unexplained chest pain on/off for a year

hi i am a 29 year old male who has been having cp and sob for about a year now...it started about this time last yr..all of a sudden i felt like i just could not get enough air..the next day it got worse and i started to have cp along with it..i blew it off until a few days later when i could feel the pvc's that i have (dx 8 years ago)..i could never feel them and had actually forgot that i had them.....this scared me so i went to pcp..this past year i had a complete pulmonary work up allof which was (-)..i have also had 7 ekgs,stress test, echo, stress echo,halter monitor all of which were(-)..ive also tried anxiety meds which help me to relax but i can still feel the symptoms that i have..3 months ago i joined the gym to try to get in shape..i felt better and was told by my pcp to call her if i have any more problems..all was good until christmas week..i was at the gym and i got this sharp chest pain..next few days it felt like i was having a heart attack..terrible chest pain, sob, my left arm felt funny, and i kept burping..i called my pcp after xmas,she did ekg and bw (all -)..then she order a myoview stress test..stress test was (-) but the myoview showed reversible ischemia, ventricular disfunction,and ef of 61....she called a cardiologist right away and he said that he doesnt believe those results...had another stressecho with him present and he said my heart is fine....i have felt terrible since...when i lay down at night it feels like my heart is pounding out of my chest, and i still have daily chest tightness...im going for an egd in 2 wks...what do u think
thanks

[CCF-M.D.-MJM]

Hi mathisen,

You would be amazed how many times we here this or a similar question.  I agree with the cardiologist that I would not believe those results either.  It is important to acknowledge that you are having symptoms -- you are feeling what you are feeling.  It is very unlikely to be your heart.  After all those tests you would expect to see a false positive eventually.  The good news is that you are not going to die from the shortness of breath and chest pain, although at times you may feel like you are going to.

We usually attibute these symptoms to anxiety.  You are around the age when young men with anxiety disorders start to experience anxiety attacks or increase in their overall anxiety.   I am not saying anxiety is the cause, but it is possible.

I think the key is to realize that you aren't having a heart attack and that you aren't going to die, and moving on with your life.  Try to not let this control you.   I have seen lives ruined by these symptoms before.

[rayg]

i know how you feel. i have the same prob with chest pain and tightness in my chest constantly. i am a 54 yr old male who had 5 stents, 2 angios, and a double by pass. i had a heart attack 21 days after a stent was placed all this after the bypass. i was told i have a blockage in the l septrum which the doctor will not do anything with. my by pass actually looked like a < after the heart attack which the doctor was going to stent but later noticed it was straight again???? ever heard of this?????? i also have pvc's and get a heart beat the sounds like it is coming out of my body. these doctors now just say its ok nothing to worry about.

[Eddie 14]

I'm RIGHT there with you on this one.  I'm 33 years old.

In fact, I ended up at the ER in early december. My BP was 210/110 on arrival, but it came down without any meds.

I get daily shooting pains in my chest, jaw, and arms.  Bi Lateral pains.  Some days I have general chest tightness.  What is interesting is that ALL of my symptoms get worse as the day goes on, and I feel best during exercise.  I rarely get the pains during exercise.  NONE of the shooting pains lasts longer than 10 seconds.  The tightness comes and goes.  Every 3 weeks or so I seem to develop a spell of lightheadedness or dizziness.

I burp CONSTANTLY.

ECG - Fine.  Nuclear Stress Echo - fine.  EF was 61%, and my heart lit up great.  No problems getting my HR up.

I KNOW that most PCP's and even a cardiologist wouldn't order much beyond this.  I understand why.  That hasn't helped me, as just about every stinking day I'm worried it's my last.  I've got a wife and two kids.

I'm on BP med (have had high BP for a while) and have borderline cholesterol but can't take statins.  I've relenquished and started taking XANAX XR .5 mg daily.  It might be helping.  I'm also on Prilosec OTC.  Still burp all the time.

I'm in a high stress job, and my life is no fun anymore as I'm afraid to exercise (jog, ride my bike etc) outside alone.  I figure at the gym someone could help me.

I'm trying to fight through it.  I'm in a field where I understand the thought process of physicans, and frankly I understand why they don't order more tests.  My BP is slightly high, my Cholesterol is slightly high.  Otherwise, not a whole lot of risk factors (Had one grandfather die of a MI in his early 50's, but he was a 2 pack a day smoker and heavy drinker).  I have never smoked, and rarely drink.

I constantly remind myself that I've felt like this before (every time the shooting pains scare me), and that I"m still standing now.  Doesn't mean it's easy.  I'm hoping the Xanax, exercise, and a bit of therapy helps.  That said, I know that the pains ADD more stress and if this is stress and anxiety related that it's like a vicious circle.

Not sure if this helps you much or not, other than to say I've been going through it for 3 months now and I'm still standing.  But, with a negative nuclear stress echo, clean ecg, knowing I have a high stress level... I'm trying to trust my docs.

I also know that not too many guys our age are getting stented or bypasses... my hope is because it's just rare, not because guys our age don't make it to the hospital to get the intervention or bypass done.

I feel for you, it sucks.

[netrox]

I am 33 and I had chest discomfort for three years so far. The extensive cardio tests (xray, stress, echo, blood, etc) turned out negative. No evidence of CAD. I get PVC's everyday although I don't worry much about them anymore.

I am pretty convinced it's anxiety. I think anxiety produces the sharp aching pangs on my chest. Sometimes it's dull. Sometimes it squeezes. It's ALWAYS the anxiety. It sucks.

Occasionally, Xanax helps me somewhat but I still get aches a few times. I get the sensation of feeling sick and my chest would start to feel more and more tight even though my heart rate feels normal and the blood pressure is slightly higher (stress, probably).

Ambien is the only one that's truly effective - it undoes anxiety, pain, and stress. Unfortunately, it's NOT good for daytime use (since it's meant for sleep and it causes hallucinations/psychosis and amnesia if you stay up) so I only take it at night before I go to bed.

[woodruff]

Xanax is good for isolated fits of anxiety, but I have found that when the problem recurs day after day or week after week, it's time to go for a longer-term solution.  For me, that has always been one of the SSRIs.  It took several tries to find the right drug:  Celexa worked, Paxil didn't, Lexapro didn't, and Zoloft has worked so well that it's my favorite.

When you find the right chemical aid, God bless it, you will be pleasantly surprised to feel your awareness of your "heart" symptoms fading away.  You will get your life back.

[Eddie 14]

Yes it's a difficult journey.  It sucks.

I'd push harder on the cardiac, however the fact I burp constantly and that always gets rid of the tightness helps a bit.  Though, the shooting pains are arms one day, chest one day, neck and jaw the next.

Also, the fact I feel better during exercise (significantly) most of the time helps me believe it is not cardiac, and is stress, or muscle/nerve related.

Another strange thing... I'm tracking my BP now that I'm on meds.  I am seeing a trend when my pulse goes up, my BP goes down.  Normal pulse is in the 70's, but when it jumps, most times my BP goes down.  Could just be an annomoly.

Getting some GI stuff done also.  

I've got an ambien RX, but I'm afraid to take it at night, I worry it would let me sleep though pains that should wake me if they were indeed real, and blow my shot at getting to the ER if necessary.

It's tough, no doubt, and it is in my head now.

It helps a bit to hear others are in this situation, though it sucks for all of us.

[netrox]

eddie, you said "I've got an ambien RX, but I'm afraid to take it at night, I worry it would let me sleep though pains that should wake me if they were indeed real, and blow my shot at getting to the ER if necessary."

Funny you say that. I have that fear but once I take 5 mg Ambien, I don't worry at all and take another dose of Ambien (another 5mg). That's a safe dose so no worries at all.

It is NOT normal to have that kind of fear. You shouldn't be worried about "what if..."

-jeff

[dmil241]

Eddie,

Lots of people worry about the "What ifs..." In fact, everyone I know from children in elementary school to my 75yr. old parents tend to worry about what has not happened yet. If you're in the middle of a situation, then you deal with it and it usually isn't has bad as the what if because you feel empowered by the mere fact that you are dealing in some way.

Just a thought about the pain-it could be some kind of spasm. Coronary artery spasms produce the kind of pain you are talking about. It is usually at rest or with minimal activity. It is seldom at exercise. So exercise away. It is good for you!!! Or...it could be esophageal spasm. I understand that is extremely painful and feel just like cardiac pain. Either way your prognosis is good. (Altough that does not help you with the pain as I know, but there is medicine that should help.)

It took 5 years for the cardiologist to finally diagnosis me with coronary artery spasms. He just kept digging and testing because I kept having unusal and unexplained pain in my chest area. I went the whole GERDS route..AND YES, my PCP kept saying it was anxiety and I went to a therapist and learned biofeedback to combat this. (Perhaps the symptoms were producing some anxiety BUT the anxiety was not producing the symptoms!)So be cautious with the ANXIETY TRAP. I believe that when a doctor does not know what is going on they simply label you "anxious" and wash their hands of you. I have had 3 PCPs do that to me over the last 5 years. For me, once they labeled me anxious they stopped listening to EVERYTHING! My anxiety was always the reason for whatever was going on. It was only my cardiologist (and the psychologist who taught me biofeedback) who refused to believe that and finally, by the grace of God, caught the spasm on a nuclear stress test. It took awhile but I am now on the proper medicine and doing much better. I am so grateful. So don't give up. Keep pushing your doctors for help.

[kitcurious]

Just wanted to commend you on your advice to people that they obtain all the info that they can.
My father passed away at 43, from his heart, my grandfather had fainting spells for as long as my mother could recall from her childhood, he was on digitalis, my 1st cousin recently passed away from a heart attack, at age 50.

In October 2004 I started getting dizzy spells and was shipped from doctor to doctor for them with no relief. The neurologist noticed tachycardia, PCP took an abnormal EKG and I eventually wound up at the cardiologist getting an echo cardiogram that said prolapse was suggested.

Now my regular doctor chalks up my dizziness and palpitations to MVP. I'd have no problem with this except for the fact that I believe MVP is congenital, so why would it wait over 30 years before it suddenly gave me symptoms ?

I still have dizzy spells on a daily basis and if I stand up for any period of time my heart will race and I nearly pass out
( almost happened today at a seminar).  I haven't been back to the doc since last spring because I know they'll just tell me to take a beta blocker, they won't look any deeper.

I think CAD is possible because, while I eat right and exercise regularly now, as a child and young adult we were very poor and my mother raised me on processed cheese,hotdogs and bologna, same kind of diet my father died eating (his first heart attack was before I was born, he was 34) As a kid, I never met a veggie that wasn't an instant potato. I assume once it's clogged it's clogged and I have dreadful heredity. My mom's older sister also died of a heart attack at 34.


I guess I won't know for sure unless it gets more drastic, but for now I am functioning this way.

[tickertock]

I would strongly urge anyone whose immediate family has a history of early heart disease 30-50 years of age or died young from CAD , especially those that suffer with symptoms to get checked out as thoroughly as possible, family history and genetics are some of the strongest markers in who will develop CAD, of course there is always an odd ball either way, those that have little or no family of CAD and develop it and those that have a strong family history but never develop CAD.

With a strong family history never take chances, insist on getting thoroughly checked, just my personal opinion and observations.

[cristabelle]

Yes, I agree with kitcurious and aldente about research and obtaining all the info you can.  I could add my family examples, however, since a few have done so (very well) I will hold off. But the family health history is very important and I have seen it come to play in my life and in the lives of those I care for.

anacyde:  good reccommendation on the GERD possibility, my sister-in-law suffers with this and she says it can mimic cardiac symptoms at times.  Good thought.

[grammyjoy]

hi i am 48 female greatly overweight and i have been having chest pains for about two months now  they start out dull then get to the point were it hurts to breath or move. somethimes i can't even talk.  the pain is mostly on the left side my neck hurts arm and sometimes my right grion area hurts and feels hot. i have had every test going and no one seems to no whats going on.  i'm to the point i hate to say anything about this. i feel the drs. think its all in my head.  i would like any one that has had similar attacks or know anything about this to e-mail  me   ***@****   i all so get dizzy and some times pass out  i get sick on my stomach and then i get a funny feeling in my head    thanks

[Eddie 14]

So here is an open question to all of you with what I consider random chest pains like I have.  Sometimes shooting, sometimes a light to medium pressure.

When I exercise, I ALWAYS feel better.  I never have worse chest pains, most time I have none, and if I do it is a shooting pain etc.

However, stress tests, and what I read says that if it is cardiac, exercise will make it worse.  Period.  I've yet to see anything that says exercise would make CAD of any sort feel better, which mine seems to do.  That is why I do have some belief mine is more stress and or anxiety related.

Anyone else out there get better, or feel better during or after exercise?  I for one do, which currently is what I"m clinging to telling me it's not cardiac.  If I do get pains during or after exercise, I ususally burp about 100 times but I feel better.

[HJK2]

My comments are mostly directed to eddie. I am in exactly the same boat. In nov 04 I had a MI, and had 3 stents. I was in good shape (male,41, Not overweight, ran 2 miles 3 x a week. low cholesteral)so it is a little bit of a mystery. However the blockage was at the bifuracation of the LAD but thats for a different thread..
Anyway, almost directly after the first incident and extending for more then a year, I too have had random, ill-defined pain in my chest, arm and somtimes jaw. Never the crushing pain of the MI, but always nagging and worrying - always the what if - is it back -kind of worry.
2 trips to the hospital, and 2 more thalliums, with all good results. (as a side note - I cannot take Nitro - I pass out due to a condition stemming from a strong heart!)
I still exersize 3 times a week running more then 2 miles. When I cease exercising I always feel better then when I started, little or no pain during, or after the exersizing. This sounds exactly what you are feeling. In fact when I start feeling worse, I make a point to go and exersize (often running on the treadmill in the basement)
It was the anxiousness that put me in the hospital those two times, and at times over the last year I have been very anxious, but like you said, I am still standing. I closely monitor how I feel, and compare it to how I have felt before. My thought has always been that if I see any major change I will go to the ER, but for a year now, I not seen any change. My Doctor (a good one I feel) agrees with me - telling me there is little more testing they can do (after a CAT and Bone MRI, and the two Thallium tests) to determine the cause.
SO - in the last year, my anxiousness has started to reduce, I am not worried, and I feel I am growing heathier. This does not reduce the ongoing monitoring as I HAVE had a MI, however I do not link the random chestpain to heart troubles.
I wonder if the pain could be linked to the Stents (the reason I joined this board) or the lipitor. Regardless, I have the stents (they can't come out!) and I need the Lipitor, so I must make peace with my pains and continue to live life to the fullest!
Hope this helps you!

[lddaugh]

I was really surprised to see that there was this many people who were having similar thoughts as I have been. I am a 37 yr old male that has been in good shape all my life. I have been having this chest pain or discomfort for a few years and kept getting told its nothing and your to young for this. I take ambian for sleep since i work rotating shifts each week. Have high blood pressure and was told I had a tma a few months back. All the test ie ekgs and stuff came back fine on me. but afterwards I was told that they would unless I was having the pain at the moment of the test. I have decided to push the issue and find a doctor that will find out why I have the pain in my chest and down my arm. I hope all will keep pushing their doctors too. My wife worries more then I do but it has gotten worse and its something that seems to worry me now. If anyone ever finds the right things that I might be able to ask my doctor to get him to understand or leed to the right direction it would be appreciated. Good luck to all and hope your health improves.

[Filip]

mathisen, you said you have an egd in 2 weeks, did you have it by now ?

for all, in which cardio-related diseases can one get shortness of breath w/o any kind of pain (not always, I mean sometimes w/pain sometimes only sod) ?

I'm still looking for an explanation for my symptoms, I get sob and feel my heart beating very hard even after 30 sec. of running (sometimes) but no pain, other times I have mild chest pain for hours while resting, but no sob ...

I'm still hoping it's either stress/anxiety related and/or nerve/spine related, otherwise at 28y I might be in trouble

plan for the worst and wish for the best

[stressed?]

I am having very similar issues. I do not have any problems exercising, passed the stress test, ekg's look good. I have chest pain (pressure) when I get stressed and I begin burping like crazy. Once I get stressed, the smyptoms last all day and they will not go away.  I am 49 years old and my father died at 45 from a heart attack so they want to run further tests on me but I do not feel like it is heart related.  I always feel better on the weekends when I am away from a stressful job. I think it has something to do with stress but I have no idea what it could be. The first time this happened I went to the emergency room. Had the chest x-ray, blood tests -all negative. The nitro did not seem to make the chest pains go away. I had a nuclear test and there is something there that requires me to do another test but it must not be a real concern to the doctor or cardiologist because my return appointment was not scheduled for 5 weeks out. The doctor precribed aciphex(GERDS)but it does not help at all. People with similiar symptoms, what have you done?

Thank you,

Gordon

[Tampa Lady]

I am 53 and have for the last 3 years experienced chest discomfort. Sometimes it is dull, sometimes sharp, sometimes on the left, sometimes on the right. I have been diagnosed with a hiatal hernia, although my Gastroenterologist said that would not be causing the chest discomfort. I went to a Cardiologist. He is #1 in the Tampa Bay area. Saw him after I was rushed to the ER for horrible chest pain/discomfort. Family history (father) quad by-pass at 73. Dr. suggested I have an angiogram. Test showed heart in perfect shape, arteries clean. Previous to this test, had all the other tests possible leading up to the angiogram. They all came back negative. During the year since the angiogram, still have chest pain/discomfort, going back to see both doctors. Now in the past few weeks in the news hearing about how women who have had angiograms are not getting the same clear results (readings) that men get. Trying to understand why I'm having this discomfort. Sometimes it hurts after I eat, sounds more gastro. Sometimes it starts when I go to walk (exercise), sounds more heart. If it's hurting while I'm relaxing, then it feels better when I get up and start moving around. I also notice when I get a little stress the pain starts to come on. I have also for the past 30 years had migraines. In the past year I have been put on Topamax for them. I also have high cholesterol and take Pravocol. Topamax can cause your nerve endings to become sensitive and Pravocol (Statins) can cause your joints to ache. I'm sure neither one of these meds are a plus for the chest discomfort. My blood pressure is perfect along with my heart rate. On the outside all looks normal. Wish I felt that way inside. I'm sure you can all agree, you do get tired of worrying everyday about what might happen next. I would just like to know why and what is causing this.

[ADRIAN 664]

hi there folks, just been reading about so many people in the same boat as me, as helped me feel slightly better, I

[Tampa Lady]

It does become very frustrating. Sometimes I think it would make it alot easier to know where the pain is coming from, even if it's not the answer we want to hear. You are you own best advocate. As you well know, it's not as easy to diag. women with heart problems as it is men. They are making great strides. I am truly disappointed to know that the angiogram I underwent is not the best testing to find out what is causing my problem.

I refuse to give up on finding out why I feel like I do almost everyday. I wouldn't give up on a family member if they felt like this. With all the excellent knowledge available on the Web, I will continue to research. At least when I go to my doctor, I have a better understanding of what and why we are discussing what we do. Only you know what doesn't feel right in your body, so it is up to you to do something about it.

[nadiyaah00]

A related discussion, Stabbing Chest pains was started.