What's wrong with me?

[Christine]

I will try to be as brief as possible.  After the birth of my daughter, eight years ago, my chest took a few spells of pain and into my left arm.  The doctor at the clinic said the the EKG was fine.  So the pain eventually faded and 4 years later, almost four years ago, I had my son.  While, I was in the hospital, my heart raced upto 129 beats a minute, I went home, this was in Sept. 95, in March of 96, I begin to have periods of pain in my chest, sometimes, sharp, sometimes dull, sometimes burning.  It would go into my back or stay in one place or move around my breast( sometimes on top, sometimes on side...ect.)  At times, my left arm would hurt, and my hand would get numb or tingle.  Sometimes my heart would race.  I wore a Hoilter moniter, and was told that my heart would beat a little faster, but my EKG'S and my Echocardigram was okay.  I was put on Corgard, after about a year, I saw another doctor and he said it was slowing my heart rate, down too much and put me on Topol.  Finally, after about 2 years, I got my doctor to send me to a Cardiologist.  He performed an Adenoise(I misspelled it--sorry) stress test, because he didn't think that I could do the treadmill.  He did an echocardigram, and someother test with Cardolite, where that machine goes around for about an hour and takes pictures.  That was in Oct of 98.  Unfortuntately, since I moved I was unable to go back and see him, however I did call and his nurse told me that if something had been abnormal they would have called, however, the tests came back normal. And that she could send me a copy if I wished.  I have been told that I have a small hiatal hernia, but that I could be having panic attacks.  But I don't have the symptoms of a panic attack, except for what I have described above, I had to bother you, but I don't know what is

[Cleveland Clinic, MD]

Dear  Christine,

There are many causes of chest pain.  The one that doctors worry about the most is cardiac because it has the potential to be life-threatening.  Once this is ruled out the work-up can proceed at a more leisurely pace.

Amongst the cardiac causes of chest pain are: ischemia (due to blockages - including both stable and unstable angina and acute heart attack and coronary artery spasm), pericarditis (inflammation of the sack around the heart), myocarditis (inflammation of the heart), cardiomyopathy (heart failure) and rarer causes such as coronary artery dissection, acute rupture of the heart and valves and infections of the pericardium.

Gastrointestinal causes of chest pain include reflux (acid from the stomach washing back into the esophagus), gallstones, esophageal spasm, esophageal rupture, varicose veins of the esophagus, strictures of the esophagus, tumors of the esophagus and other less common GI problems.

Pulmonary (lung) causes include pneumonia, pulmonary embolus, pneumothorax, pleuritis and bleb rupture.

Other potential causes are aortic dissection, back and spine problems and musculoskeletal (muscle strain, rib fracture, etc.).

Psychological causes of chest pain are common and include panic attacks, anxiety, stress and mental duress.

As you can see the list of potential causes in long and may take a little bit of time to determine the precise cause.  A good Internal Medicine doctor should be able to work through the potential causes of your symptoms.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

[LuckyCharm2002]

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