Angina Pectoris? Syndrome X? Stenosis?

[cold103]

Hi. I'm a 22 year old male.

My heart condition started 6 years ago as a result of an extremely stressful time in my life.

I have breathlessness. I feel squeezing and choking sensations in my chest and I feel pain in my chest. I feel pain with physical activity, extreme cold, emotional stress, and heavy meals.

My cardiologist won't let me have a 2nd stress test because the 1st one turned out OK. The reason that it turned out OK is that he had me taking 25mg of Atenolol per day, which caused me to not feel the pain that I normally would have. He had me start taking Atenolol 3 weeks prior to the test. I wasn't expecting Atenolol to help me as much as it did when the time came for me to have a stress test. As far as I know, it's important for the patient to feel pain on the stress test for a diagnosis to be made. I strongly feel that that wasn't a fair test. It's extremely important that I have another stress test ASAP. I would step down on my Atenolol dosage for it so that I would certainly feel pain.

Atenolol is helping my heart to an extent in every way including: breathlessness, physical activity, and pain

It seems likely that I have Syndrome X or Stenosis. I don't have atherosclerosis. I never feel sudden pain at rest. How can I have another stress test if I my cardiologist won't schedule one for me? How can I possibly diagnose my Angina Pectoris if I can't have another stress test?

I've had 5 or 6 worsenings. The most recent worsening was caused by doing too much physical activity. Hopefully I never have another worsening in my life (because I'm already in severe shape). But if I do have another worsening, are there any tests that I should have done ASAP that would diagnose Unstable Angina? Would an EKG be a good one to have ASAP if I have another worsening? If so; if I call 911, will the ambulance come with an EKG? I've never called for an ambulance, so I don't know.

When a worsening occurs, pain lasts longer and is more intense for the following week or two. But after the week or two has passed, it is still very clear that things are worse than they were before the worsening. Is this Unstable Angina?

I've read that Syndrome X is not life threatening and does not increase your risk of heart attack. Does this mean that people who have Syndrome X don't experience worsenings (hence I don't have Syndrome X)?

It's extremely important to me that what I have is diagnosed ASAP.

I wore a monitor for a week. An irregular heartbeat and premature heartbeats were found.

Ever since my heart condition began, I feel stings in my head whenever there is too much brain activity. It seems that it's most likely due to insufficient blood/oxygen as a result of my heart condition. Stings are usually due to either thinking too hard or spontaneous worry. The more that I overwork the brain, the worse the stinging gets. When the stinging was at its worst; I experienced near-fainting, I was very dizzy, I felt run-down, and I felt tired. But the stinging is reversible by keeping my mind at ease for a longtime.


Does any of the info that I've given rule out anything?

Thanks in advance for any help.

[grendslori]

I'm not sure you are understanding what I am trying to tell you: CAD (atherosclerosis) and Congenital Heart Disease (CHD) are really the ONLY forms of heart disease that cause chest pain in people. You don't have either one.

Stenosis is regarded as being a narrowing of something; Stenosis is found in any of the blood vessels in the heart and elsewhere; if you had that in the heart you would have a form of CAD, or a form of Cardiomyopathy called Hypertrophic Cardiomyopathy; you don't have any of that.

You asked about the Cardiac X Syndrome; (Syndrome X) you obviously don't understand that syndrome because in that syndrome the signs of it require an abnormal Stress Test with a normal angiogram. Your Stress Test was normal which negates the Cardiac X Syndrome as a possibility.

Your pain, you say has never gone away in 6 years. If I take that literally, which is the way I am taking it, the only forms of heart disease that would cause that to happen would be the Hypertrophic Cardiomyopathies and the Restrictive Cardiomyopathies. The walls of the heart become so thick that the blood supply to the walls just isn't there anymore; those patients NEVER stop having some degree of pain.

Having worked in the cardiology field of medicine, having best friends in my life who are cardiologists, and having to deal, and live with, a daughter who was dying as a result of heart disease, everything you are saying in your post basically leads me to believe that you do not have heart disease.

You say that you do not have panic/anxiety attacks and that you know that this is not the problem. Do you not understand that the way you are writing in this post, makes it pretty obvious that this is a real possibility? You are actually focusing on something that isn't there based on the test results that you have had done. As long as I have lived on this earth, with all the work I have done in cardiology, I have never once EVER heard on one person who mentioned, in ANY way, stinging in the brain as a result of their heart disease. Heart disease doesn't cause a problem like that. You should see someone who can help you get this all under control.

[cold103]

Thanks for you reply, Grendslori.

But it's a certainty that I have no panic or anxiety problem whatsoever.

I know I don't have CAD, but that doesn't rule Syndrome X, Stenosis, and Angina Pectoris.

If it was an inflammation or strain, it would have gone away within the 6 years, wouldn't it? What I have hasn't gone away once since it began 6 years ago. I can stretch my arms out without feeling pain. That seems to rule out that it's a surface/muscle type of thing.

No amount of rest makes my heart's sensitivity go away. I'm confident that I have a heart problem of some sort.


I'd type more, but I'm not feeling well.

[grendslori]

yes, it rules out heart disease! What your post tells me is two things mainly: that this problem started when you were 16 and that you really need to get a grip!! The only reason young people have chest pain and some of the other symptoms you are describing (minus the stinging in the brain???) IF they have heart disease is due to congenial forms of heart disease where there is a blood flow issue; a lack of it. These are usually forms of Cardiomyopathies and are life threatening without transplants. These youngsters are extremely ill and if you had these problems, there is no way on God's green earth it could have been missed. The second cause of true heart related chest pain is due to Coronary Heart Disease which doesn't affect a person until the 40s+. It takes approximately 20+ years to build up enough plague in the arteries to cause chest pains due to CAD; you aren't old enough for that kind of a problem. Even taking drugs, during a stress test, that problem would have shown up; so that's why there is no point in repeating the stress test. Unless you have the cardiomyopathies, you would have chest pain at rest; you would have it with activity and that activity would change the look of the EKG so again, if that didn't show up on the stress test, it's not an issue for you. You DO NOT have unstable angina; you do not have the heart problems that cause that problem, plain and simple. Even the brain issue you are writing about is not symptomatic of heart disease. PACs and PVCs are WHY your Holter says you have irregularity and EVERYONE on the planet has those everyday of their lives. God gave the cells the power to become a 'back-up system' for the nomal SA Node and AV Node. They are normal until people begin to panic about them and cause the problems to become worse, and they will due to catecholamines being flushed into the blood system, which will, in turn, increase the number of premature beats. The pain that you are having is probably due to cartilage inflammation or muscle strain; try taking some motrin and seeing if that helps you at all. What is most important here is that you do not waste away the best years of your life thinking you have heart disease! At 22 my daughter was having a heart transplant; at 16 she had no friends left because she was in heart failure and couldn't keep up. Today, she is enjoying the life she never had. You really need to stop worrying yourself into an early grave and if you can't do that, by all means, get help to deal with all of your anxiety and panic. As you get older, you begin to wish for those years in the 20s, time passes way to quickly the older you get!! Take care