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Chest Pain/Shortness of Breath over last month

For the last month or so I have had pain in the left side of my chest, directly over my heart. I'd describe it as sharp at times, and persistently dull or just plain 'uncomfortable'. At times I will get shortness of breath with it. It comes at all sorts of times (first thing when I wake up, afternoon, night time, etc). It will sometimes be better when I am sitting, and then get worse when I am standing, though last night it hurt so bad, I was awake until 4am because of the chest pain which was dead center and felt like someone was squeezing my chest up into my throat.

I went out to urgent care two Sundays ago because the shortness of breath was extremely bad with the pain.They did an EKG and blood work and said everything looked good and sent me home with suggestion to follow up with my PCP. I did and he said it looked good too -- related it to esophagus spasm, GERD, and anxiety but said I could get an echo just to be safe (Thats scheduled for tomorrow).

Since then I have been to a Cardiologist and ER (because the pain was very pressure like and in the center of my chest). They each did an EKG (ER did blood work and chest xray) and they said that I may have an enlarged heart, but neither were concerned and left me to my echo appointment.

My question is if the pain gets really intense and the shortness of breath returns should I even bother going back out to the ER/Urgent? cause I really dont have anymore money at this point, and they have seen nothing -- I'd like to think after 2 blood enzyme checks, and 3 EKGs (one done and read by a Cardiologist), and 2 chest Xrays that something would have been found.

I am going to have a Echo (possible stress echo) tomorrow. If that comes back fine, should I be very safe to assume that all this pain is not cardiac related. I am driving my wife crazy with worrying, lol.

I am 22, havent smoked for 3 years and rarely drink. I work at a desk, so not very active at all.
1 Responses
1495448 tn?1326846430
MEDICAL PROFESSIONAL
I'm sorry to hear you're having some difficulty.  Given your age, coronary artery disease is unlikely but still possible.  Conditions such as coronary vasospasm can occur in patients your age and can mimic heart attack symptoms.  If you have had an ECG DURING your pain and it was normal, this diagnosis is less likely.  If you really want to rule out coronary disease you could get a cardiac catheterization with or without ergotamine challenge to induce vasospasm.  You could also consider a CTA of your coronary arteries to rule out coronary disease.  All this being said, if your ECG, labs, and echo are all very normal, I would consider something besides your heart as the source of your discomfort.

Best of luck.
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