infarct

I have been experiencing atypical chest pains for at least 18 months without a diagnosis. During this time my ECK's have gone from normal to slightly abnormal to abnormal to indicating infarct and back again to normal. Last month I was admitted through ER and tested within normal range for an exercise stress test. However, 5 days ago I was once again admitted through ER when EKG's indicated an spectal infarct. However, several hours later, my last EKG indicated normal sinus and The cardiologist was very firm in her opinion that I had not had an MI now or at any previous time and there was no cardiac basis for the chest pains based on the recent normal stress test and the latest perfectly normal EKG.

Why the fluctuations in EKG results? Why are they unable to identify orgin of the pain and provide diagnosis and effective treatment after so many months?  

[Michael J. McWilliams, M.D.]

EKGs vary by lead position.  It is very common for me to read EKGs and have a "septal infarct" or "inferior infarct" that is gone the next day.  It has to do with lead position and what phase of the respiratory cycle the EKG is done.  I do not like to call septal infarcts on EKGs because it seldom is an actual infarct.

From a cardiology perspective, we rule out cases of chest pain from coronary artery blockages.  We are not good at diagnosis a definite cause for non coronary chest pain.  There is not a great test to clarify the issue and the history is often not very helpful.  Atypical chest pain is common in people with depression and anxiety so it often chalked up to anxiety, but the physiologic cause is not known.

I know this doesn't answer your question to your satisfaction but as of now, there is often not a good answer.

i hope this helps.

[RNP]

I and my daughter  were dx with SVT and atypical chest pain. Which would occur at times without a rapid heart rate. eg. in the am upon rising. If I worked out more than a couple of days in a row I would have chest pain for a week. Many ER visits, with Morphine to relieve the pain. We are both failed ablation,EPS studies. I was placed on Lipitor for a persistant level of 225. Not bad, after three days of lipitor I realized my heart pain was significantly better, after two weeks I have no heart pain. I still am on the Coreg, off the Norvasc which was used for vaso diliation. I have No other medical probs. We placed my daughter on Lipitor whos cholestrol was 180. Her chest pain has now resolved. Our Cardiologist is Dr. A Bhandari. who is amazed, we all are. He plans to write it up. He has another patient he used Lipitor with and same results. He told me that our problem was small vessel spasms, which feel just like the real deal...