chest pain

[Bernd]

Dear doctors,

I am a 41 old man. The last two weeks i had several times
(9 - 12 times) a sharp pain in my chest. Right in the middle under my chest bone. It last for some seconds, some times 30 seconds/a minute. Sometimes they came two, three, four times after each other. I've got them when i'm walking but also in rest (sitting or in bed).

Since 1992 i have very frequent pvc's,  mitral valve prolapse and i go every year to my cardiologist for a check.

I went to a doctor last week but he thinks its not my heart (chest wall muscles, he says). But i still have them and i really think that its going to be a heart attack.

Questions:

a) are these sharp pains related to a heart attack?
b) can these sharp pains have anything to do with my palpitations or mitral prolapse?
c) what can be the cause of this pain?
d) i will go to the my cardiologist in october.
Is it necessary to go sooner?

Thanks a lot.

Bernd

[angeldr]

Hi,

I am 25 yrs old and have had chest pain occassionally.  Right now for example I feel some slight pain on the left side of the chest and am worried what it might be.  I am feeling this as I woke up to go to the bathroom in the middle of the night.  I do workout, but this pain is not an outside one, it is inside.  I've always thought that I feel my palpitations too easily and have gone to see a cardiologist a couple of times.  I have been tested on all the heart related tests, and nothing seems to be wrong with my heart.  My question is, what could this be then?  In relation to the palpitations, whenever I am laying down I just feel my palpitations continuously, and I would not necessarily have high blood pressure.

[Mels22]

I HAVE BEEN HAVING CHEST PAIN FOR ONE MONTH NOW.  I AM 25 YEAR OLD FEMALE.  JUST HAD A BABY 5 MONTHS AGO.  NORMAL WEIGHT AND BP ADN 135 CHOLESTEROL LEVEL.  NO FAMILY HISTORY OF HEART DISEASE.  I DO HAVE ANXIETY BUT THIS IS DIFFERENT THAN WHAT I'VE EVER FELT.  I AM ON PROZAC AND TRAXENE AND THEY DON'T SEEM TO BE HLLPING.  I WENT TO ER WITH CHEST PAINS 3 WEEKS AGO - THEY DID PHYSICAL EXAM, BLOOD WORK, EKG MONITOR, CHEST X-RAY AND CHEST CT SCAN - ALL NORMAL.  I WENT TO MY REGULAR MD AND HAD EKG WITH "INVERTED T-WAVES" SO HE ORDERED MYOVIEW NUCLEAR STRESS TEST.  EVERYTHING CAME BACK NORMAL.  I HAD ANOTHER EKG 3 DAYS AGO THAT WAS NORMAL BUT CONTINUE TO HAVE CHEST PAINS AND IMPENDING SENSE OF DOOM.  I ALSO HAVE A LOT OF BURPING AND INDIGESTION WHICH THE MD GAVE ME PRILOSEC.  I'VE BEEN TOLD EVERYTHING FROM POST-PARDUM, ANXIETY DISORDER, GERD.  I STILL AM TOTALLY CONVINCED I AM GOING TO HAVE A HEART ATTACK.  I LIVE IN CONSTANT FEAR ADN IT IS DISRUPTING MY LIFE.  I CAN BARELY TAKE CARE OF MY BABY.  I JUST WANT TO KNOW...
1 HOW ACCURATE ARE THE TESTS I'VE HAD
2 DO WOMEN REALLY HAVE SYMPTOMS OF IMPENDING DOOM, INDIGESTION, FATIGUE A MONTH BEFORE A HEART ATTACK? - I READ THAT ARTICLE
3 SHOULD I PRESS FOR MORE TESTING
4 WHAT SHOULD I DO
PLEASE HELP!!!!!

ANY COMMENTS WOULD BE APPRECIATED!

[peter piper]

I was told chest wall pain as well - very quickly - not many questions - "take Aleve." I am a young woman - so I do not think the first thought is "heart trouble." Almost a year of reoccuring symptoms - I was diagnosed with Aortic Insufficiency. My chest hurts mostly when I am laying down - mostly on my left side.
I am not saying that you have a heart problem - merely - that if you feel uncomfortable with no resolution - continue to explore the issue. Everything in me told me that I MAY have a heart issue - yet I listened to a quickie fix (I feel that the doctor was not as thorough as in the above description). Now I have several more symptoms.
Being careful doesn't hurt anyone. If you find out it isn't serious - great. If you are thorough and find a problem - then you have the opportunity to address it accordingly.
Good luck and good health!!

[caregiver222]

Generally cardiac chest pain is constant and not positionally relieved. It is generally substernal and often felt as a "pressure". It could radiate in the left shoulder and arm. Usually this pain is indicative of oxygen starvation secondary to restriction of a blood vessel leading to the heart. A nitroglycerine challenge will resolve the issue. That is to say, if you place a nitroglycerine tablet under the tongue and the pain disappears, the likely cause of the pain is a spasm of blockage of a blood vessel feeding the heart muscle. All in all, your symptoms are not consistent with a "heart attack", but sound pleuritic in nature.

[Cleveland Clinic]

Bernd,

An importnant component of diagnosing the cause of chest pain lies in a carful history taken by a physician. Specific factors such as location, quality, radiation, and exacerbating factors help guide the physician to the underlinh cause. Some factors of your story on the surface sound noncardiac such as the repetitive nature, the nonexertional component and the continued duration wothout frank escalation of symptoms. Depending on your overall risk profile I might not pursue other testing and look into other noncardiac causes especially if you had few risk factors. If you had a strong family history or other cardiac risk factors I might pursue stress testing, but all this would be after a carful history.

a) see above. But it sounds unlikely.
b) probably not.
c) I would look more towards a GI cause or muscular pain.
d) not unless things seem to be worsening or you just cant wait it out.

good luck