chest pain

[tiler]

I am 33 and started getting chest pain 10 days ago. I went to hospital for an ecg which was fine but it showed irrugal rythem. Anyway my sitting heart rate seems to vary from low 50 to 90 and gos up and down without me moving. I am concerned these chest pains are related as I only get them when sitting.   Its strange but at 3pm I had an average heart rate of 90 for 30mins sitting doing nothing. Yet at 930pm I took a fast walk for half an hour and my heart rate started at 65 and finished at 86 averaging 92. So should I b concerend that my sitting and walking heart rate is the same?   I must point out that I am exteremly fit and half worked out with cardio all my life so a resting heart rate of 90 seems high

[MichelleP_3811]

Did you ask the doctor what type of normal arrhythmia it was?  It might be helpful to at least know that.  I am not a doctor myself but the things that come to mind are sinus arrhythmia or ectopics (pacs or pvcs).  Both of these conditions are considered normal by most though they do produce some symptoms.  Well the ectopics do at least.  Sinus arrhythmia is a change in ones heart rate between inhaling and exhaling.  Everyone has changes but I believe it is deemed an arrhythmia when the rate is exaggerated.  I had a holter which diagnosed frequent sinus arrhythmia where my rate at times can be 90 and then drop to 60 up and down during inhalation and exhalation.  It is generally when I am in this type of rhythm that I get pvcs.  It is likely the sudden drop in rate causes my ventricles to react and drop a beat of its own even though the a beat was going to show up.  When I have a number of ectopics close or have an extended amount I can get chest pain.  Sometimes the chest pain is short lived other times it can last all day but it is generally gone by morning.  Is your chest pain persistent or is it gone in the morning only to come back later in the day? Is it all over pain or does it feel localized?  Do you notice if you start to stress out a bit when you start to feel anything odd with the heart?  It is possible if your rate is slowing more due to your good conditioning the slow rate may be making your heart ache a bit.  But the general rule that I have read is chest pain that is transient isn't anything to be too concerned about but if it is persistent and extremely painful it should be tended to.  That said, your ekg was clean. This likely means you did not have a heart attack.  They can see that on an ekg.  This is good news but I am not certain it rules out all heart issues like congestive heart failure or some other sort of cardiac issue or inflammation due to a virus or something.  I guess if I were you and the pain persisted I might ask if you can at least have an echo done to make sure your heart is structurally good.  If your ekg and echo come back normal then what is going on is most likely benign but you will definitely want to keep on top of the chest pain and get it fully evaluated.  I assume they gave you the antacids to try and rule out acid reflux or stomach issues as the cause of your chest pain.  Since they are not working go back to your doctor and ask if you can have the echo.  If they are resistant then maybe find a new doctor who will take your concerns seriously.  Until this is worked out though try and take your exercise a bit slower.  I know when I push myself too hard is when I generally get the more pronounced sinus arrhythmia which causes all the other troubles to flare up as well.  And also try to make sure you manage any stress you might be having over this if you are indeed having any.  Stressing about what is going on may be making things worse.  This way you will know that your symptoms are real symptoms and not simply a reaction to stress.   The thing to keep in mind is your heart is a very resilient muscle.  It can take a lot and act all weird and still function quite well and it has an amazing ability to heal itself or work around any issues so have faith you will get through this and continue to live a long and prosperous life.  Take care and keep us posted on how you are doing.  

[tiler]

Yes I used a heart monitor to check my heart rate. And yes I said my ecg was fine but it had irrgeular rhythem, the ea doctor said this was normall. I've spoke to my gp who give me anti acids which haven't helped and she said she can't refer me for to a cardiologist or anyone else as the ecg is fine. So I still have the pain and don't know what to do

[Bromley]

Hi. The most important thing may be that you have chest pain.  It is very important that you have a medical doctor look at you and diagnose why you have this pain --- it is not acceptable to have undiagnosed chest pain.  Your doctor will want to account for the ecg readings when he or she makes a diagnosis, so be sure to give them your ecg information.

Also, I am not sure I understand your statement that the ecg was fine, but that it showed an irregular rhythm.  Did I read this correctly?

Chances are, with your age, you have nothing to worry about.  But you need to see a doctor, and to get a diagnosis from them,  if you are having chest pain.

[RICHARD566]

How are you measuring your heart rate?  Do you have a monitor?

If it were me,  I would start a log and keep track of these higher resting pulse rates and pain.

I would also make an appointment with a cardiologist.  

What is your blood pressure?  Is it usually normal?

I do not think your resting heart rate should vary that much.

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