I'm being investigated for probable angina. Usually it is exercise-related, but yesterday I was under a lot of stress at work and I had the same heaviness, radiating slightly to my jaw, but lasting for about half an hour, when I used GTN and it eased temporarily. My BP was 157/100 at the time.

My GP said I should be concerned if it lasts over 10 minutes, but the stress was on-going. Do I need to worry?

Hello Asc,
If you don't take it already - I would start today taking an aspirin a day (150mg, or better still 75mg twice a day) until you get to see a specialist and get a proper diagnosis and blood work - it can't harm you - so take it even if you don't need it.
Any chest pain that is possibly angina needs immediate investigation - you must have some history here because you had GTN handy and used it. What you had seems like angina and if so it should have been diagnosed before it ever came to you using nitrate.
I'm not sure what the GP meant about being concerned if the pain persisted over 10 minutes. I would be VERY concerned. The sort of pain you describe means the heart is not coping well.
Here in Australia the specialists don't seem to mess around - they take a look at you, ask if you ever smoked or have any family history and often it's straight into an angiogram. (You could get a CT scan - it's non-invasive, or less invasive, but the x-ray dose is about the same and the resolution of your heart's fine blood vessels is not as good.)
So I would be looking for a good cardiologist that specialises in angios. And remember you might be asked about possible stents during the angio.
There's also slow release nitrate that might be worthwhile - until you get a full diagnosis and know exactly what the problem is.
Btw your BP seems high - you need medication for that unless you can get it down by cutting salt or light exercise - deep breathing exercises can help too.
Good luck, beefsteak.

I have had every test done besides a cath and they all show my heart is fine. I do notice that when im under alot of stress my left arm starts bothering me and my left jaw. This usually last a few hours or can linger for a day or so. I dont know if its the stress causing it or what but i never get chest pain with it. I ask my doctor but they seem to think its not related to angina.

I'm waiting for an appointment with a cardiologist (NHS) and my GP expects him to arrange an angiogram. A nuclear scan in the spring didn't show anything significant - I went for a period of about 9 months symptom-free but they came back about 6-7 weeks ago and I had one really bad episode. One GP says it can't be angina because of the test, the other is pretty sure it is in spite of it! All I know is that central chest pressure on exertion or stress, radiating to the neck and jaw and easing with GTN or rest sounds very like it and is very unpleasant. Over the last few weeks I've had show chest pain on more than half the days, although apart from the one severe episode which lasted 25 minutes not severe. Nearly all have been exercise-induced, three by stress.

I'm 61, female, a non-smoker, blood sugar slightly raised but not diabetic, on treatment for hypertension and raised cholesterol and with an almost 100% incidence of coronary artery disease on Dad's side, so I've always known I was likely to get it. An echo showed slight left ventricular hypertrophy from the hypertension. I'm on lisinopril, diltiazem, aspirin and simvastatin. I try to eat healthily and am increasing my exercise.

Although I suffer from long-term dysthymia/depression I would not say I am an unduly anxious person. However, that one attack when I ran for a bus was REALLY scary.

This morning I had it very mildly on exertion.

You definetly need that angiogram. I passed all my test for 7 years until I finally failed one and had an angiogram. I always questioned rather it was my heart or not until I felt the pain during stress....then I knew for sure something was wrong. Best wishes....Treze

jaguar63122---what kind of testing did u have done that you kept passing? What were your symptoms and how long did they last? I do feel pain during stress but not chest pain, the doctors all say its not related.

Confused....Real quick history I am 38 year old female started having chest pain/pressure when I was 31. Got the usual I am too young for heart problems.....yada yada yada. I'm not overweight never sick...exercise pretty regularly....heres the kicker...I WAS a smoker though. Over the 7 years I had around 4 stress test, 2 nuclear test, about 5 or 6 holter moniters, 2 eco's, 20 or 30 ekg's , and then finally the test of test...angiogram. I had 2 upper GI's, 2 endoscopes, and 1 Hida scan...looking for digestive problems. My symptoms were chest pain once a month sometimes more sometimes less. Pain lasted usually less than 15 minutes. Was a burning that started under my breasts and radiated up into my neck and shoulders and caused me to burp alot. My pains were only in the mornings right after I got up, and usually would be triggered by me bending over. (the assumption is that I would have a coronary spasms at the site of blockage) Never had pain during exercising. I was mis-diagnosed with acid reflex, GERD, Galbladder Disease, Esophugus spams. All treatments failed over the last 7 years so I just kept returning to Dr. After having my stent, and opening my blockage....I have not had any pain, burping, or anything that feels like heart or gastro pain. This whole time it was my heart! I fell very lucky and privlaged to still be alive. My blockage was in my LAD (the widowmaker) I was scheduled to have my gallbladder removed and promised that it would solve all my issues..thank goodness I did not. I probably would not have made it through the surgery. Please do not pay attention to what the Dr. say....use your gut.....I always knew there was something more wrong than GERD and I kept pushing and pushing. My pain was not overly painfull or anything but it was uncomfortable and different from anything I had ever experienced. I also started having PVC and PAC's about the time I first started having chest pain. I feel it was al related and warning that something was not right. I wish you luck in your journey and hope you can get the correct answers fast than I did....Treze

Treze- Thank you so much for taking the time to tell me your story. I worry everyday that they are wrong and that my problems are my heart. My arm pain can come at anytime, with stress or without i can just be sitting and it can start and last for days, same with the jaw pain. I can go days where neither bother me. I was told by one cardio that they would do an angio but i didnt want to risk it after 3 others telling me it was not necessary. I am worried the procedure might cause harm when in fact i didnt need it at all. How did they finally find your blockage?

Confused....They finally found my blockage because I was suppose to have my gall bladder taken out, and I had never had any kind of surgery and was scared. I really thought it was my heart and not my gallbladder so I told my GP that I wanted to have 1 more test on my heart to prove again to me it wasn't my heart. He laughed and said he'd scedule me for another Nuclear Stress Test because it had been 5 years since my last. Finally when I was working the stress test they stopped the test and gave me nitro. I wasn't in any pain and doing fine on the test, but they seen my heart wasn't getting enough blood to a part of my heart. I was admitted to the hospital that day and an angio done the folowing morning. It was only my persistence that probably saved my life...and there are 1,000's just like me..most who were not as lucky as me. I don't have any heart damage which is a plus because I didn't have a heart atttack. Once you have a heart attack and get some damage in your heart things are alot worse. I am on blood thinners, bloodpressure meds, cholesteral meds, and asprin. This is the standard I am told with CAD. My diet consists of less than 10 grams of fat a day. On the outside I look 100% normal....I feel 100% normal...but in reality I am in a fight for the rest of my life. Statistics are not that good especially starting at age 38..most people get this disease in there 60's. Have you had a Hida scan yet? Since you said your pain can last for a day...that doesn't sound like the usual heart related pain..but it still could be. Like I said before...you have to use your gut feeling. I knew...and I knew from day 1. I just couldn't get anyone else to believe me...and my pains were classic. Just didn't have the test results to go with it and couldn't get anyone to believe that a woman in her 30's could have a heart problem. If you have any other questions feel free to ask me anytime. Treze

Actually, taking an Apsprin a day can harm you. It can cause bleeding internally, yes while this is rare, it is a mis-truth to say that aspirin is 100% safe/

Confused, I am with you!!! My pain can last for hours at a time and sometimes days. I have been told that one thing that is helpful is to take a Zantac to see if it helps and for me, usually the Zantac will help if I catch it early enough.
I have to say that I do get really worried sometimes, especially when my pain is bad, but the anxiety then kicks in and I am worse yet... My jaw hurts on both sides and it sometimes burns in my sinus area, the jaw joint and behind my ears.
Have you tried the Zantac or some other remedy of that nature to see if it will help you?
Take Care, I hope you find an answer..
Crazy

Crazy-I havent tried zantac....along with being a hypochondriac i also suffer from being scared of pretty much every medicine besides tylenol. I am always scared im going to suffer side effects from the medicine that make me feel worse than i already do.

Treze-Thanks so much for telling me your story. Im so glad they found the problem before your surgery. You knew something was not right and didnt give up till they found it, that is great!!! Everytime ive had a stress test done i expect them to pull me off and the same thing happen but so far both nuclear ones have been fine along with the 2 regular ones ive had. They say i suffer from this obsession because of my fathers history of heart issues. I say what if i suffer this cause of my fathers issues because its been passed down to me.

Confussed....With you family history the best thing you can do is exercise and keep your total fat percentage to 10% a day. That is very low, but I am reading a book that says if you keep your fat intake to this level that you can almost avoid CAR and most cancers. I know its just a book...but if you are scared of your future the best thing you can do now is live as healthy as possible. Best of Luck....Treze