Severe chest pain and bloodwork...

Posted By mommydee on December 23, 1998 at 02:02:27:







Thank you for all the help you have been helping me understand my daughter's (age 14) chest wall pain.  She went to her pediatric cardiologist today and had a normal exam with a normal EKG, however she has been pain free for a week and has not been allowed to exercise or do the activities that bring on the pain prior to this checkup.  Now, particularly because of her history of positive antidsDNA, he wants to do one more thing to definately rule out her pain and shortness of breath induced by exercise having a cardiac basis.  She is now to engage in the kinds of activities that bring on the pain.  The purpose of this is twofold...one...the gastroenterologist has put her on some antireflux meds and they want to see if the pain will recur or be as severe while taking these meds.  Two, if the severe pain recurs, I am to take her to the emergency room along with a prescription he gave me for some bloodwork....something about cardiac enzymes.  The prescription says "Check CK-MB fraction and TROPONIN levels with
severe chest pain.  He told me to go ahead and take her to ER for this test during the severe pain so they can also give her some oxygen and relieve her pain with an injection (we did that the first time the severe pain and breathing difficulty hit her two months ago, and the oxygen and shot helped).
He said if the enzymes are normal, we will be able to conclusively and definatively rule out a cardiac cause for the pain.  If however, there is an abnormality in the enzymes, they will want to do a thallium stress test.  She has already had normal echo, exercise stress test with PFT, and 30 day loop monitor.
Personally, I am fairly confident her pain is not cardiac, but I am glad they are working to make sure of that.  Can you explain this bloodwork to me and tell me whether or not normal values during pain will truly give a final answer that her pain is not cardiac.  Also, if she has to have the thallium test, are there risks involved?
Finally, assuming everything turns out normal, and assuming the problem is not reflux (gastro doc says it is not typical for reflux), what is the next step?  She has mild exercise induced pain most of the time when she exercises and some mild joint pain, but she never lets that slow her down.  These two major episodes of severe chest pain, which was worse with inspiration and made it very difficult for her to breathe while prone, have been much more difficult for her to handle.  This last episode kept her in severe pain and short of breath for a week.  Where would we turn next?  What other kind of things could trigger this kind of pain?
Also, antacids seem to have little to no effect on the pain....ibuprofen or naprosyn does seem to help, but only at prescription strength dosages, 600 - 800 mg ibuprofen for example.
Hopefully, I won't have any more questions on this issue after this.  I just really want her to be able to do the activities she wants to do, and her goal is to make Junior Olympics...but the pain means she has to keep stopping her training.
Thanks again, Dee