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Old 10-02-2005, 04:39 PM   #1
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Angina? Symptoms

I have been having pain with exercise the last year or so. The pain sometimes feels similar to indigestion (starts in upper stomach) and other times is a burning pain that radiates to my right torso and arm. The pain is automatic if I have a couple of beers before doing anything strenuous. Like today, at the Patriots game, I had a couple beers and I could hardly climb 20 rows of steps to go to the bathroom without severe pain. (for some reason I remember this happening to me when I was much younger as well so if this is caused by CAD, then I have had it for a while. More concerning because it started within the last year is, when I have had no alcohol, the pain is more the indigestion type in the high stomach and comes on with intense exercise. I was a division 1 college athlete and never had any trouble with exertion. I have had two exercise treadmill tests which I passed with no symptoms (of course, I wish I had the symptoms so I would feel better about the good scores). The ETT's were also considered by the md's to be pretty conclusive because each time I got my heart rate to 210 bpm's or so with no symptoms or irregularities. I am a 30 year old male with hiatus hernia, elevated cholestorol 215 total but my HDL is low and my LDL is high, normal BP, 5'8'' 160 lbs (stocky build), both grandfathers died young of heart disease (55-60) but my parents and siblings are fine, I do not and have never smoked and I don't drink more than say 8 beers per week. Should I take my doctors word and not worry about this as they are confident that at my age and limited risk factors that my heart and arteries are fine? Any thoughts on this? Thank you for your help.

 
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Old 10-03-2005, 05:33 PM   #2
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Re: Angina? Symptoms

Although all chest pain should be carefully investigated, it sounds as though your doctors are looking after you OK. You say the pain radiates down your right arm and chest. I am not a doctor,so can only speak from experience, and personal knowledge, but it does not sound like Angina to me. However, you DO need to find out the cause of the pain, and although you may be reassured on the cardiac front, I would not leave it at that.It sounds like you should perhaps revise your diet too, although this is very likely not be be relevant re your present complaints. However,especially with heart disease in your family, you need to look after and preserve your future.
I hope you find out soon what the problem is and have it dealt with soon.Keep us posted.
Regards, Excelsior

 
Old 10-04-2005, 10:12 AM   #3
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Re: Angina? Symptoms

fallon,

I think it's angina.
Youu should have a stress test with a thallium scan to check for sure. A plain vanilla stress test and echogram is not good enough.

The issue is that you are getting the pain with only the exercise but yout DIDN'T get it with a heart rate in excess of 210 BPM...these two situations don't add up.

What do you take for your hiatal hernia? Was it diagnosed endoscopically? Does it cause you GERD pain?

But like I said, angina is my guess.

 
Old 10-04-2005, 10:40 AM   #4
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Re: Angina? Symptoms

I agree that it doesnít add up. I actually take it to mean that if (twice) I can have no pain and no symptoms and no ekg changes etc. at that intense level of exercise, then there is no way I have CAD. However, the fact that it remains undiagnosed worries me. I have had endoscopy and confirmed hiatal hernia, but my gastro said that they donít usually cause any symptoms. I am on nexium for gerd but have absolutely no heartburn ever. The interesting thing is that, the day after my stress test (210 bpmís no problem) I went running and couldnít last 5 minutes without having to slow down because of the pain. The pain is right where the hiatal hernia is (just under Ė vertically- the end of my sternum) at least thatís where it starts and then it feels like bad indigestion all over my upper torso (and usually radiates to the right) until I slow down and then it goes away. I can almost control it. I thought maybe it was the breathing that was aggravating the hernia at first. I would think that, if I had CAD, I would never be able to exercise to the extent I did on the stress tests with no symptoms (even if that is not the typical response). I mean, my CAD would not go away on a certain day and then come back the next. Everything I hear tells me that angina (stable) is fairly predictable and comes on at similar heartrates. I requested thalium, but was told it was not necessary due to my age and risk profile. If had gotten the pain at the stress test and still my heart looked fine to the docs, then I would be satisfied however, that is not the case, but by the same token, I should look at it that the fact that I could go that long and at that intensity without pain most likely lends itself to the fact that my pain is not CAD. The problem that this presents is that after 2 great stress tests, my doctor is reluctant to do anything else. However, I do have great insurance (PPO) by which I can go to any cardiologist I want and state my case, but I really want to trust my doc and not worry about this. Thoughts?

 
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