daily chest- pain tightness- weakness

[paulr936]

Iam 40 yrs old- in relatively good shape- 6' 3   about 230 lbs- do not smoke- very light alcohol-daily and exerise 3- 4 time a week- recently i have had daily episosodes- of a non predicatable chest tightness followed by weakness some shortness of breath these occurences happen almost typically late in aft or early eves..about a week ago I was playing golf and had to call 911 and have an ambulance take me to ER- from the course as i was in capable of continuing becuase of the symptom of tightness- feel like i was goung to lose consciousness- and could not walk to my ball to hit- this is was the first time ever in an ambulance- all tests incl ekg- blood enzymes- we're fine- they gave me morphine with adevin and in a few hours it supsided- my BP in hosp  increased to about 190....i was very nervous and felt like extreme tighntess around rear kneck area and general tihness in uppper chest...was cold and shakey---since weds I have had repeat occurences- where all of a sudden i get a sharp twinge in my chest followed by tightness- and have to sit down and dr prescribed adevin and metropol- so far i have no idea what is gonig on- in the past 6 mos- I have had a STRESS ECHO test Calcium plaque scan- (16) all other tsts have been neg- My primary Dr put me on Lipitor to manage down mildly high cholesterol.

I feel I am a prisoner to these daily episodes - thay have strong characteristics of what could be angina or heart blockage  - But Iam not sure...yest morning i was able to exercise at the gym with 15 min cardio where my heart rate was 120 after15 min and i lifted weights with no issues- but then around 3;00 pm I had another eposide- could this be stress? or someting else-

other symptoms- recently- more yawning- a little more cough- not sure if it's related to any medication that was prescribed..

my thoughts are I would like to have an angio gram to clearly see if there is any blockage as all the other tests seem to be more invasive and dont show everything..

[Darcy Green Conaway, MD]

An angiogram is an invasive procedure, but will tell you if you have coronary disease or not. It does not mean, however, that if you have coronary disease that it is the culprit of how you are feeling. It seems a little strange to me that 15 minutes into cardio your heart rate was only 120 (either very light cardio or you are in excellent condition); I think I would consider a second noninvasive study, such as a myocardial perfusion test ("nuclear stress test"); would also consider a 24 hour Holter monitor to looks for abnormal heart rhythm. If those are negative, you may not warrant proceeding to angiogram; if you are a more aggressive person by nature and you are willing to accept higher risk, then an angiogram may be appropriate but I would discuss the risk to benefit ratio with a cardiologist. Hope this was helpful!

[jabeckwith]

I had an episode about a year ago that sounds exactly like what you experienced and then once again last week. The time a year ago I ended up taking myself to the emergency room because the pain and pressure in my chest had become so bad that I could barely breathe. All my tests came back normal and the Dr. gave me a dose of Atavan which helped me calm down a bit and my chest relax. I was able to leave after a few hours with only a mildly sore chest. My wife seemed to think I might have suffered a panic attack because the symtoms are really similar, and I responded to the Atavan. I always thought you needed to be a really stressful person to get panic attacks, but they can happen to you with no warning. When I had the episode last week, I was able to recognize the symptoms and layed down for a while and focused on my breathing. That helped me a bit at work since I didn't want to take any 'downers' at the office. When I came home I took one of my wife's Atavan's and it helped out too.