This happened to me...

In the spring of 1999, I had a treadmill stress test done. A dye was injected into arm and nuclear imaging was done. Cardiolite? The results...I was told I had some ischemia in the lower right heart area. No heart cath. was done. Now, jumping ahead to Sept. 2003, I had the same test performed as well as a heart echo. I was told that there were significant (bad) changes in my heart compared to 1999. My present doctor questioned why a heart cath. was not done in 1999. Angioplasty and bypass surgery were even mentioned to me. A heart cath. was performed on me. The results...absolutely nothing. I was told I had no blockages at all! They said I had a strong and healthy heart. I was told that the thickness of my chest (muscle), threw the test off. I do have a heavily muscled chest due to weightlifting. Doctor, what are your comments on this?

[CCF-M.D.-RCJ]

Roland,

Thanks for the post.

My comment is congratulations on the good news.  Multiple things can throw off these non-invasive tests, and while it is unusual to have such discrepant results, it sometimes happens.  It is certainly a shame that you had to undergo the cath due to false positive tests, but I wish we had more patients who got the news you did.

[kennyd]

This makes me wonder what the rate of false negatives are...I had the same test (with the radioactive isotope injection and subsequent imaging, before and after exercise) and was told everything was normal.  But I still get bad chest pains, which, due to all my normal tests and that I am only 33, appear to be related to anxiety.

I also did a Holter monitor, echo, and stress test -- all came back normal.  But of course, Murphy's law held true and I had no chest pains during these tests.  Blood chemistry normal.  But I still always wonder if something was missed, especially since the therapy for my anxiety has been very successful yet the pains continue.  To the best of my knowledge, my anxiety was triggered when I started dwelling on chest pains I started having over a year ago.

[tlcjuliet]

Have they checked to see if you have the helicobacter pylori Kenny?  I was having sever chest pains for ages, and it was eventually put down to this, had treatment, and no pains since!!  They can do it by a simple breath test or blood test.  
Go get it checked out, as there are a HUGE number of the population with this bacteria, and they don't know it.  I believe this is a big contributing factor in ulcers as well :)

Hope things work out ok for you

[michi]

i went in august 2003 to the hospital re. chest pain. i am only 31. they did the heart cath thru the vene and atery and found nothing. which is excellent. but i still have the chest pain like you. sometimes i wonder if in such a short time i could get a blockage. but so far i never got an answer. i went to the gastroentologist for this aswell and mentioned the helico.. bacteria but he did not seem to be concerned about it, but i think its a good idea to push the doc to do it. i had an regular endoscopie done which was fine. i will mention that bacteria again. good luck to you.

[kennyd]

Thanks for your replies!  Perhaps I will pursue the test for the bacteria...I know my mom had it.  Although my chest pain isn't really heartburn like, it's either sharp and short, or a dull ache.

It was about a year ago when I first noticed the pains, and I started worrying about it alot despite a normal ECG.  Then suddenly I ended up in the emergency room, thinking I was having a heart attack, but I now know it was a particularly bad anxiety/panic attack.  So, I most certainly have anxiety.  But whether I always did and didn't know it (hence the manifestation of symptoms like chest pain), or whether it was caused by my incessant worry about the chest pain, is hard to say.  So I did pretty much the full spectrum of tests as described above to rule out any physical causes.

With therapy I was able to address the mental aspect of anxiety.  It took a few months, but I was able to first eliminate the attacks, and then greatly reduce the general unpleasant symptoms associated with anxiety.  But the pain...it comes at any time and does not subside through any cognitive methods.  That's why it continues to scare me, and I have come full circle into wondering once again whether it is physical.  Problem is that if it is anxiety-related, it will never go away until I accept that.

I should also mention that I have no chest pain problems when exercising.  I can get my heart rate good and high through running on the treadmill with no problems.

[Tony1]

Kenny I have had the same problems you describe. I am 35 yr. old male, 210 lb, 5/8" who does have high cholesterol. I have been experiencing chest tightness and pressure in the center of my chest for 4 weeks. The first day it started I went to the emergency room after it lasted all day. They did blood test (to check for a heart attack), an ekg and a chest x-ray. Nothing was found and they sent me home. I went to see my dr. of internal medicine and I had a stress test/ekg. It was normal. In fact he said the ekg and my exercise tolerance looked great.  I was experiencing symptoms at the time and even had a small panic attack while doing the stress test. My internest didn't think there was any reason to believe the chest discomfort was cardiac in nature.  Even after this testing the constant discomfort started getting to me and I developed panic attacks again.  I say again because I have not had any in about 4 years but developed them when I began having migraines.  But the constant worrying about it being something serious got the best of me.  I did revisit my internest and told him I was worried about my heart.  He told me I could to the thallium stress test but I declined and opted to wait awhile and see how my anxiety medications did. I have found others on panic and anxiety boards who have had chest discomfort for long periods of time too. I get arm pain but have a shoulder injury that causes arm pain if I try to workout but I thought at first it was because of my heart at the time.  Then I get sharp upper back pain, I thought heart related but when my wife pushes on my back it is definitely intramuscular pain.  Now I am wondering if something was missed and I should have the thallium stress test done.

[kennyd]

Tony,

My experiences are very similar.  In fact, I also had back pain just below my left shoulder blade but, just like you, my wife found a bad knot there.  In a way this was comforting, because I reasoned that if there is a knot there, there's no reason why this tension couldn't wrap around my side and into the front.

My cholesterol and triglycerides tested very good, so that combined with the other tests pretty much convinced my doctor that it's "all in my head".  Kinda hard to accept though when I previously had no apparent anxiety problems and then suddenly I am dealing with this.  One day fine, the next day...my life is very different.

The one thing I can say though is that I definitely fell into a constant cycle of worrying about my heart, about dying, etc.  If I didn't have anxiety before, I certainly developed it in a big way over this.  This calls into question how much impact the anxiety has on my chest discomfort, because I am now acutely aware of every little sensation in my body, particularly if it happens to be on the left side (I also get arm pain on the left).

I'm not on any medications, I am just seeing a therapist.  However the thought always crosses my mind on those "bad" days.

I do know that in cases like ours, you must pursue to your satisfaction whether it is or isn't physical, because if it isn't you must be convinced of that in order to recover.  That is what I am currently struggling with...

[DavidT]

Hi,

I too seem to have gastro/anxiety related chest pains.  What's wierd about  the pains that I have is that they go away if I cross my arms.  Yet it's still scary because what if it is cardiac related.

Due to anxiety driven fears about heart health and these strange pains I've had many different tests done.  Even a heart cath in Jul. 2001 that showed  no blocked arteries with "essentially normal coronary arteries".  I was 41 at the time.  

The cardiologist that did the procedure told me that fish oil and Omega 3 fatty acids are very good for heart health.  So I've been talking fish oil every day and eating fish at least twice a week since then.  I also take several anti-oxidants like Alpha Lipoic Acid, Vitamin B stress fomula, Vitamin C, Lycopene, CoEnxyme Q10 and several other things that are supposed to be good for the heart.

I sometimes worry that perhaps things may have changed drastically from the time that I had the cath done.  I've read that heart disease progresses very slowly, I reason that if things looked very good after 41 years of living that another 2 years wouldn't make that much difference.  Especially if my lifestyle is much healthier now than before.  For example, no red meat and low fat diet.  Never smoked.  Good cholesteral and triglyceride levels.

Yet I still tend to get concerned.  I really don't want to go through another cath just out of curiosity.  My GP was a little irritated with me going to a cardiologist even though she told me that I didn't need it and that there was a risk of death or blindness from the procedure.  Does anyone know what the progression rate of heart disease is really like?  If you have no obstructive coronary artery disease at 41 will it just ramp up significantly to cause a problem at 44?

The H-Pylori sounds like a possible cause of these bizarre pains, since I notice that if I press below the lower left rib that the pain will increase at times.  I also seem to have to burp a lot when I get this discomfort or pressure.

[okjay]

Hi all,
I also have frequent chest pain that has landed me in the er
all too many times. My chest pain is from variant angina and is
usually redused to almost nothing by chewing a norvasc along with nitro sublingual. But my employer panics when I turn gray and start to sweat and cough and show signs of being short of breath. 3 nitros later and the norvasc the ambulance arives and takes me for an expensive ride that I would rather decline. But all tests came out negitive and I'm told that I have to live with this....I just wish that other people would learn to trust us when we say that we will be fine while we are experiancing #9 chest pain.  I'm looking forward to receiving a $550 bill for most recent ride to e r less than 1 mile away and will probably have a real M I when I open the envelope!
        good luck to all, Jay