Confused/concerned about Chest Pain

[Scagnetti_2005]

Greetings,

35 y/o male with a family history of heart disease. I went in to see a cardiologist to baseline my results and finally be pro-active about my heart health.

EKG was normal, nuclear stress test was "slightly abnormal, could be attenuation". Cardiologist advised that I eat right, lose weight, exercise and we reschedule a follow up stress test one year later. He also put me on Zocor and a daily aspirin.

A week after this visit, I started experiencing chest pain and I'm not if I should visit a doctor or not. Initially, I would describe the pain as a 1-2 second jolt-like stabbing pain to the left side of my chest. I would experience this for 1-2 seconds, every 20 minutes or so. After a full day, the jolting pain on my left side went away, but now I feel a similar 1-2 second jolt, only this time it's on my right side, on my throat, just under my jaw. This pain does NOT radiate from my heart, it is confined to my jaw alone. Now entering my third day, I still feel a very slight, occassional, brief discomfort in my chest and the jaw-jolt I just described.

I've looked up and down on many websites and I do NOT have any other symptoms: crushing pain, pressure, tightness, lightheadedness, sweating, no issues with breathing or coughing, etc.

Chest wall pain or a respiratory issue could be the cause, but reading the symptoms of those conditions makes me think it isn't likely.

Would you recommend seeing a doctor or waiting it out?

[Emmaj]

Oops! Lisa, check out the post by Mighty Lovely Man on 2/15. I'mailheart (a few comments down) posted this article he found online... it is long (and kinda longwinded), but it does mention pain with palpitations! Maybe you would find it interesting (Sorry, I spoke to soon!)

[Emmaj]

First, Scagnetti, I think people would have responded to your post if they felt they had some suggestions or comments for you! The symptoms you mentioned are atypical if they have any relation to ht heart disease, so I think everybody (at least I was) waiting for the dr to respond... and I think it was a good response.

Lisa, did you ever have pericarditis ruled out? Reason I ask is the pain of pericarditis can be sharp and it might account for the positive ana titer. I don't associate pvcs with pain at all -- they are really just irregular heart beats. I haven't heard of other people finding them physically painful either...

Hope you are okay, both--

[tickertock]

nearly all threads are hijacked, be glad that you got to post a question to the doctor, most don't have that luck. some persons never appreciate anything, the are usually selfish angry individuals with a chip on their shoulders, i personally think your comment to lak was uncalled for, maybe your attitude might explain some of your symptoms.

try and be a little more considerate to others and look up TMJ when you get a chance.

[wizkid]

I think that you should see a doctor again.  Your pain symptoms, particularly the severe pain in  your back, worries me. Spend time reviewing your symptoms before you see your cardio, and be sure to describe all of them...

Also, I would either verify the qualifications of your present cardiologist, or seek a qualified cardiologist to assess you.  When I say "qualified" cardiologist, I think you should have particulars, beyond medical certification, to look for. Since you cant always tolerate mistakes.

Good luck.

[desi000]

Hi Everyone.  HELP! I have been trying to post a question to the dr. and can't ever seem to get through!!  I am 34 yr old female, 5'8 128lbs, wk out 3 x's a week. I have 2 children 2, and 9 months old.  In Oct. my OB noticed a skipped beat while listening to my heart 5 months after my baby was born. I had occassional awareness of my heartbeat, but no other symptoms during pregnancy except what I think was sciatia? (Severe pain shooting down my leg from my lower back.)  I also had headaches in my last month.  I saw a cardiologist the first week of Jan. who did a stress echo (deemed "normal") an EKG (normal).  A 24 hour holter revealed 4 episodes of what he said was PAT or SVT (each lasting about a minute in the 130-140 range) and about 600 PACs.  He told me to take Toproxl 25mg "as needed" for palpitations and said this was merely a nuisance. I saw another cardiologist for a second opinion who said my holter report showed sinus tach not SVT and agreed with the Toproxl as needed/ "nuisance only" diagnosis.  The Toproxl does not seem to help with the palpitaions and I still feel fluttering in my chest and an occassional hard thump now and then, sometimes 10 or so times a day.  I also have had 2 episodes in the past month where my heart has pounded for about 4 or 5 beats, then calms down.  I have also developed a shooting pain in my left arm, originating in my middle arm and radiating down into my hand.  It comes and goes -- at rest, activity, etc. No real pattern.  I also have severe pain in the middle of my upper back.  I really do not want to go to the doctor AGAIN after 2 doctors have said my heart is fine, but I don't want to ignore serious symptoms either.  Is it possible something was missed on the echo and I do have heart blockage?  How likely or unlikely is it that this arm pain is angina?  SHould I take another type of medication to control the sinus tach/palpitations?  Is it possible that my heart palps are being caused by damage to my back or nerves sustained during pregnancy?  I don't know what the heck could have started this!  I gave up caffeine 2 months ago, no alcohol anymore, my bloodwork was all "fine", I even started back on a multiviatimin to seem if that helps. I have never had panic attacks or depression before, but this is causing me a great deal of anxiety.  Anyone who has useful comments for me would be greatly appreciated. Thanks! Desi

[Scagnetti_2005]

Lisa,

I really don't appreciate you hijacking my thread. If you have a question you can post a question like everyone else.

[lak]

Thanks for both of your responses.  I am really having a bad day today.  Stabbing pains in the middle of my chest this morning... I actually got the phone and laid it beside me while I was getting ready for work.  I have been slightly dizzy all morning and a little clamy.  I hate to go to the ER I know its the PVCS. Are yours sharp, usually mine are not. Scarey !!!

[mindyrk]

Your scan sounds pretty normal.  an EF from about 50-85% is usually normal. Breast attenuation  just means that a defect on the scan was seen, but they believe it to be from your breast and not from an actual area of ischemia on the scan.  Usually you only need to worry if the area of the defect was worse on the stress scan than it is on the rest scan, which yours was not.  I know pvc's can be scarey.  I have them every day also.  You would be amazed at how many people have them. I see people ever day that have them, most of them never even know it.  I also see people that have left bundle branch block all the time.  If your scan was normal try not to worry yourself to much.  Be sure to talk to your doctor about the chest pain and see if you can't find the cause for it.  Maybe an event monitor would help to find out if the pvc's are the cause or if it may even be something non cardiac. (just remember, the advice on here, besides the doctor of course, is just guesses and you need to talk to your doctor about all of it. He is the one who knows you best). Good luck, I wish you the best.

[CCF-M.D.-MJM]

Hi Scagnetti,

Sorry this is a day late.  I have the flu.

Your symptoms do not sound cardiac.  However, I do not feel comfortable advising you not to see a doctor without doing a history, physical, and seeing an EKG.  He probably don't need to see a cardiologist, your internist would do fine.

I hope this helps.

[michi]

hi,

a weak positive ANA titer does not have to mean anything! If you had mono your ANA is positive you may have a slight higher chance to get illneses like lupus etc. but all the other factors have to be right to get ill. don't think too much about it. retest your ANA in a few weeks maybe its even false positive. If you feel fine besides your palpitation don't think about it.
thats what my rheumatologist told me.

good luck

[lak]

Could someone explain to me what a weak positive ANA means.  My cardiologists sent me to am arthritis center.  I do not think she has connective tissue diease at the present time with a weak positive ANA TITER.  There is no evidentce of connective tissue diseae to explain her cardiomayopathy.  I did not even know that I had cadiomyopathy.  Which from what I had read it is a weaking of the heart muscle. Is that right?

I just got to reading my results from Myocardial Perfusuion Study and it says my ejection fraction is 54%, left ventricular chamber is of normal size.  There is a fixed defect overlying the anteroseptal wall on both stress and rest imaging. This is thought to be related to breast attenuation artifact since this wall does thicken and move appropriately.  Convincing evidence of reversible ischemia is not identified.

I have thousands of pvcs daily, high blood pressure, left bundle branch block.  I have developed now a constant ringing in my ears.  I have recently developed a loud ringing in my ears.  Has anyone experienced that with Heart disease.

I am not even sure if I have heart disease the way the doctor's talk around issues and say pvcs and trigemy, bigemy and sinus tachycardia is nothing to worry about.

Should I call and see cardio every year or something or not?

Any comments would be greatly appreciated on any of the above topics.

Thanks
Lisa

[Emmaj]

Hi Lisa,

Maybe you could post to the doc? I really feel like I am venturing into foreign territory, and I apologize in advance for anything misleading or erroneous ... but here goes! ANA is anti-nuclear antibody, and having that antibody might indicate that you are having an autoimmune response... in your case, mild and evidently not a cause of your cardiomyopathy ... The "defect" mentioned is evidently just an artifact, that is, not significant. For example if a metal ring shows up in an x-ray of your hand, it is just an artifact, not significant at all to a health problem. Your ef is great! The ringing in your ears ... that can be caused by a lot of things. I don't know about heart disease being a cause... but maybe? you could do a search for the American Tinnitus Association. They provide a lot of information and ways to cope with it. Sometimes head trauma, medication... it is very common among people with hearing loss... but people without hl get it too. I too had 1000s of pvcs on a 24 hr holter... you have some arrhythmia, for sure, and that could hopefully be controlled by a beta blocker. Last I was checked, I only had 240 pvcs over a period of days (now a pacemaker keeps track for me), and I take a betablocker, which really helps.