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Still having chest pains
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Still having chest pains

Hi. I keep getting severe chest pains in the center of my chest, which radiate to my back and neck, and sometimes my left shoulder. Last month, I had a heart cath, which was negative for any findings. About 1.5 years ago, I had an echocardiagram and a cardialyte nuclear stress test, which both were also negative for any findings. I continue to have these episodes of pain. Have I exhausted all my options for any problems with my heart, or is there something I could be missing? Thanks in advance.
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Avatar_f_tn
have you heard of angina spasms i cant spell the correct name for it but apparently can only be detected with a drug they inject you with while they perform an angio to cause the spasm thats the only way its detected maybe you can ask your cardio for some nitro and see if this relieves your symptoms to see if you are having angina  this type of angina  is not brought on by excursice manly at rest.fairybell
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Avatar_n_tn
Thanks fairybells. I wonder if when they did the cath if they would have checked this out?
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Avatar_f_tn
no only if they have a suspision you have this mind you it is very rare but it does happen talk to your cardiologist about this most of the time the spasms can be controlled by nitro angina meds. this usally happens at rest when you will get angina pains. check it out on the net . im all so searching for answers for my chest pain ive had stress tests but aparently they are not that accurate people have had them done with the all clear and have had heart attacks next day . i know my body than any doctor does and i know something is not right.all the best in finding out what it is fairyxx
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Avatar_f_tn
Out of curiosity, have you looked into GI problems?  I have also had negative heart tests and they later found out I have a hiatal hernia with GERD which is causing all of my problems.  If you check out my other posts it has all of my symptoms and the MANY tests I have had performed.  Granted it could be Prinzmetal's Angina, which are basically coronary artery spasms, and like fairybells said is rare.  Talk that over with your cardiologist but since I was diagnosed with hiatal hernia and GERD my cardio believes that is all my problems.  I never had any symptoms of heart burn except for the extreme chest pressure which also travels into my left arm, neck and back.  If you google either hiatal hernia or GERD you will see that it mimics a heart attack completely.  Good luck to you!

Shell
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159619_tn?1318997813
One other thing to think about........... I also had chest pain for over two years. I had every heart test except a cath for two years and everything was normal. My doctor decided to have an abdominal ultrasound done and sure enough I had a gallbladder full of stones. It was removed and most all the chronic chest pains are gone. My pains also were mid sternum and radiated to my back. I was told that gallbladder attacks could mimick a heart attack.

About the same time I was also diagnosed with RA and started taking Plaqeunil for the inflammation which also may have been associated with the costal joints in my sternum. This took the rest of the pain away.

Don't want to down play the importance of keeping an eye on your heart, but just wanted to pass my experience with chronic chest pain along.

Good Luck,

Jon
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Avatar_n_tn
First, thanks to all.

I hadn't heard of stress tests being inaccuate. That makes me nervous. Could anyone tell me more about this?

I did have an EGD and was negative for GERD...totally negative. Also, I had a gallbladder ultrasound and PIpida scan. Pipida was normal. I do have what is either a small (4mm) stone or polyp in my gallbladder.  However, the GI said he is almost certain this isn't causing my chest pains, because of the severity of the pains.

I hadn't been told of Prinzmetal's Angina. My caridologist said he was aboslutely sure it wasn't my heart, and he was the one who sent me to the GI doc. He said he didn't need to see me again. Should I call him, though, and ask him about this, though?

I am so upset about this. My primary literally has blown me off. He said, "You are physically fine." And gave me a script for anti-depressents--which I have not filled. I am not depressed. And I am not a hypocondriac. Up until this started, I was an active, happy person. Like Fairybells said, I know something is up with my body--I just don't know what. I am scared!
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Avatar_f_tn
It's a question of sensitivity, or the chances that a negative result on a test is a false negative. An ordinary stress EKG isn't very sensitive, something like 70% depending on your age, gender, risk factors. Sometimes even though your heart isn't getting enough oxygen, it doesn't show up on EKG. A nuclear stress test is a lot more sensitive, better than 90% because they're looking for areas where not enough blood is reaching your heart muscle. But a heart cath is the most sensitive of all, pretty close to 100% for any narrowing of the larger arteries at the time of the test. So I really wouldn't be too worried about a false negative on a stress test with a clean cath result in the last month!

Are you sure they didn't try to provoke a spasm when you had your cath? I don't know for sure but I would think they would, if you have chest pain at rest and negative stress tests. Why not ask your doctor, or ask the hospital for a copy of the cath report? Then you will know for sure!

Also, have you looked into costochondritis? People who have it say that it feels exactly like angina.

I hope you can find a diagnosis. The worst thing is not knowing what is wrong when you know there is something.
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Avatar_f_tn
with the coranary spasms are usally not blocked and are fixed with angina medication just ask cardiologist to try you out on that . explane to him your getting these chestpains  at rest .what are your symptoms?
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Avatar_f_tn
i also think try another cardiologist till you find one who listens . most doctors like to put it down to a mentle illness i my self had so many troubles with doctors  saying its gerd its anziety i know this is no panic attack and me too im no hypocondriact it takes something big for me to go to doctors . all the best fairyxx
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Avatar_n_tn
I have a call into my cardiologist asking about whether they tried to induce spasms during the cath. The cath was in the past 4-6 weeks, but the nuclear stress test and echo were within the past 1 1/2 years. I did tell the nurse to let the doc know I am still having severe pains at rest and had a negative EGD.

Fairybells, believe me--I believe you!!! So far, my cardiologist seems to believe me. It's my primary who is being the jerk. We'll see what else the cardiologist says when he calls me back today.

Oh, and P.S...I have a history of lymphoma, so it's really stupid--in my opinion--my primary would consider nothing wrong with me without even considering the possibility of a recurrence! Thank God I can self refer, or I wouldn't have even gotten a caridologist or a GI doc!!

Thanks again to all!
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Avatar_f_tn
I hope the cardiologist can help shed some light on this for you!  I went today for a CT scan of my chest and neck along with x-rays of my ribs to r/o a problem with my subclavian vein since along with the arm pain I have swelling from time to time in my forearm.  I go tomorrow to my GI doc for my 6 month follow-up and I'm curious as to what he is going to say to me.  He doesn't think this is related to my hiatal hernia/GERD but the cardio docs do, so I guess we'll wait and see.  Keep me posted on what the doc says.  I am thinking of you!!

Shell
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