Chest pain after perfect nuclear stress!

[marcmega]

Ive had in the last 4 weeks ..4 ekgs 24 holter echo doppler and a nuclear stress test 3 visits to the er and and i have been under a cardio spec care this friday he saw my nuclear stress.....and offically released me from his care...ive been on ativan for the last 2 weeks cause the er doc said i might have anxiety but since yesterday ive had serious chest tightness...my cholesterol by the way is 125 ldl of 52 ...i quick smoking and im 169 lb and 6'2' what could this be the report said the following:the likelyhood of angiographically significant coronart artery disease is low!!

Somebody help me out im freaking out!

[heyguy]

I have had 5 stress tests - 3 nuclear in the past 6 years because of chest pressure I feel.  I get this feeling (like I need to burb - and usually I do and it goes away) when I overexert myself (I am am 65year old male) like biking up hill on a hot day or carrying luggage up steps. As soon as I stop, it goes away. Yet I work out every other day and get my heat rate up to 115 or so for 10 15 minutes without any symptoms. My most recent stress test (which the doctor said was extra long) included a stress echocardiogram . All tests have been normal.   I do have a 50-60% blockage in one artery found by a CT angiagram but 3 cardiologists have told me it is very unlikely to be causing my chest discomfort.  All other arteries are clear and my calcium score is 71.  I am on atenenol and simavastim.

I don't have advise for you but wanted to share my story so you can see you are not alone. In fact, I feel much of the uncertainty you express. It seems we are getting mixed signals.

[erijon]

ed is correct, tests can give false negatives, but keep in mind his case is the exception, not the rule. You will hear about people that had a false negative results more often than an individual who has a negative test and never has another problem, such as myself. These thousands among thousands of individuals with normal test results simply don't have any need to post so you don't hear from them. A normal nuclear stress test has a negative prognostic value of .062% risk of a cardiac event per year for the 10 years following the test. That's a real number published by the AHA and the Framingham Test group.

Relax, trust your doctors and work on your anxiety issues. If you feel you are having cardiac symptoms, get it checked out, it's not worth taking the chance, but don't let the anxiety rule the quality of your life. I was where you are a few years ago, it took three years, three normal nuclear stress testes, three normal echos, three years of normal blood work, two cardiologist and two family doctors to get me past my issues.

Get some regular exercise and find something to get your health off your mind, you'll do great!

Jon

[ed34]

I think that nobody knows your body better than you do. Let me share with you what I
have experienced with the results of different tests....
Jan 2006 I went to A&E (your equivalent to ER) with very severe chest pains. Suffice it to
say I was on my knees crying with the pains. I told them I had been suffering throat discomfort for a few months and had been getting mild chest pains. ECGs, echoscan,
chest xray and blood tests found nothing linking the symptoms to my heart. I was discharged with anti acid medication for my stomach.
In Feb 2007 I had a heart attack. This time it was correcly diagnosed. ECG still didnt
reflect anything wrong and it was a troponin blood test that found the problem.
Angiogram was performed and a stent was put in. LAD was found to be totally occluded
and RCA was a real mess, totally occluded in the mid section before acute margin.
Nuclear perfusion scan was performed to see if tissue was damaged. The results astounded everyone, according to the results my heart has no problems at all even
though I was suffering incredible angina.
So, I am not one who is confident in tests.
You can do tests yourself, without all this expensive and complicated equipment. You can FEEL your body and equipment cannot. Relax for about 20 mins in a chair, let go of
all your anxiety. All discomfort should be gone. Your heart should be relaxed and feeling
no problems. Now go for a walk, start slowly, speeding up gradually for a 20 min brisk walk. If discomforts in the chest appear, then you can speed up to see if they worsen. If they do, stand still and see if they disappear within a few seconds. If you feel no discomfort then I would put it down to something else. Try to go for a walk when the air is
coolest because this promotes angina if you are having problems. Do the same walk for a few days, and if you suffered no symptoms, the task should be much simpler.
Let's say for example that you start to get chest pains after 5 mins walking and they disappear within 20 seconds of standing still, your GP will have enough evidence to
insist the hospital do further investigations. If you suffer no discomforts, then forget about
your heart and live your life relaxed. To help you, here are some common angina symptoms....

Mild chest pains. These are not throbbing pains, they are constant. They are a piercing
pain which is like a large 'stitch' that you get sometimes when running.
Other pains.  Other pains can shoot into any arm, through to the back, up to the neck.
Throat discomfort. It feels like bad heartburn but without the acid. Each time you inhale you feel the discomfort even more. Standing still or sitting down makes it go away.
Lower jaw ache. It can affect the lower jaw in many ways, such as making all your lower
teeth hurt. Your jaw may feel stiff and ache, like it wants to seize up. Basically it feels like you have been chewing gum non stop for several days.
Sweating/nausea. This can accompany angina and it is often along with lightheadedness. This is usually caused by a sudden fluctuation in blood pressure.
Eating. Eating food puts extra demand on the heart. This can bring on any angina symptoms in some people, even exhaust them to the point of falling asleep.

I'm not trying to frighten you, I'm simply giving you the truth because I wouldn't want to tell you to forget your problem if it really is a serious one. Try the walking test and please
come back and let us know how it went and how you felt. Most importantly, don't worry
about your heart, there are lots of treatments if you have a problem, including simple medication. Stay chilled because stress WILL damage your heart long term. One step at a time.

[itdood]

I think with all those tests and ER visits cardio is pretty much ruled out.  I used to have panic/anxiety disorder and it sounds to me like that's what's going on with you.  It *****, I remember it well.  Following is one of my favorite quotes from that time in my life

"I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain."
Frank Herbert, Dune

[erijon]

marc,

I don't know what anyone else can say to you. Your tests are all normal, you have been checked out by a cardiologist who says you're fine, yet by reading all your posts you still seem to think they're wrong and you have heart disease, you just don't. The possibility of something being wrong is EXTREMELY low given your results. Everything you describe sounds like anxiety and it's going to ruin the quality of your life if you don't let it go. It is NOT a good idea to do continued tests, the more tests you run at this point, the more invasive they become and the greater the risk. Plus, you risk false positives which will lead to tests and treatments you don't seem to need.

You sound like you're fine, so you need to address your anxiety issues. Chest pain always needs to be checked out, but anxiety can bring on chest pain as well so try to relax. I just don't know what else anyone can say to reassure you. Talk to your doctor about dealing with the anxiety and try to stop out guessing their judgement, they do know more about these things than you do.

Good luck,

Jon