A couple of questions

[ChicagoDude617]

I'm 21 years old, 135 pounds and I don't smoke. No known family history of heart disease either.

I've had chest pains while running since senior year of high school. It would be a dull/pressure/achy pain in my mid chest that would go away when I stopped. I've had a resting echo, and MRI and a CT scan and they all came back normal. However, I've had 3 stress echo tests [one at 17, one at 19 and one at 21] and all 3 of them showed changes on the ecg which they said indicates lack of blood flow to my heart. But the echo portion came back normal... but the doctors said they weren't able to get clear pictures because I have a chest deformity. They still called it normal though.

If I'm having chest pain while running, and I have ECG changes, how can this be considered normal?

Also, if someone were to have heart related chest pains while exercising... would the chest pain be brought on my any type of exercise [biking, running, weight lifting, etc] or can it only show up during certain exercises?

[ChicagoDude617]

thanks for your reply!

I didn't receive the MRI as part of a stress test. It was separate and done after the stress echo. Also, I did get checked out by a pulmonologist and he ruled out the lungs being the cause for my chest pain.

The cardiologist I saw at Mayo Clinic in Rochester said it didn't sound like it's muscle/bone related because the pain came on while I was running and went away within two minutes of stopping.

I guess I was just freaked out because of the pain and weird ECG findings. I forgot to mention in my initial post, but my EP found an episode of NSVT [about 3-4 seconds long] while I was asleep on an event monitor 2 years ago. So all of that just gets me nervous when I exercise.

[CCFHeartMD20]

Hi ChicagoDude617,

It's always difficult to answer these questions via the internet, particularly without seeing your imaging tests myself.  That being said, i'll give you some thoughts.

The EKG on a stress test is a relatively crude way of identifying any heart abnormalities.  Usually, if we see a problem in a young person such as yourself, we follow it up with a CT scan to see if there are any abnormalities.  If anything suspicious is revealed in terms of the arteries feeding the hear, then we usually proceed with a heart catheterization to take a better look.  That seems to have checked out in you.  The MRI is used to identify a variety of other abnormalities (some of which you can be born with).  Depending on what type of MRI they did, it can also be a stress test.  The MRI is often much better than an echo, so if it's a cardiac MRI you received, that should give them better pictures than an ECHO.  

It seems like they have done all the right tests.  You could always request all the CDs for all your testing and get a second opinion just so there are fresh eyes looking at your case.  Sometimes larger medical centers will pick up rarer findings that are not commonly seen.  That being said, you have to remember there are other things that may cause chest pain such as your lungs.  You could consider getting evaluated for asthma.  

It shouldn't matter what type of exercise you are doing if it is the same intensity level and gets your heart rate to the same level.

Hope this helps!
CCFHeartMD20