chest tightness

[jono]

Hello

For the last two years I have been having trouble with my stomach and chest tightness. I have been through lots of tests, but I am still awaiting a diagnosis. I guess my overall concern is that it is heart related.

I have been had lots of tests for the heart (blood tests, ecg’s, 2 stress test one being three weeks ago, 24 hour BP, Echo) the only things noted was that my cholesterol is a bit on the high side and that I have a aortic root at approx 4cm. My doc is happy that with all the tests for the heart we can most defiantly rule this out as being the reason for my chest discomfort.

But still on a daily basis and for more then 50% of the day I have this tightness in my chest which makes it hard to breath (well I have to force myself to breath in) this is associated with tight neck mussels and some jaw pain. Also I have had pains in my arms, localized rather then shooting pains up and down my arm.

The past two weeks have been horrible with a feeling of tiredness has being out of it. People keep on telling me that I am very pale. I have also noticed that my pulse is very weak at times.

I am 33 years old and male, I smoke and my father has a history of angina.

My main concern is about the effectiveness of stress tests. I have read that they are 70% effective. With this in mind and my constant chest discomfort is it reasonable for my Doc to rule out heart issues.

Should I put this down to anxiety like the doc suggests (keeping in mind the only thing that make me anxious is this discomfort)

Is there anything you can suggest or your thoughts on my problems.

Also I see advertised on this site (I know it is google advertising) angioprim - it is supposed to clean away the plaque build up in our artries. is this just a myth

Many thanks

jono

[Forum-M.D.-bkj]

Jono,

Unless your father developed his disease at a very ealry age it would be highly unlikely that CAD is causing your symptoms. There are a lot of potential causes of chest symptoms that would be more likely including musculoskeletal, GI, asthma, and anxiety.

Angioprim is a chelation therapy and there is NO evidence that chelation therapy is helpful. In fact there have been trials looking closely at it's effects showing no benefit.  My question for you is: Why would you be looking into therapies to prevent or cure CAD when the biggest treatment is under you nose -- STOP SMOKING. I can't begin to empahsize how this is going to impact your overall health.

While I can't make a diagnosis without examining you, I wouldn't be surprised if it is the smoking that is causing your symptoms.

good luck and stop smoking.

[tanns]

I also have a chest discomfort of unknown origin.  I have had many tests, doctors and now bills.  All tests show normal or negative results.  That should be of some comfort...but it's not.  I also feel like the chest pain/discomfort precedes the anxiety feeling. The pain causes the anxiety, I believe, but everyone tells me it is anxiety causing the discomfort.  I am at a heightened health, specifically heart, awareness because of it.  Now it's the old "What came first, the chicken or the egg?" question.  I have heard (on another forum) that anxiety is the great imitator.  Can mimic many ailments, basically whatever the fear of the individual is.  For example, I have a heart related issue and have chest pain--a friend has been diagnosed with anxiety and she has horrible headaches, she's convinced she has a brain tumor.  It would be almost comical is it wasn't so darn scary.

I don't smoke but I have a family history of heart disease.  All the cardios (4) that I have been to have said get rid of all risk factors you can.  I can't get rid of family history, neither can you but the smoking.....easier said than done though.

Good luck to you and I hope the doc is of some comfort to you.

[jmike1_]

Sorry to hear about your chest discomfort - hope the docs figure it out and help you feel better soon.  Only question I'd have is what kind of stress test did they do?  There's a big difference between a regular exercise (treadmill) stress test, and a nuclear stress test where they inject you w/ a radioactive dye.  The nuke test is much more accurate.  I am 40 years old, and now have 5 stents from blockage in my LAD.  I passed every EKG, every echo, and every exercise stress test prior to and after my first heart cath.  After much prodding, the doctors finally decided to do a nuke stress test.  That test showed mild ischemia, which didn't concern the docs, but because I have a strong family history they somewhat relunctantly scheduled me for a heart cath in MAR 06.  They found three 90%+ blockages and put in 3 stents.  Since that first heart cath, I've had 7 additional heart caths during which they've either added additional stents or just done angioplasty to clear blockages in the original stents.  And again, during all this time, I've never failed a regular exercise stress test, echo, EKG, etc.  The only tests that have found my problems are the nuke stress test and the heart cath.  Your experience is hopefully much different than mine, and I hope you have no problems (and I'm not insinuating that you do have any problems).  But I wanted to point out that there can be a big difference in the diagnostic ability of the two different stress tests.  If you continue to have chest discomfort (especially given your high cholesterol and the fact that you smoke), you may want to ask for a nuke stress test which is a better diagnostic tool.  Good luck to you!

[jmike1_]

By the way, some of your symptoms are similar symptoms for reflux.  The docs also did a endoscopy test on me, which came back negative.  As a result of the negative reflux test, I was able to push the docs a bit harder to do further cardio tests.  

[tanns]

Your post was both interesting and alarming to me.  My family history is STRONG on my mom's side for heart ailments.  I have seen 3 cardios in my hometown and one at the Mayo Clinic.  I have had numerous EKG's, 3 echos, two stress tests (one regular/one nuclear), at CT-Angiogram, an MR-stress, 2 holters and 1 event recorder.  In your experience, and I realize that you aren't the doctor, would this be sufficient testing?  Did you have the CT-A or and MR-stress?  My heart was taxed pretty good with adenosine in the MRI, they found no inducible ischemia.

I just know myself and know what I am feeling, anxiety doesn't seem to fit for me.

[jono]

Thanks for your comments,

tranns I think you are in the same boat as me. A very frustrating journey but I am trying to keep an open mind hopfully we will both get our answers.

Jmike1 thankyou for your advice, I am in the middle of getting tests done to evauluate a GI cause as my stomach is also causing the pain - it is ths frequency that this chest tightness and pain occour that i can not let the heart question drop.

I have only had the regular strees test - but if all my test come back negative I will pursue this nucular strees test. If you dont mind me asking what sent you to the doc's in the first place. If it was due to tightness/pain in the chest could you relive this pain somewhat by switching position.

the reason I ask is when I am lying down and the pain starts up I can turn to a different position and the relives the tightness up to 90%

best of luck to you both and thanks again

[sunny in beantown]

Hi there,

I really dont intend on hijacking this thread, honest!  jmike, I'm wondering if you wouldnt mind sharing what your physical symptoms were prior to discovering the blockages?
Did they come on suddenly or did you notice gradual changes? I hope I'm not intruding, I have a very very stubborn hubby...I have noticed lots of changes in him, he has a horrible family history. Well anyway, if you dont mind, I would love to hear it!

Thanks,
Sunny

[tanns]

It is interesting that you mention your chest tightness when laying down.  I, too, can feel something when I lay on my left side.  If I switch to the right, it goes away.  It is just another reason I think heart.  Left side=heart  in my head right now.  I have been seen by a gastro doc, I had an endoscopy, small bowel series, esophogram, upper GI (and lower but that's a WHOLE other story!!!).  All results have been normal.  I kind of wished I was looking at GERD for a diagnosis but the doc says no.  

It is a frustrating thing.  I saw the doctor at the Mayo Clinic yesterday from all my tests I had done there in late February.  I felt foolish for sitting there knowing darn well my tests were normal because I had been to three other cardios in my area.  He told me that he has no doubt I feel "something"--but he can't find a physical issue wrong with my heart.   But basically, now I'm left with lots of bills and no diagnosis or resolution.  AGH!!

[jono]

What you are feling when you lie on your left side is your heartbeat, This is nothing to worry about it is quite normal. I never felt it when I was overweight but when I got close to my normal weight I could also feel this, and I asked a lot of people could they feel it some could some could not.

It is just that the heart is located on this side. have you noticed when you are hooked up to a ecg machince they always put a sensor on left side. where this sensor is placed is where I can feel my heartbeat when lying on my right side. it is quite normal as to is the fact when we are lying on our backs we can see our stomach pulse. it could be that you are more aware of your heart then most people, being this aware might make you more sensitive to feeling palputations or PACS. but because you feel this pulse does not mean there is something wrong with your heart.

I do understand what you are going through but the way I look at it when i feel this pulse is at least i know it is beating and when it is steady i take comfort from it.

I am more concerned with the tightness i feel in my chest, when I am standing up this is helped by crossing my arms, when I am lying down i can change the intensity of it by sitching positions.

One positive thing I am doing is seeing a phsciatrist (neve know who to spell that) the way i figure it is while I am going through these tests it is no harm to talk to someone that can help if it is anxiety related if not they can help me deal with the symptoms i am facing.

I think this would also be of benifit to you as well.

take care.

[tanns]

I wish what I was feeling was just my heartbeat.  Actually when I do feel it or it feels harder than normal it IS of some comfort!  But when I lay on my left side, well, the only way to describe it is that it feels like a hose has been pinched shut and the water starts to back up and have a lot of pressure building.  It feels like there is a ton of pressure that goes under my arm and around to my back....until I change positions anyway.  It is very weird and at times, pretty scary.

I agree, I DO need to see someone because I have certainly developed an extreme health anxiety, I feel everything and I know I do.  That being said, I know there is something different and either 1) it hasn't been found yet or 2) I am underestimating the power of anxiety.

I have tightness occasionally too but it doesn't sound quite the same, positions don't change it.  I get it right in the middle of my chest, right below my sternum and it is an intense tightening that feels like my skin is being pulled really tight--I hope that makes sense to you!

Anyway, thanks for listening and thanks for replying, this forum really has been of great comfort to me in such a weird time.

Good luck, I hope you get your chest issues resolved quickly!!

[NurseKagome]

Hi there,

I have been having left sided chest pain, left upper quadrant stomach pain, left sided back pain and left neck and shoulder pain especially on breathing in. It has been going on all day and now tonight and it's starting to worry me. Has anyone had this before? Arg, anything paining on breathing or etc. plus the heart palps is so hard to tolerate...it really stretches my nerves... :(

[jmike1_]

Sorry to be so late in getting back to you, but just now had a chance to get back on the site.  Both of you asked about my symptoms that drove me to seek help, and I'd be happy to share.  I started having a pinching sensation in my left shoulder near the collarbone.  It just felt like someone was sticking their little finger in to the shoulder, and holding it there.  It started out very light, but over time (several weeks), the pressure slightly graduated.  Also, after a few weeks, I noticed that my chest was getting heavy, and again, it felt like someone was kind of poking me in the center and left center of my chest.  There was no real pain, just discomfort and pressure.  And eventually, the pressure got a lot bit more intense and I could not get comfortable, no matter what position I was in (no real pain per say, but lots of pressure/discomfort).  I tried laying down, but the discomfort didn't go away.  I was also very short of breath, and my left arm would sometimes get numb.  My symptoms were a little different, because I had the pressure/discomfort most of the day (I guess w/ most people it comes and goes), and not solely w/ exertion.  My wife always knows when I'm having a problem because usually when I'm not feeling well I'll take my right hand and grab my left shoulder.  Don't ask me why, but this somehow makes me feel better and has become an instinctive reaction.  After my 7th heart cath, 5 stents, and 2 angio's later, I'm actually feeling much better.   Up until the last two months, I had not had a discomfort-free day since Feb 06.  But now, I have several.  I still get discomfort every now and then, but nothing like the discomfort I had before.  I don't want to alarm anyone with this, because everyone's symptoms are different.  But thought I'd share what I went through in response to your questions.  Take care, and hope you start feeling better soon!

[jmike1_]

As I'm not a doctor, I would not want to comment on whether you've had the right tests or not.  I found a cardiologist I trust, and that has been very important for me.  Even though I still sometimes have discomfort, I've been checked out fully and he tells me that my arteries look pretty clear (but my checks usually include a heart cath).  I trust him, and have found much relief and a reduction in stress as a result.  I imagine we all have false pain every now and then......the key is figuring out when the symptoms are real, and when they aren't.  If I can get that one down, then I'll save myself a lot of trips to the ER.  And the first step in doing that is having a doctor you trust.  Wish you all the best!

[jmike1_]

Forgot to mention, also had discomfort in my back shoulder blade.  The pinching in my collar bone eventually moved around to my back.  I could simply not get comfortable.  If changing positions helps your symptoms, then maybe reflux should be seriously considered/tested.  BUT AGAIN, I'm no doc.  Take care.

[MikeB.]

I'm also experiencing the same sort of tightness\pain in my chest.  I'm 36 and have never smoked and really don't have any history in my family of heart problems.  I went to my doctor about 2 years ago with this problem and he did an ekg as well as a chest x-ray and said everything was normal.  He said it was probably anxiety related.  Well, it never really went away and lately it has become worse.  It's a general tightness in my chest with occasional sharp pains in my upper left chest area just below my collar bone (about 2 inches).  I exercise (run) and it doesn't seem to matter what my heart rate is.  It happens when I'm lying in bed or when I'm running.  I can't really pin point what causes the pain.  I'm really starting to worry about it which is probably causing more anxiety!  2 weeks ago I started to get really bad acid indigestion.  I have never had that before so I really started to worry!

What should I do?  Go back to my regular doctor, go to another doctor, nothing?  I think worrying about it is giving me an ulcer!

Thanks,

Mike

[jmike1_]

I'm not a doc, so my advice is just "friendly advice".  But if it is something that concerns you, you can ask your doctor to refer you to a cardiologist.  I probably wouldn't be overly concerned if your cholesterol levels are normal (since you don't really have a family history and don't smoke), but understand your anxiety and if your insurance covers it, it certainly wouldn't hurt to see a cardiologist and have additional tests done that are better than a chest x-ray and EKG at detecting potential blockages - those tests have never shown anything on me, and I have 5 stents.  But I have significant family history and my cholesterol levels were very elevated.  The least invasive test that I feel comfortable w/ the results of is the nuke stress test that measures for ischemia (lack of oxygen to the heart - possibly caused by blockage in the arteries).  This test has always been reliable for me, and is the next best thing to a heart cath for determining if there is or is not a problem.  So guess my only recommendation to you is to go see a cardiologist - since the discomfort is causing you additional stress, and have them do a more comprehensive set of tests on you so you can be comfortable w/ the diagnosis.  Good luck.

[chek101]

I don't know if what I feel is the same thing. All I know is I feel a constant tightness at the back of my throat ... like my throat is suddenly smaller  thus  restricting some of the air from getting through to my heart or wherever. It just feels like I'm not getting all the air I should. When it goes away, I feel like I can draw a full breath for a change. I take Toprol XL 100 mg, Vytorin 10/20, Plavix (as I have 4 cardio stent impants) and a 325 mg Ecotrin tablet everyday. I positively dislike taking all these meds!!! I never had this feeling till AFTER I started taking all these meds. What precipitated the stents was chest pains.
This other came later, like I said, after the stent surgery and the use of Plavix.
I wish I knew what was going on?