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Old 11-04-2006, 05:49 AM   #1
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Chest Pains - how do you know if it's angina?

I was diagnosed with PAC's & PVC's last summer. Since then, I've had chest pains which have gotten more frequent over time.

The pains occur in the same places - breastbone (more achy & prolonged), over left breast, under left breast (more like a stabbing pain occuring every few seconds/minutes). It sometimes goes on & off all day - no matter if I am lying down or walking.

I've had an EKG, Event Monitor, Echo, and Thallium stress. All came back normal (except showing the PAC's/PVC's).

Cardiologist said that I MIGHT be having arterial spasms.

What Im wondering - how is "rest angina" or arterial spasms diagnosed, if one does not happen to have a spasm during a test ?

We talked about trying a beta blocker to help with the palps; I'm open to ANYTHING that will give me some relief. I am sick of feeling like I'm having a heart attack - or wondering what the pain/palps mean - every day of my life.

 
Old 11-04-2006, 05:52 AM   #2
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Re: Chest Pains - how do you know if it's angina?

I know an easy test for you... when you are having these pains..try poking around on your chest or moving different ways or taking really deep breaths. If any of these things increase the pain..even by a little bit..then its not your heart. You cannot duplicate heart pain. Also.. heart pains are rarely "sharp" pains..but not impossiple. Try those tests first and see if you can ease your mind.

 
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Old 11-04-2006, 04:51 PM   #3
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Re: Chest Pains - how do you know if it's angina?

I have the same problem, pain in under the breast, through the breast and above into the shoulder mainly left sided. Have had this for years and have been dxed with Fibromyalgia and costochondritis. At times the pain goes into my arms.

The above poster is right according to what my Dr. told me. My husband had by-pass 3 months ago and gets the sharp shooting pains and the cardio said that is nerve pain not heart,the same with with pushing around your chest, if you find a spot that hurts like crazy when you push on it, it is muscular. I had the quick sharp shooting pains about 2 years ago for 18 hours straight, one after another in the upper chest from shoulder to shoulder.I went to the er, was checked
out for heart but told it was nerve entrapment from either the FM or Costo.

I know how this hurts and it is scarey. Moist heat does help and a board I go on some of the people use vicks to help them, they claim it works. If I use it it makes my allergies drain. Some say to use it on the bottom of your feet if you do not want the smell in your face.

Hugs, Linda
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Fibromyalgia
Myofascal pain syndrome
Costochondritis
Arthritis, cervical and thorastic

 
Old 11-05-2006, 08:45 AM   #4
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Re: Chest Pains - how do you know if it's angina?

Hi & thanks for writing back, you guys

Pressing, moving or breathing does not affect the pain. Actually I was having the pains the other on & off - and I happened to have a cardiologist appointment. He pressed on my breastbone & stuff - and it did not cause pain or recreate anything.

So, I dunno...... I'm totally fine with whatever this is, I'd just like to know WHAT it is so that it can be dealt with, if necessary.

I'm in that trap - the young, thin, healthy looking female. Even though I smoked & drank like a madwoman my whole life & two parents with heart disease..... you think they'd want to just rule out everything if possible.

Anyway, thanks. I'm still wanting to know HOW they diagnose arterial spasms. Maybe I have them. Maybe I don't. But I want to know how the doctor can tell if someone has them.

 
Old 11-06-2006, 05:21 AM   #5
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Re: Chest Pains - how do you know if it's angina?

"Arterial spasms" is a very limited cause of heart pain roughly in the family of unstable angina.

More common is STABLE angina which is caused by exertion. The common way to test is with a stress test with echo, EKG, and nuclear scan. This battery pretty well rules out the heart as a cause of any chest pain (or confirms it . ) If your insurance company will pay for it, have a nuclear stress test.

Simply taking a nitrate piill under the tongue can help diagnose chest pain as anginal...it only stops one kind of pain.

If the pain is positional it is not heart. If it increases with exertion, it probably IS.

You put all the data together and you get a Dx.

 
Old 11-07-2006, 04:52 PM   #6
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Re: Chest Pains - how do you know if it's angina?

Lenin,

"Simply taking a nitrate piill under the tongue can help diagnose chest pain as anginal...it only stops one kind of pain".

Can you clarify what you mean by one kind of pain?

 
Old 11-08-2006, 05:40 AM   #7
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Re: Chest Pains - how do you know if it's angina?

KK,

What I mean by "one kind of pain" is that IF nitrate stops the pain it is NOT chest wall pain but rather coronary pain. It can be used to exclude costochondritis, pinched nerves, rotator cuff, injuries etc.

 
Old 11-08-2006, 08:33 AM   #8
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Re: Chest Pains - how do you know if it's angina?

You may have something there. Before giving a stress test, have a patient take a nitrite tablet. If pain is diminished or gone, recommend an angiogram. That may be the correct protocol for a diagnosis or partial dx in an emergency?

 
Old 11-08-2006, 06:01 PM   #9
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Re: Chest Pains - how do you know if it's angina?

It is my understanding that nitrates will also stop pain caused by esophogial spasm as well so they still can't be used to confirm pain from CAD. At least that's what my cardio told me.

Tony

 
Old 11-09-2006, 03:53 AM   #10
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Re: Chest Pains - how do you know if it's angina?

Quote:
You may have something there. Before giving a stress test, have a patient take a nitrite tablet. If pain is diminished or gone, recommend an angiogram. That may be the correct protocol for a diagnosis or partial dx in an emergency?
They gave me nitrite in the ER and it relieved the pain, however they went on to do a nuclear stress test, which came back negative. My Dr. later had me take the nitrite whenever I had pressure/pain in the chest going into the neck and arm, and it also relieved the pain. They did an angiogram, and it was clear, and the cardiologist also told me it can relieve esophagal pain. He also said it could be microvascular as well. I still have pains, and still don't really know what's causing it, but at least I know my arteries are nice and clear.

 
Old 11-09-2006, 08:33 AM   #11
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Re: Chest Pains - how do you know if it's angina?

Thanks for the information on nitrates. So one can have esophogial spasm (pain) and silent coronary ischemia with no angina or concomitant esphogial distress and angina, thereby, relying on nitrates would be inconclusive and further tests should go forward. I appreciate that information.

Last edited by started04; 11-09-2006 at 09:20 AM.

 
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