| | If my heart is fine, why do I have chest pain?
I'm a 54 yr old female who just had a pacemaker implanted a month ago. I had symptomatic bradycardia which showed up after many tests, including an Event Monitor. I also have "extra beats". The pacemaker, I'm told, is working fine. I still have palpitations so my cardiologist put me on Toprol, a beta blocker. Just before they put in the pacemaker, they did an echocardiogram and a stress test. The stress test showed some ischemia so they did an angiogram. This turned out beautifully...no blockage whatsoever. So they went ahead and put in the pacemaker. Now my heart rate stays in the 60s rather than the 40s and 30s.
What I do not understand is why I've been to the ER 3 times since then because of chest pain. I've always been told never to ignore chest pain and each time I call my cardiologist, they tell me to go to the ER. I never get a good explanation as to why I still have pain. I (naively) thought that the pacemaker would solve everything so I wasn't expecting any problems at all. The last time was just last Friday night. But the heart enzymes were OK, chest xray was OK, they gave me nitroglycerin which eased the pain but didn't make it go away entirely. And then they called my cardiologist (or rather his partner) who said I could go home with nitro patches and was told to see my own cardiologist on Monday, which I did. The diagnosis the ER doc gave me was angina. He did not specify what kind. He said it is possible to have spasms of the coronary arteries even when they are perfectly clear.
When I saw my own cardiologist, he said that my heart is fine and suggested I see my gastroenterologist for another upper endoscopy. I have had many of those because I've had a history of GERD, ulcers and have even had a Nissen Fundoplication (the surgery for GERD where the sphincter is tightened). None of that ever felt like this current chest pain.
He also wrote me a script for Xanax. I've been under stress (who isn't?). What I don't understand is how stress causes chest pain.
Today soon after I woke up I started feeling the chest pain again. So I put on a new nitro patch, took a Xanax and ... nothing. Still have the pain.
How do I evaluate whether I'm experiencing coronary artery spasms? Is it really safe to just decide to ignore any future chest pain? I'm on a low dose of Toprol...just half a 25 mg tablet per day. My blood pressure is normal or slightly low.
Anyone have any clues as to what is going on here? I don't have any blockage, but are coronary artery spasms dangerous?