chest pain

[jimmyC22]

Hello,
I am a 44 year old male. Never smoked. No allergies. Diagnosed with mitral valve prolapse 20 years ago. Never was an issue, and cardiologist says is still mild with no regurgitaton. Last year, diagnosed with Pre Atrial Complex, which  cardizem has seemingly corrected. But I also get chest pains, not when having palps(and MD says they are not related) directly over the heart(just left of upper sternum). Pains also to lower left rib cage. Been getting these pains for probably two years, but they are becoming sharper, and more frequent. i used to get these pains once a month to once a  week or so. Now I get them most days. Maybe 40 times a day.May have no pain for 2 or 3 days, then starts again. It is like a burning throb, 2 seconds in duration, and then gone.Feels like someone stabbing me with a hot poker from the inside out. A few minutes to a few hours later, i get another . Very rare if I get them consecutively.They may disappear for a week or two, but they come back. I also get left arm pain but not when i am having the chest pains(usually about 2 to 5 minutes after). I have had 2 stress echo's, a Cardiac CT, and numerous ekg's. All were excellent(except for the PAC's). Coronary arteries were in pristine condition.
  No pain upon exertion. Always at rest. Only twice while at sleep(unless i am sleeping thru pain, which is unlikely as i am a light sleeper). I can not reproduce the pain by twisting, turning, contorting, lifting. The pain does not worsen upon deep inspiration. Also, if i go for a run(my doc says it is ok) while having the pains(20 miles a week), they do not get worse. Infact, they sometimes go away. Nor do they cause shortness of breath. The arm pain does not "radiate". It just stabs. If I happen to be taking my pulse, a pain episode does not alter the rhythm.
  My Cardio thinks it may be Gastro or Neuro. But antacids don't stop the pain, nor do muscle relaxers. I am very concerned about Variant, or micro angina. My doc says there is no way I have either, but will send me for angiography with ergo if it will make me feel better.
   Sorry for the long post. I am scared that something is being overlooked or missed. THE ONLY ANXIETY I HAVE IN MY LIFE IS THE ANXIETY CAUSED BY THE PAIN. It causes a terrible disruption in my life, as no matter what I am doing(work, playing with my 7 year old son, listening to music) I stop and immediately wonder if this is the biggie. Doc gave me nitro, but honestly, the pain hits and leaves with in seconds, and it is a crushing burning pain. Even if I were to pop a nitro, I would have no way of knowing if it worked. The pain is gone before I open the bottle.
I am going to a gastro, and a neuro(emg, etc), but it truly feels like deep heart pain. Please cure me LOL, or atleast comment. Thanks.............jimmy

[jimmyC22]

thank you so much. I was kind of hoping it would be costrochondritis, but my pain is mostly to the very left of my left pec(with some pain in the mid sternum). Could this still be the case. Thanks again!!!!!

[erijon]

I understand, went through the same thing for a couple of years, same type of pain. I had all kinds of tests from 2004-2006, everything normal. I remember every time I felt a pain it just led to more doubts and anxiety. My parents had both had recent bypass surgeries, but not until they were in their 80's so not a real risk factor, but it was stressful. Finally after a couple years of normal tests, my cardiologist suggested my family doc have my gallbladder checked. Sure enough, it was diseased. As soon as it came out, the pains were gone for good. Even to this day I can remember the anxiety. I started working out, some to get into shape, but mostly to check my heart under stress. I always figured if I could do an hour on a bike or treadmill at the appropriate heart rate, I must be OK. That was the anxiety talking, I did end up losing over 70 pounds, controlling my BP and cholesterol so it was worth it. It's strange, but the anxiety is what allowed exercise to become a habit.

I wouldn't be too worried about angina, it lasts much longer than just a couple seconds. It could very easily be a gallbladder or even a chronic case of costochondritis.Trust your doctors, but get checked if you have other symptoms.

Hope this helps,

Jon

[jimmyC22]

Thank you for your reassurance. On the days that I have no symptoms, I feel like I will live to 100. Then when the pains start, I worry if I will be there next week for my son and wife. Most of the posts I have read concur with your assessment. And as I have said, I have been assured and reassured many times by the forums. But during the episodes, it all goes out the window.
  Although I have looked up esoph spasm, I thought I read that they present mid sternum. Although I get pains there, most of the time the pain is left lower ribs(though for the last three days it is right where the heart is.

The reason i was worried about variant angina is because it almost always comes while at rest. I truly feel I have all of the signs and symptoms of it, minus the "severe" pain, however, my doc says no way. I guess thats a good thing. Anyway, thanks again! I appreciate your time.

[erijon]

Your pain is not typical for cardiac pain. Pains that only last for seconds and have gone on for a long period of time are almost never heart related. Also, heart pain usually presents with exertion, not with rest.

Seems you have been checked out pretty closely and that lookingg for a gastric or neuro cause next makes sense. Could be an esophageal spasm caused b y reflux as well.

Good luck,

Jon