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exercise induced chest pain
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exercise induced chest pain

hi there,
for the last little while I have been experiencing chest pain while walking with a stroller.  The pain is generally in the center of my chest and sometimes spreads to my lower neck and is also felt in the left shoulder blade.  It does not happen each time I walk, only sometimes.  It starts about halfway through the walk and increasing the intensity of the walk (ie, going from level to uphill) doesn't make it worse, either.

I am 33, female, non-smoker.  4m post-partum and 40-50lbs overweight.  Blood pressure 105/70 (always lower), no diabetes.  Had recent echo done (routine) that showed mildly elevated pulmonary pressures but was otherwise normal.  I suffer from health anxiety.

When I have the pains they gradually diminish then go away.  When I have them, I feel like I want to massage my chest and shoulder blade, the pain is dull and achy.  I am a known upper chest breather but am working to relearn proper breathing with my diaphragm.

Should I be concerned?

should note, when I check my oxygen sats during this it is still 97-99%
6 Comments Post a Comment
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976897_tn?1379171202
My very first symptoms with heart disease were very similar, but this doesn't mean you have this problem. Some days I had pains worse than others, some days none at all. I couldn't make sense of it. I now know that there are factors which can affect the heart, such as how long ago you ate before exercising, and WHAT you ate. Fatty foods certainly make things worse.
As a quick test, start your exercise and when you feel pain, stop the machine and just stand still. How long does it take for the pain to disappear.
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976897_tn?1379171202
Another thing which affects angina is temperature with most people. The colder the air you breathe, the worse the angina gets. I don't know what your weather is like, but if you get a chilly day, see if it's harder work than a warm day when walking outside. When we had the summer months, I had no pain but as soon as winter came, that was a different story altogether.
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Avatar_n_tn
yes, I do notice it is harder when it's colder.  I guess I just don't understand why it would start in the MIDDLE of the walk (always outside with a stroller) and why increasing the intensity doesn't necessarily make it worse.  I would think increasing the intensity would increase workload on heart and increase pain??

also, is heart disease simply plaque building up in the arteries??

I should also mention my walks are always AFTER breakfast, usually within an hour of walking as I like to get my little ones out the door before the rest of the day's activities make it impossible to walk later.  Breakfast isn't very fatty, usually egg whites and toast or oatmeal.  

Besides my obesity, I'm not sure what other risk factors I have.  It does concern me and I do see a respirologist on Wed. in regards to the echo I had done.   The echo tech told me he did not see any signs of CAD based on the size/shape of the stuff in my heart.  

Thanks for your help btw.  Can heart disease be reversed?
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976897_tn?1379171202
Perhaps I can explain the pain with exercise a little more so you have a clearer picture of what could be happening.
Imagine a major coronary artery which is totally clear of disease. As you walk and go uphill, your heart reaches its max necessary rate for that exertion, but the extra required blood has no trouble reaching the heart muscle, hence, no pain. Now imagine a blockage of around 70%. Your heart can handle can just reach 'below' the required level of work. It just starts to get pain as you enter the max necessary workload of the heart. So, as you work, your heart is getting just under the amount of oxygen required, hence small amount of pain.
Now imagine it has 80-99% blockage. Now you would notice pain very early on in exercise, and the pain will increase a lot as you push yourself harder because there simply isn't enough oxygen getting to the heart muscle.
It sound like your blockage is probably 60-70% if it is the case.
A standard echo will not reveal disease until it is quite severe because the heart is at rest. A stress echo will reveal more.I bet you didn't have chest pain when they did the echo, which means it will look normal. An echo doesn't look inside the arteries, it just looks to see if the muscle is slower at reacting in different areas.
Disease cannot be reversed. However, if a single blockage exists, or several blockages, then they can be treated to open the artery, using stents. However, if the disease is diffuse, in other words, spread along the artery quite a way down, then this is a different story.
You CAN slow or stop disease getting worse by huge lifestyle changes. Healthy diet, no smoking, regular exercise, blood pressure monitoring, blood cholesterol monitoring and avoiding stress as much as possible.
I would ask your Doctor if he/she thinks you have stable angina, because you certainly show the classic symptoms. A low dosage of beta blockers may get rid of your pain totally.
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Avatar_n_tn
thank you Ed!  I keep hoping it's GERD (minus the burn part) or something musculoskeletal due to poor posture when pushing a stroller, but I guess I have to face the reality I haven't been so kind to my body the last few years (little to no exercise and a diet high in fat).  
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976897_tn?1379171202
Well, it might not be heart disease, you need further tests.
I have had more than one heart attack, and suffered stable Angina for years. I can tell you that when I got esophagitis, it felt just like a heart attack. I really could only tell one difference, and that was that the pain didn't get worse with exertion. So, you could be right but it requires specialists and tests.
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