angina pectoris

Posted By  CCF Cardio MD-SGM on November 16, 1997 at 12:13:21:

In Reply to: angina pectoris posted by Amy on November 07, 1997 at 17:18:39:

: I am 22 years old and 5'8" 130.  The statistics are important because I don't think I am extremely overweight. My upper body is very small.  I am sort of the pear shape.   I exercise 3 times a week via water aerobics.  For the last 5 years I have experienced an extreme tightness occasionally under the breast bone.  It normally lasts 10 seconds and doesn't occur on a regular basis.  When it happens, I have to breath very shallow to lessen the pain.  It feels as if my heart has a cramp in it.  I am not a hypochondriac, but I am worried that the symptoms may worsen.  My grandfather died of a heart attack at 62.  I am wondering if this is cause for concern and should I see a physician about this?  Any input you have would be greatly appreciated.  
  Respectfully yours,
  Amy

[CCF Cardio MD-SGM]

Dear Amy,

When considering the causes of chest pain, a broad list emerges.  As cardiologists, we often see patients with coronary artery disease causing angina(or chest pain due to ischemia of the heart muscle), but we also evaluate many non-cardiac chest pain syndromes.  In deciding which is at play in a particular case(cardiac vs. non-cardiac chest pain) factors such as symptoms, physical examination findings, and medical history are considered.  In your particular case, the probability that your chest pain is due to coronary artery disease(such as experienced by your grandfather) is extremely small, and in fact approaches zero.  Thus, it is more fitting to consider non-cardiac causes of your chest pain syndrome.  There are many possibilities on this list as well, mostly having to do with musculoskeletal tissues that reside in the chest, gastrointestinal syndromes(reflux esophagitis, gastritis) and others.  I would reassure you that your chest pain is due to one of these conditions, although its exact cause may be  difficult to pinpoint.  I hope this information has been reassuring from a cardiac standpoint.  If, however, these symptoms are troubling you significantly, you may want to see your general physician and undergo a physical examination with the possibility of testing to discover the cause.  I want to warn you that it's quite likely that pains such as these, referred to as "atypical chest pains", often defy specific explanation, and sometimes the best the medical community has to offer is reassurance.  In any case, a visit to your doctor would be a prudent step.
Information provided in the heart forum is for general medical informational purposes only. Specific diagnoses and therapies can only be recommended by your personal physician.