Unexplained Chest Pain

[Ekno]

I am 27 yrs old male, 6 ft, 170 lbs..experiencing chest pain since june06. I am physically active, nonsmoker and no history of heart troubles in the family.
It all started with a viral infection. Kept on feeling tired and had SOB at times. They treated me with antibitics thinking it was bacterial, allergy medicine (nasonex). Then I got a month long diarrhea. Felt like bloated at all times. Gastroneurologist gave me Priolosec OTC along with a fiber suppliment which made me feel better and the diarrhea was gone.. (although the stool formation was not consistant..I still had fatigue, nausea and SOB)
Had chest X rays 2 times (normal)...Then since June06 I started to get dull chest pains on the left side and seemed to trouble my shoulder neck and back..heart tests were ordered.. EKG (normal),Thallium stress test(normal), eco(normal)..had to go into emergency once (blood tests, EKG were normal again)...other tests..cholestrol (60/55)..BP is usually 115/75 at home and elevated at Doc office (130-140/80-85)..my instrument checked for accuracy..hemoglobin @16..some elevated numbers for liver @200..checked for hep A and B (-ve)...was told that it might be anxiety and treated with meds..didnt help much...i have acid reflux...endoscopy and colonoscopy ordered...
I have read similar stories but not one with any diagnosis..I fear at times that its my heart but the tests say otherwise...and if its my esophagus why does the pain spread to back and neck...also the pain occurs any time..especially during early morning hours and I have started experiencing dizziness at times.. PLS HELP

[Cleveland Clinic]

ekno,

thanks for the post.

You are going to hear a lot of different hypothesis of what may be causing your symptoms. Be careful as its impossible to diagnose over the internet.

That said, wiht your evaluation, it would be essentially impossible that your symptoms are coming from you heart.  Luckily you have an abnormality to focus your evaluation on. Elevated liver enzymes are abnormal and the work up of the finding is usually straight forward.  
Given this finding, I would start there.

good luck

[jmike1_]

Thanks for your post.  I have some very similar symptoms and am very interested in hearing the comments that result from your post.  I too have chest pain/dull ache and sometimes pressure.  I also have the back pain, and the bloated feeling.  I've had diarreah/loose stool for the past month plus.  I've been back to the cardiologist for several tests (EKGs, echo cardiogram, and a nuke stress test) and all were negative.  However, I do have confirmed CAD and I have 5 stents in my LAD resulting from 6 heart caths all in the last 6 months.  I know I don't have a "stress" problem, but guess sometimes my symptoms get confused.  I can usually tell if I definitely have a blockage, because I get severe chest pressure (not pain) and a noticeable shortness of breath.  However, the symptoms that I'm having which are similar to yours are confusing.  My cardiologist is sending me to the gastro clinic (again), but I've already been once and had the tube down the throat test, and I don't have reflux (seems to be the cardiologist first choice of diagnosis when they don't know what could be causing the problem).  I sure hope someone provides some good advice, because I really hope to start having some good days.  I really haven't had too many since FEB of this year.  I tried to check out fwilson's site, but wasn't able to pull down any info.  May try again.  Anyway, just wanted to say thanks for the post.  Hope you find some great info, and I am able to benefit from the "crumbs".  Take care!

[halpme]

Right there with all of you.  That and my PVC's are the biggest problem.  Mine come combined with jaw pain.  Come and go every 2 weeks.

Magnesium seems to help a bit, and toprol xl takes the edge off the PVC's.  Also trying an antibiotic for potential Lyme as I've been exposed quite a bit.

I will say the magnesium and antibiotic started at the same time and I am "Better"  less frequency and intensity.  Though, the last 2 days have been bad after 2 pretty good weeks.

It is hell on earth.  36 year old, wondering what is going on.

[jmike1_]

Hey Al!  I'm doing better I guess, but still having my bad days w/ aches and pressures.  But my cardiologist has been great about having me go through a broad range of tests.  I have to get the manometry test in JAN, and must admit I'm not looking forward to it.  I did the endoscopy several months ago, which was no big deal.  But the manometry doesn't seem quite as easy.  But at least it will either identify another reason for my chest pressure, or rule out another option and maybe put the focus back on a cardiac issue.  Either way, I'll be better off for it.  So guess I'll just have to suck it up and do it.  Hope you are doing well!  Take care!

[Mels22]

Hi all...glad to hear you are doing better Jmike.
I have been having terrible indigestion, chest pain and left arm pain all the way down to my fingers for 2 months.  Had chest CT scan, myoview stress test, many ekgs, chest xray, blood work and everything and still all negative.  Had a echo done last FRiday and they never called me back...does that mean nothing is wrong?  The nurse said they would have called, had soemthing been wrong, is this true?  I'm 25 female wiht no family history and my BP and choleterol are good.  That said, could I still have heart problems?  Docs say I have GERD adn anxiety...but I just don't know.  Why the left arm pain?  Isn't that only in cardiac problems?  Please help...I'm very worried and have a 6 month old baby.  I am scared everyday of dying.  No prilosec or prozac is helping.  Could I have heart problems with all my tests being normal?  I just need answers and would appreciate any insight anyone can give.  THank you and God bless!

[Mels22]

Hi all...my echo came back normal.  Therefore I've had a normal myoview stress test, 8 EKGs, chest x-ray, CT scan, echo, MRI and physical check up...normal blood tests, BP and cholesterol.  The only thing that came back abnormal was my liver blood work.  Here is my question...could I still have a heart attack?  I just don't know what to do.  I still have left arm/shoulder/chest pain.  I've been to 2 regular MDs, cardiologist and neurologist and now they are saying maybe fibromyalgia.  If anyone has any suggestions, I would really appreciate it!  Do you think my pain is of cardiac origin?  I also have terrible ingiestion, burping and upper stomach pain - have had it for 2 months.  Is this normal?  Do you think I'll have a heart attack?  I'm scared everyday of this.
Help!!!!
Thanks!

[Ekno]

Hi Mels22,
your case is just the same as mine....i had everything normal except my liver numbers were silghtly high ( read original comment)....Since my last post i have been tested for lactose and bread intolerance...i have a endoscopy scheduled on the 17th...I also took a second opinion and the Drs dont feel it is heart related...Recently I have started feeling better ( not normal)...
a) my fear has gone down...beleive me that kills you and doubles your existing pain..try and gain control.
b) Try and get an endoscopy done...ask you doc if a 40 mg Nexium is better than the 20 mg Priolosec...that along with a reglan ( helps to keep your esophegual splincher tightly colsed) had helped me a lot..
c) I still get bad thoughts like you do...but remember this
1) our age and all the tests being normal are the biggest positive factors on our side.
2) we are doing all we can and there is not much more we can do....i have started to beleive that in times of anxiety and pain you should rather listen to the more knowledgeable people (e.g. doc) than our brain.
3) keep on perceiving until you feel good...some times time is the biggest medicine.

HOPE that helps

Ekno

[Mels22]

Ekno,
Thank you so much for you thoughts...very nice of you!  How old are you?  I will try to keep that in mind.  It is hard when all you read is that indigestion and left arm pain means heart attack, especially in women.  I try to keep a perspective though, for my husband and baby's sake.  I just can't understand the left arm pain.  Did you have that too?  Was it the GERD?
Thanks and good luck!

[Eddie 14]

Mel,

I'm a 34 y/o male.  My BP runs slightly high, as does my cholestorol.

Over the last year I could be your twin as far as symptoms and tests done, I've also had a 64-slice ct scan to boot.

On top of that I run 1000 or so PVC's a day.

For a while I was convinced I was going to die, well, very soon.

I'm not saying I'm recovered, and I sure would like an explanation.  But, I've had the tests, they are all clear, and I'm still here.

Anxiety plays a part, but I know what you mean when you are CONVINCED something is wrong because you didn't feel this way before, now you do.

I also went the prilosec route, among others.  Didn't help might have made things worse.  Did the GI scan, everything.

BEST help so far - exercise, relaxing and magnesium orotate suprigingly seems to help a bit with PVC's.

I'll tell you what I tell myself a lot.  You are not going to die.  It's gone on over a year, NEVER at exercise, and I'm still here after some big exercise efforts.

Just keep trying, telling yourself you are OK.  I"m MUCH better when I'm occupied.  Yard work, playing with my kids, out with my wife, etc.

It's worse before bed, while at the computer, when driving etc.  ... When Im not occupied.

Anxiety plays a part in mine.  When I'm stressed, - pvc's and sometimes pain.  BUT I never get the pain during exercise. So, it's stress not CAD.

Keep plugging away.

[Mels22]

sorry Ekno,
I see how old you are now...any luck with the reglan?
Thanks

[Ekno]

Mels22,
One thing that i have learnt very frequently may help you a lot..I initially thought indigestion, chest/shoulder/arm pain mean heart trouble...eventhough that is true it does not certainly mean all chest/shoulder/arm pains are heart related...if acid from your stomach backs up into your esophagus (tube that carries food) it may cause spasms inturn causing pains that may radiate in your back/shoulder/arm/ neck and jaws....You can find tons of information on the internet about GERD and reflux disease.....once the heart is ruled out DOCs usually concentrate on this...BTW iam 27 yrs old with very similar complaints like you....

Good Luck

[Mels22]

Sounds like we all have a lot of the same problems.  Does anyone know of anyone who died as young as us from heart problems?  Today I woke up with pressure pain in my left underarm/chest area.  This is different from my typical shooting pains so I got scared.  But if it were cardiac, would I be dead by now?  I read on teh internet that you can have a heart attack for 12 hours or more.  If this is true and if our symptoms are the same as those of a heart attack, how are we supposed to know when we are truly having one?  My right arm feels like I've been working out but I haven't.  Would your right arm hurt if it were cardiac?  So you think exercise will work?  I will try it but now my doctors are saying fybromylagia...never knew what that was til now.  What do you think?  Any suggestions?
Thanks!

[chetna]

SIR, I HAVE FAMILY HISTORY OF BLOOD PRESSUR AND I M DIAGONESED WITH ANGINA . MY CLINICAL TESTS ARE ALLRIGHT .PLEASE SUGGEST THAT WHETHER TO GO FOR OPERATION AND MY AGE IS 55 + .PLESAE I HAVE TO AVOID OPERATION AND SUGEEST ANY PRECAUTIONS AND REMEDIAL MEASURES.

[mojo786]

hi there, i have been having these symptoms from 2002, they have gradually got worse over the years, but only recently have i started suffering from pains around my heart area and chest, especially on the L/H side, also suffer from indigestion and i get sharp pains on R/H side around the abdomen. i am also burping alot even though i haven't even had a meal.  i also suffer from diarreha from time to time.  i have had ultrasound, camera down the throat and ecg, and the treadmill test, blood test(all ok) suprisingly.
any advice out there please would be very handy, as the doctor' and consultants have run out of advice.  p.s. i dont smoke or drink and consider myself to have a healthy lifestyle, 30yrs old almost.

[irontom]

I am a 45 yo male, with same exact symtoms and it was actually nice to see I'm not alone. I had the chest pain for about 10 years with no explaination it was never as severe as it has been the last 3 weeks. It use to last very briefly for a couple minutes a day then go away for months at a time. Now I have felt slightly dizzy last year or so and fatique. In the last 3 weeks have been to ER twice because of chest pain and dizzines, even had cardiac catherization because of the pain, of cause it was normal doctor who did it said I had heart of 20 yo. I also have in last 3 weeks been burping alot, even without eating or drinking. Just had the endoscope done, normal of course, evn wake up now in middle of night with pain. Doctor mentioned stress I know he will say anxiety next, It is what they always say when they dont know. I know i dont feel anxious before pain, but will glady take any medication if pain goes away. Hope all feel better soon, will look for any advice.

[irontom]

BTW all my blood work is normal, and no history of pvc that i know of. My cardiologist wants me to try a medication  that is for angina and high blood pressure even though i have neither. Gonna get a new cardiologist for another opion, not expecting any answers.

[Mels22]

Ok so far all tests ordered normal.  Only thing is abnormal liver.  My cardiologist says I don't need to see him anymore but I'm still having symptoms.  I have chest pain that is either under my left breastbone or in the middle in my sternum.  I also get pains in my back between my shoulder blade.  I can eat almost nothing wihtout experiencing pain and belching way too much.  I have heartburn some days.  I also have shooting pains down my left arm into my fingertips.  Sometimes its a dull ache and sometimes its shooting.  I have also had a lot of shortness of breath which there is no explanation for.  My BP and cholesterol all good and am 25 female.  I don't know what else to do.  I was even seen by a gastro and given 40 mg nexium for the past 2 weeks and had an upper endoscopy.  It showed some gastritis and he did biopsies for h pylori.  Those won't get back til next week.  He said that GERD cannot be diagnosed by an upper endoscopy.  He said its more diagnosed by symptoms and he said my symptoms all sound like acid reflux.  He also said gastritis shouldn't cause chest pains...is this true?  Should I look for into cardiac?  My regular MD, my psychiatrist, my gastro and my cardiologist are all saying not heart related...why can't I believe this?  I'm so worried of dying everyday.  I'm on ativan and prozac.  I am also seeing therapist but its not helping.  I'm also having trouble sleeping even with the ativan.  Sometimes, in recent weeks, I feel my heart racing as well and sometimes skipping a beat.  My questions are...
1. do you think its cardiac?
2. should i get a 2nd opinion?
3.  is it possible for me to have a heart attack even with no fam history?
4. do you think anxiety?
5. is the gastro right about GERD and gastritis?
6. how long will it take for nexium to work?
I would appreciate ANY responses.  Thanks and good luck to all of you!

[irontom]

Mels22, sorry to hear you have no improvement, have comfort in the fact that after getting normal results from cardiologist it is very very unlikely that you will have heart attack at your age. I personnally feel that the excess burping for some reason causes chest discomfort and palpiltaions. I for one are now gonna try to lose weight, think it can only help. I'm about 20 lbs overweight hopefully this will cut back on symtoms. Remember to try and not worry  too much, that will cause anxiety. Not sure about fibromyalgia dont know much about it, but thought you have pain when you actually touch certain spots and you need at least 11 different spots. Not sure if this is true. My pain feels more deeper than that, like inside my chest and inside my arm and shoulder, even my left thigh.  Hope you get well soon.

[Bushman]

Hi all. I'm a 26 year old male, and have had chest pain since last April (1 year 8 months now). Its usually short, sharp, left of center, and only when i inhale deeply. and it appeared pretty much overnight. Went to 5 different doctors, only one of them bothered doing an EKG (which was fine), an i've had diagnosis ranging from Cartilage damage, to Mitral valve prolapse, to my lungs clearing all the tar in them (i'm an ex-smoker)...
I've lived with the pain, and not been too concerned 'cause of its unchanging nature. But in the last coupe of weeks i've been experiencing a more consistent pain, ranging from my chest (several locations) to my neck, leg and arms. I've also been getting light headaches, almost daily. (And i almost never get headaches, normally). Went to the doctor again, and he assured me its just cartilage damage (Again!). Any ideas, it's now really starting to bug me.
Thanx!

[Gniederg]

There is comfort in knowing that you’re not the only one going through this.  I’m a 45 yr. old male – in excellent health (honestly)  - except for the anxiety of dieing from a heart attack every day accompanied with excessive burping, like 1000 times a day.  

This past September, I was driving to work when I felt that something was very wrong.  I was experiencing chest pains – pains in my left shoulder and elbow, I was perspiring, had a wave of hot and cold flashes, burping excessively – accompanied with the feeling that I just had to let someone know that I was about to die.  Imagine this – the vehicle in front of you is driving at 50 mph and the driver opens his door  --- that was me.  I didn’t know what I was doing except that I knew I needed help because I thought I was having a heart attack. I called 911 and had an ambulance on the way. This elevated my blood pressure – the ambulance driver gave me some nitro.  Got to the hospital – and except for my bi-jiminy and tri-jiminy (PVC’s or skipped heart beats) I was fine.  All the tests came back – fine. My Dr. ordered a stress test and an eco.  Both tests came back fine.  And the tests and bloodwork that the ER ran also disproved a heart attack. My heart is fine.

My Dr. put me on a generic form of Zanac called ALPRAZOLAM .25mg. and Protonix.  He then ordered an upper GI.  You know, where you swallow the yucky stuff  - they take pictures- then you poop white stools for a couple of days – gross.  The Alprazolam did reduce my fear of dieing, a little.  The Protonix didn’t do anything so I stopped taking it.

A month later, I woke up in the middle of the night with hot / cold flashes / perspiration/ pain in and under the center of my chest and the upper left area of my chest, my collar bone and left shoulder blade.  I thought this was it, I’m going to die.  I ran into my wife – (woke her up) and asked her to pray with me cause I’m going to heaven tonight and I don’t want to be afraid. AND I WAS AFRAID.  It finally all passed within 2 - 5 min. and I was able to go back to bed.  (I don't think my wife was able to get back to sleep ?)

Here is the most important thing my Dr. said - Stress or panic/ anxiety/fear) cause increase acid  -  which brings on the pain associated with GERDs which mimics the same pains associated with having a heart attack which brings on more anxiety. …etc.  It’s an ugly and vicious cycle.  And it all feeds into the feeling that “I’m going to die” or  “impending doom”.

Finally I had the upper GI. It showed that I have a sliding-hiatal hernia.  He put me on Nexium (since I told him I stopped taking the other stuff).  He said that the Nexium will work on the acid from the hiatal hernia and the Alprazolam will work to reduce the panic.

Each day on my way into work and usually when I’m alone I feel the panic coming on. I remind myself that no one has ever died from a panic attack.  This feeling that I’m going to die is false.  I remind myself of the truth – that the stress test was good, the eco was good, the ER tests were all good......  I have a good heart.  I force myself to relax - go limp - and it passes.