Anxious about this chest pain help me please..

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PIPE - 12 Mar 2006 18:47 GMT

I need serious professional help, I have been getting chest pain on and off
for 3-4 yrs started of very mildly like every 8-10 monthes,

for the last yr I have been getting it quite regularily symptoms include
chest pain,headache, pain in my left shoulder blade and something stuck in
my throat when I get symptoms also I get pain running down in my left
forearm. I got chest pain episode about 4th time now within 1 month had to
goto emergency for it, called the ambulance etc.

first chest pain episode occured within a month was milder and now they are
getting more frequent every 2-3 days now after meals while on computer
playing action games(put me in some stress) I stopped eating large meals but
this aint helping much. I am 28 yr old Indian ethnicity currently living in
Australia.

I had stress test done about a yr ago, it came up normal although I had pain
during the excercise and stupid me I didnt tell the doctor about it, so next
time I told my GP about this pain he asked to get holter monitor and it
showed I have ectopics, after this I also had echo done that came as
negative a yr ago same time a yr ago.

ok at the emergency(in hospital) they did standard cardiac enzyme test, ECG,
BP and that all came normal, gave me anginine(nitrate) to relieve the pain
had to give me like 3-4(2 in ambulance) throughout all these episodes I also
have a HEADACHE associated with it.

results of cardiac enzyme were,

My first chest pain episode were CK were in 900~ish and troponin lvl were
normal
2nd episode CK lvl dropped a little
3rd episode dropped a bit more
4th episode dropped more and troponin were normal in all.

after my 4th episode cardiologist finally saw me in emergency department and
asked me to do Stress MIBI, ok I had it done, did stress test with MIBI and
had the pain again after the excersise, radiologist showed me heart under
stress pics and normal I could see narrrowness understress and he also said
oh they are normal since you are athletic type of person, basically he said
your test is negative!

I went to cardiologist and all he had received was the report from
radiologist faxed copy that my stress MIBI is normal, now cardiologist said
you are fine don't take anginine or blood thinners, that concluded the
follow up.

2 days later I got the pain again while playing computer game
again(competetive game) and right now I am writing this I got the pain
running throuhg my left shoulder and throat now.

Help me please my pain is coming often now and I am scared that I might cope
it a big surprise and body is telling me do something.

BTW I do not smoke, I drink every 3-4 weeks thats if, I goto gym about 3-4-
times a week mainly do weight training weigh about 110 kg not now after the
pain episodes I lost 5 kg so now I weigh 105kg. My spouse dont believe me
and she thinks its muscle related since I push heavy weight if it was muscle
related why do I get it while playing a computer game or eating a meal..she
is a nurse btw my dad is a doctor he thinks it might be musclular too like
all the people I talked to.

All I need is someone to understand me the pain is more frequent and without
excersise I dont goto gym now cos I am scared.

All I wanna know why would cardiologist not look at the pictures I had from
the origianal scan(stress MIBI) and believed radiologist report I am not
saying that radiologist is not competent what they are doing but still..it's
someone life that is on the edge.

Suggest me please how do I go about this I can't go private hospitals I got
no money only option I got is goto emergency whenever I am getting this pain
and they just send me back home next day and this pain keep on coming
back(squeezing) and more often( always with headache and now bit of neck
too)

Sorry for the long post, I had to say all that to someone.

Sincerely
Sunny

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ohush@unc.edu - 13 Mar 2006 03:53 GMT

> I need serious professional help, I have been getting chest pain on and off
> for 3-4 yrs started of very mildly like every 8-10 monthes,

snip for brevity

> Suggest me please how do I go about this I can't go private hospitals I got
> no money only option I got is goto emergency whenever I am getting this pain
[quoted text clipped - 3 lines]
>
> Sorry for the long post, I had to say all that to someone.

Some info on noncardiac chest pain:
http://jaapa.com/issues/j20060101/articles/chestpain0106.htm

Since your cardiac studies were all negative, it wouldn't hurt to be
worked up for another source of pain, like GERD for example.
Gastrointestinal pain is a common source for noncardiac pain.

And I know this may sound flippant to you, but it isn't intended to be
so: You might try some simethicone to see if it reduces your symptoms.
Gas can be quite painful and can be exacerbated by stress or exercise
just like cardiac pain, and pain from gas bubbles can sometimes be
"referred pain," which just means you may have pain caused by gas at a
site where it isn't possible to have gas, like in your shoulder blade.
(But not shooting down your left arm -- I have no ideas there if not
musculoskeletal pain or cardiac pain -- maybe neurogenic pain?)
Simethicone is simply a wax that breaks the surface tension of gas
bubbles in your GI tract so you can expell them by the usual means.
It's dirt cheap and comes in softgels or chewable tablets. Wouldn't it
be great if your mysterious, ominous pain were just gas? If that's it,
the simethicone will make you burp and your pain will probably be
improved within 15 to 30 minutes. If it doesn't help, in your shoes I
might visit a GI doc for a workup.

Anyway, if your doc thinks it's musculoskeletal, he's probably right.
Usually this is determined by whether the pain is reproducible with
palpation. That is, can you produce the same pain by pressing on your
chest or moving in a certain way?

And by the way, you're not alone. Only 20% of people who go to the ER
with chest pain are determined to have a cardiac source for their pain.

Good luck,

--Patti

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Pete - 13 Mar 2006 04:34 GMT

> I need serious professional help, I have been getting chest pain on
> and off for 3-4 yrs started of very mildly like every 8-10 monthes,
[quoted text clipped - 64 lines]
> report I am not saying that radiologist is not competent what they
> are doing but still..it's someone life that is on the edge.

You hit it right on the head Sunny...It didn't used to be that way not too
many years ago. Pulmonolgists, and gastros use to look at all the scans
they ordered (back when you would take hard copies of the film back to your
doctor - everything's on disc today, but they can still
make hard copies if need be - but the doctors can look at them off a lan (or
network) at the local hospital, etc). I used to go over the films with my
old pulmo back in the mid 90's all the time.

Now all you get from pulmos and gastros, and even the oncologists, when you
ask them if they could go over the films with you, is "I'm not a
radiologist". And apparently the damn cardiologists are doing the same
thing (per your post). This really pisses me off, and is just one more
thing I don't like about doctors, and what has been happening in the medical
arena in the last 10-15 years. If a damn pulmonologist can't read a chest
catscan as good as a radiologist then he shouldn't be a specialist treating
lung diseases/conditions. And the same applies to the damn gastro and
cardiologist. I'm not saying that they have the extensive training that a
radiologist has in all the areas of the body, but they should damn straight
be able to read the scans in the areas pertaining to their specialty.

I could tell you a story how the radiologist misread my chest CT in 2002,
but it would take too long. And how I tried to get the head of radiology to
show me my enlarged lymph nodes in 2004 (that were unchanged since 2002, but
the radiologist in 2002 said no adenopathy - One of them is as big as a golf
ball - duh!). I met with him, and all he did was discuss the report that he
reconfirmed, but would not take the time to show me the scans on the
monitor - and I told him how the guy in 2002 misread my scan and he had
nothing to say. I asked my pulmonologist, and an oncologist to show me the
enlarged nodes (and even took the disc with me - you can put it on any pc),
and they both told me "they are not radiologists". So I know exactly what
you are saying. It's all about medical insurance, and law suits, and
malpractice insurance, and it is totally chicken sh.t and ludicrous when
your damn specialist can't (or won't) go over a scan with you.

If your father is a doctor, can't he help out, or is he over in India. It
sounds like you have had a good amount of testing done. Maybe it does have
something to do with your weight lifting (did you specifically ask your
cardiologist about that). Best wishes.

Pete

> Suggest me please how do I go about this I can't go private hospitals
> I got no money only option I got is goto emergency whenever I am
[quoted text clipped - 6 lines]
> Sincerely
> Sunny

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