symtoms (symptoms). My resting heartbeat is below 50 and I can still hold my breath for underwater swimming for 90 seconds!  I can still get my heartbeat up to 165 bpm as well as sustain 360 watts of work for 30 minutes.......not easy for most! My heartbeat drops 35% in two minutes after a vigorous workout showing good aerobic response!  My breathing during exercise may be slightly labored and then not!   I can sit in a chair and have a full feeling in the chest as well as associated pain in the middle of the chest which seems to be around the diapham.  I sometimes have a pressure/contracted feeling in the back of my throat and feel (feels like I have to burb all the time) my entire length of the esophogus for days.  None of the pain or shortness of breath comes on in the middle of the night during sleep however I do frequently experience nite sweats from my neck up (kinda funny and I been doing this for at least 7 years) to the extent of soaking the pillow on occasion!  The chest pain and/or pressure can come and go at any time during waking hours. Sometimes I can go for days without noticing pain or fullness or be aware of my breathing.

I sought out my internist on these issues which started a whole flurry of activity and money I might add!!  First I went to the pulmonary DR for issues there. After the blow test and oxygen test he found that I had slight restriction in the upper broch due to occasional acute asma and the ox level in all extremities was good.  Occasional inhaler for this problem, which I can't see or feel the difference (12% improvement the DR says).  Next was the cardio DR with the first test being a stress test on the treadmill that shown no irregular issues!  Then an oxygen uptake test of the heart muscle (a radioisotope injection at rest and right after exercise and eating....you know the routine)....in which he said that things looked pretty good however there was a small area at the bottom of the heart that looked a little abnormal but was a guess that it really was my diaphram pushing against it etc.......so he suggested a drug (dilacor) to dialate and help the heart muscle and throat, for that matter to work better and take asprin just in case.  He stated that if my symptoms persist after 8 weeks that he wanted to do a cathe to see if anything was there?  I question this, whereas I don't want to spend a day laying flat on my back if I don't have to as well as the money!  Soooooo.........here I am at your suggestion for the future actions!  I guess my questions are:
.......are we on the right track or should we look at gastro?....... should I have the cathe done and/or can a new procedure called fast ct scan be used in place of the cathe?.............any other suggestions that anybody can figure out are well appreciated!!
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Avatar_n_tn
Dear Steve,

Your history is quite complex.  It is likely that much of this may be related to GI.  You may be having similar spasms and fasciculation in the esophagus that may bring on this discomfort.  It would also be important to rule out pancreatitis given your high triglycerides.

I hope this helps  keep us posted.
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