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Advice:
on and off chest pain
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The past 3 weeks ive been having on and off chest pain. I went to dr and had an exercise stress test the results were normal. I also had a chest xray. I have a slightly underactive thyroid and take no medication for it. I have high cholestrol and am 10 kgs over weight Im also big busted . I have a stressful job and busy lifestyle . I walk every nite for 30 mins and eat quite healthy. I have no support at home and even even the dr says its stress and not sure what else to do. i have a history of heart disease my father had 20 years of heart failure and my brother has died of a stroke at 30.Can I have some advice if this pain is heart related or am I a hypochondriac

ta
Posted on 10/07/09, 05:39 am
14 Replies | Most Recent Add Your Advice
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Reply #1 - 10/09/09  4:29pm
" Sometimes it's hard to tell if it is heart or lung or muscles or joints, etc. Even my doctors aren't always sure. Does the pain get worse with exertion? Can you touch a spot on your chest and cause the pain? Does it radiate to another place? After all the other pain, I was getting pain across my breast bone and the doctor told me it was inflammation of the cartilege in that area. Stress can do a lot of things. Stress is at the root of my heart condition. "
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Reply #2 - 10/10/09  5:55am
" It sometimes is sore on the side of my left breast and back shoulder blades. Im starting to think it is muscular and stress. I think stress is a big part of it too. its amazing how it can effect our bodies "
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Reply #3 - 11/02/09  12:03am
" Prior to my first heart attack, I had symptoms but the tests showed that I had a healthy heart. It wasn't until they did an angiogram (angioplasty) that they were able to see the heart's arteries in real time. Insist on it. I had to insist the second time. "
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Reply #4 - 07/02/10  9:21am
" I bet you could write a book on your chest pains?

I too experience chest pains going on several years. I have had two angiograms....1 stint. And still have chest pains....

Yes I been there and told it's stress, or It Gerd, or it's cartilege, that is the biggest thing cartilege!!!!! Or muscles?

Yes I have blood work up and everything normal....been told even after the stint and before that my heart is normal.
Even after a CT SCAN and it show my heart enlarge they still say it's NORMAL?

I wonder some times why they say what they say.....I don't get answers that help me.

I gone to the ER so many times it is hard now for ME to keep going. I think they have a bed with my name on it.
I even had a nurse that sometimes is on duty when I have gone to the hospital......that tells me "Oh not YOU again"!!!!!!
so when I ask should I really go to the hospital I have doughts now.
I hope you understand THIS IS ME ONLY ME. NOT YOU!!!!!!!!!!!

This last time I went and I did go to the hsopital that they found one signal I call it that I had a heart attact!!!!

So always go to the ER!!!! "
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Reply #5 - 07/03/10  10:24pm
" This seems to be a pretty common thing...chest pain we can't decipher as "heart related" or not. The media, and the American Heart Association must not use the services of the general ER in their neighborhood, or they would know, even when we have had legitimate cardiac issues, have risk factors out the whazoo...no one really wants to believe it is heart related (including us), unless some fancy new blood test, or some EKG, or stress test...or on and on and on, proves it to be our heart.

It is too easy to blame stress, too convenient that the same nerves operate the esophagus AND cardiac tissue, and too sad no one understands how much frustration plays a role in stress!! I have a similar situation and posted about it here a few days ago. I have now been diagnosed as a Type-II Diabetic and...that adds one more risk factor to my list. Still, it seems to me that no one really takes my concerns seriously...so, I asked the question.

I waled into my physician's office, told him what I was feeling about how my cardiologist reacted to my questions...and I said, "Did I misunderstand my risk factors? Do the two stents I had place two years apart indicate I am no longer at risk? Have all the doctors I have been seeing for the past few years been intentionally misleading me to think that I might have heart disease, when in reality, I don't?" Oh, then I added, "Because, if I am not likely to die of heart disease, and I have overreacted to the information I was given, can someone with "M.D." behind their name put that in writing in my record, and give me a copy...you know, so I can convince my insurance company I am not such a sucky risk for life insurance? Oh, and so all the concerns my husband has for me can be 'laid to rest'...no pun...hehehe". You can imagine none of them is willing to document that I am clear of any impending doom associated with my cardiac risk, yet still the dreaded "a" word...or "s" word is raised (anxiety or stress).

I do not deny being stressed. Part of that could be reduced simply by knowing when they want me to complain and come to the ER, and when they want me to stay home and leave them alone. I didn't have a heart attack...never had cardiac enzymes out of limits. I never failed a stress test, in fact one wek prior to having the 95% blockage in my "widow-maker" LAD stented, I helped my husband pull an 80 pound hog out of the creek, as I had just killed it while hunting. I walked about 3/4 of a mile with that hog hoisted on one shoulder, my husband carrying one half...and still, no heart attack. Phooey on stress tests! It simply did not indicate that I could have died from a heart attack when I was able to perform all that activity with the only symptom being shortness of breath and a couple epidodes of cold sweating. I am as perplexed as can be.

I have a feeling I will die perplexed, and my cardiologist will be shaking his head and saying...."why didn't she complain?....why didn't she come in?" DUH! Because you made me feel like I was making it all up when I tried to tell you in the first place! I guess we can't really win this one, huh? "
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Reply #6 - 07/03/10  10:28pm
" Ummm, sorry. Tirade (vent) over. The one thing I do know about chest pain that must be reported is....when it is changing chest pain...and, when the pain comes without exertion. I had thought that the non-exertional chest pain was of no consequence, but, turns out...they want to hear about that. I thought they'd say it was stress since there was no physical stress on the heart. I have that every now and again, and have broken out in a sweat three times now. But, I am unsure if I should mention it because of the issue of my cardiologist mentioning I might be stressed over having a heart condition...(you think?)! "
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Reply #7 - 07/04/10  2:34pm
" I have had on and off chest pains, tightness/pressure, my heart rate slows down and skips a beat then returns to somewhat normal, it can race high as a kite and slow down to less than 40 beats a minute..... I've had doctors tell me it's my imagination, stress, anxiety, I have a heart murmur they can't figure out, I had an enlarged left atrium that finally has decreased in size but I still have the other issues. One doc told me that they have no idea why my left atrium enlarged but they are keeping an eye on it as well as getting chest xrays done every year because I get lesions on my lungs that are from pneumonia and my asthma meds. My chest pains come and go.... sometimes last a few minutes, sometimes a few hours but my ekg's always come out normal. This year they told me that it might be time to do a stress test and cardio cath to double check some things because of the fact even when I do go out and walk 2-3 miles or do 20-30 minutes of a good workout my blood pressure doesn't increase much, my feet and hands are always cold.... so something is definately going on... but being a dependent of the military it's a hurry up and wait thing. You have to pressure the doc to get something done, don't take the lets wait and see what the tests show......

My chest pain is under the breast and goes from the left to right and into my shoulder blade........ and I can say for a fact that it happens when i'm sleeping, when i am laying down to relax, when I meditate, when I walk, when I drive.. whenever it wants to regardless of situation or surroundings. Pay attention to what you feel, notate it, and be persistent! "
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Reply #8 - 07/04/10  6:09pm
" Hiya all you good souls deserving of fair play and a good second chance at this wonderful life we have been given. A question presented. When is it and when is it not Heart Related. Well if we look at extremes and then temper with actual sensed evidence we should get to the bottom of the anomaly.

OK Extreme!

a) Well you have unbearable chest pain and you are here to pen about it.
b) Well you had unbearable chest pain and you are not here to talk about it.. Passed away. Interred. Gone to meet our maker and attain all the answers of the universe.
c) No symptoms and suffer a major heart attack. Wow can that be? Absolutley.

We air our concerns to the medical society only to be bombarded with a slew of maybes. This whole worry, of not knowing, adds to stress and is actually contributing and culminating into full Cardiac Arrest. Now those who know me, already know that I am a huge proponent of Root Cause Identification. The medical community would like you to believe they are also.

A Scenario:

We are 30-50+ years old and have lived a pretty active life We attempt to continue to go at the folly pace of our youth and slowly wind down into a smoking, overweight, beer guzzling, stressed out, sedentary time bomb. Barring any trauma we start to become symptomatic with classic angina pectoris. We seek help first from a PCP who may attempt to intervene with some lipid controlling, choleserol reducing medications, all the while covering his ass with a referral to a Cardiologist.

Blood and urine samples are taken and an ECG snapshot is secured. CBC and WBC blood indicators reveal very high LDL, very low HDL and lip(a) triglycerides far outside the Bell Curve (the norm). Glucose is evidently high and BP and BPM are dangerously high. The cardio orders a stress echo and examines the results which by all conjecture, appear normal. Normal as defined as no immediate danger. We go home and suffer a major heart attack and are rushed to the ER with massive damage to a large section of heart muscle.

WHY:

1) Because our echo showed no sign of pending cardiac event!
2) Our blood work did not include a cardiac profile which could, present historical data to include present and past cardiac distress up to and including a serious unnoticed cardiac event.
3) Medical Intervention must be predicated with a risk assessment profile indicating immediate distress in lieu of an "If it ain't broke don't fix it" mind set.
3) Labs don't really reveal the presence of GERD or another problem which can mimic cardiac related symptoms. All they know is that the blood-work, that was ordered, shows no signs of distress.
4) We are probably instructed to continue on the cardiac risk reducing medications, medications to neutralize acid or an acid production inhibitor to rule out an indigestion related shadow of the symptoms of Cardiac decline.
5) Our 13 year old daughter comes home from Wed. night bible study and infoms you that she is pregnant.
6) You wake up in the CCU with tubes coming and going from every possible orifice of your body.

What happened and Why did it Happen?

A cause, not necessarily root cause, is the starving of oxygen to the heart muscle causing damage and even death of heart muscle tissue.

Probably most likely, basically, are different antagonists which were not visible to the cardio during the stress echo. Not present because of the change of venue and the elimination of immediate stressors.

So what can be the difference which resulted in a cardiac event. The cholesterol was the same CBC and WBC indicators were normal. Same BP BPM and pain sense threshold was the same.
Well if you look at the already mentioned cause, decreased oxygen to heart muscle causing the angina and eventually heart failure we can also ask what the hell was the difference.

Inflamation to narrow the arteries from a pulmonary environment which does not encourage a healthy exchange of CO and O2?
Inflamation? Absolutely. So we can ask, “what inflammation”. Well if you subscribe to the basic philosophy that all actions are predicated with a cause which validates an effect, the inflammation may not have been present and the correct conditions were not met to induce a heart attack during the stress test. However; the added stress of a 13 YO daughter coming home pregnant effected the necessary environment ripe and ready for a coronary event.

So, also, if you look at the "Fire Triangle". What must be present for a fire to occur? Fuel, oxygen and heat (or an ignition source) Take any one of these elements, and if one of three elements were eliminated, the fire would not have occur. This is not unlike what triggers a cardiac event.

Additionally we are seeing DS folk who are experiencing and presenting clear anxiety / depression symptoms characteristically supporting a ripe environment for a Cardiac Event. We are sent home with instructions on diet, tobacco use, overindulgence in alcohol and a pat on the butt suggesting we relax and “Take it Easy”. Here lies the paradox. Do we go home following a “We can’t find anything” repose and change any triggers for a future event? Probably we do not. So even if we have a solution minded Cardiologist, an uncooperative patient will do little to support the proactive suggestions that the doctor has recommended.

So ultimately we are part and parcel the first and best defense to thwart off an impending cardiac event. Maybe we are putting to much emphasis on the “Doctor Doctor Fix me” rhetoric and not enough focus on our own contributions to our cardiac demise.
This does, not at all, vindicate cardiology norms for trying to reverse the damage and actually reciprocate the event with increased heart function. I do believe we have tested tough technology to do that. What would qualify us to venture those advances and allow us to undergo the reversal? I don’t know. But I would suspect, bean counters have set up algorithms, which create an environment that does not fair prudent financially for the HMO’s. Cheaper to support the Pharma’s then correct the problem. So finally are we victims of a clandestine practice to allow a “Run to Failure” mentality given the unlikely-hood of us cooperating with a solution oriented intervention by adjusting our lives to support a “Best Practices” approach from our health care providers.

Interesting this is.

Best Regards,
Just Joe "
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Reply #9 - 07/06/10  2:37pm
" Its so wonderful to meet you all. To know I'm not alone.

Yes they call it stress, and the other "A" which I hate that word.

I'm having chest pains...I took one of those pills nitro a long or so ago.

I think it's stress this time. I'm on m oxygen it seems to be ok.
My hate rate been down to 49 up to 51 then down then up to 70 ccording to the oxymeter I have on my finger.
My oxygen was in 79 up in 86 then to 88 then 90 so I know I'm ok/
Can't trust those oxygimeters you know.

Well I am waiting it out hope my left should and back stop hurting soon....and I don't know why I'm having so much trouble breathing I have my oxygen on.

Oh well here I go again. "
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Reply #10 - 07/22/10  1:59am
" I read your letter to us Joe.

I want to say it was very true you hit the ball out of the ball park.

I learn something from what you wrote...and yes I do I'm told ok normal so many times yes I do......go back to bad habits.

thank you for your insite, and knowledge.....gave me lots of food for thought. "

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