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  Kinds/Types of Chest Pains

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Riker1964
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posted 08-28-2003 12:32 PM     Click Here to See the Profile for Riker1964     Edit/Delete Message   Reply w/Quote
When people have heart disease, or problems with their hearts, what kind of pain do they feel? Is it sharp and stabbing, is it a dull ache, it is like a heavy weight on their chest? What is it like?

I ask because the center of my chest and back always ache, like the muscles or bones, not under the breast bones.

Thanx.

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cutup
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posted 08-28-2003 01:00 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
Everyone is going to feel something different. I was lucky enough that I did not have a heart attack, but I did have blockage. Looking back my first chest pains were on the left upper side of my chest. Lasted only seconds and I would describe it as sharp and pressure. This only happened twice and it was months apart, but during this time I was also have occasional periods of shortness of breath. The day before everything came to a head I had discomfort in my shoulder. The next day while cleaning my beauty salon I experienced dull pain in my upper back between the shoulder blades. It made me feel a bit nauseous. Then it moved to the center of my chest. It felt like a weight and made it difficult for me to breathe or talk. It lasted about a minute then stopped. In the meantime I had called my husband and then 911. At the ER the EKG and blood tests were negative for heart attack and I had so few risk factors that they assumed it was my stomach. I was told that if it was my heart the pain would not have stopped. WRONG!!! I took a treadmill stress test and had a nuclear scan which showed nothing. For some reason that day I was able to run on the treadmill with no pain or shortness of breath. A couple of weeks later I was walking to my neighbors house and had to go up and down some hills. On the way back I had the pressure in the center of my chest and felt short of breath again, but not as severe as the first episode. I sat down until it went away and then saw my doctor a couple of days later. They did EKG which showed nothing and the doctor thought it was my lungs. Possibly asthma and prescribed an inhaler. About a week later I was just standing in my kitchen and felt a heaviness in my chest again and felt like I couldn't breathe. Went to the ER where they admitted me and did a cath the next day. I truly believe the did the cath only to show me that it wasn't my heart because I kept insisting that it was. They found that I had a 75% blockage at the top of the LAD. Sorry so windy but I get on my soap box when I get on the subject.

------------------
It isn't time that heals all wounds, it's what you do with that time. Dr. Phil

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momofmany
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posted 09-09-2003 11:05 PM     Click Here to See the Profile for momofmany     Edit/Delete Message   Reply w/Quote
Hi Cutup,
I have a few questions for you...why doesn't the "up-to-date" tests show a heart blockage? I have symptoms for about 6 months now. Nothing major (yet)...chest tightness, occasional shortness of breath, tiredness, and yesterday I had pain in my left shoulder and between my shoulder blades and occasional nausea. I have high blood pressure and high cholesterol. Right now I am on 50mg Toprol XL and 60 mg Altocore. I just don't believe that it is all stress related...I mean, up until 6 months ago, I was in pretty good health. I am a 41 year old female and would sure like to find out what is going on with my health. Any suggestions?
Thanks!!

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cutup
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posted 09-10-2003 07:07 AM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by momofmany:
Hi Cutup,
I have a few questions for you...why doesn't the "up-to-date" tests show a heart blockage? I have symptoms for about 6 months now. Nothing major (yet)...chest tightness, occasional shortness of breath, tiredness, and yesterday I had pain in my left shoulder and between my shoulder blades and occasional nausea. I have high blood pressure and high cholesterol. Right now I am on 50mg Toprol XL and 60 mg Altocore. I just don't believe that it is all stress related...I mean, up until 6 months ago, I was in pretty good health. I am a 41 year old female and would sure like to find out what is going on with my health. Any suggestions?
Thanks!!

My cardiologist told me that the stress test alone is not a good diagnostic tool for women so they recommend the nuclear scan along with it. Even the nuclear scan didn't show anything on me, and for some reason I never ever had pain or shortness of breath while on the treadmill. When my cardiologist did my cath he said I really did not expect to find this. I wondered whether there was some slight changes shown but because of my age and not a smoker they overlooked them. I had a very hard time getting diagnosed correctly I think in part because I did not look like someone who would have heart disease.
Your symptoms are alarming to me because they sound similar to mine. I had all of the symptoms you describe. Have you had any testing done?

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amarra
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posted 09-10-2003 08:29 AM     Click Here to See the Profile for amarra     Edit/Delete Message   Reply w/Quote
Wow. This is very scary to me. I can definitely relate. I am brand new to this board, which I joined mainly because I've been diagnosed with hypochondria due to heart concerns and chest pains. I am a 36 year old woman, about 50 lbs. overweight with elevated BP, but normal cholesterol. Heart disease runs on both sides of my family. My regular MD did every test under the sun, too, and said I have anxiety. She said I need to lose weight and that will fix everything. She said that my symptoms have been around too long for them to be heart related (have had chest pain since 01/02, but all EKGs come back negative). As a woman, I've been researching this and have also found that women's symptoms are often not the same (and less severe) than men. My pain is also in my upper left chest area above the breast. But when I push on it, it hurts, which I've been assured is a definite sign that it is NOT heart related (ER diagnosed chronic costochondritis). But why do I get pain across my shoulder blades? In my neck area? Down my left arm? Why does it make me catch my breath? I have had a stress echo (not nuclear) when I was 34 and was assured that the test is "good" for two years. I was also told I have very low risk factors (my age and low cholesterol) and SEVERAL doctors have told me "you're fine -- treat your anxiety". I've been on anti-depressants, but the pain is always there. I sometimes feel nauseous and lightheaded -- again, I'm told it's anxiety, but the meds don't fix that. I am shocked and very discouraged that the nuclear stress echo didn't show the blockage -- my last resort to calm my own nerves was to insist on this test. Cutup, how old were you when this happened? I'm considering seeking a female cardiologist -- what are your thoughts on that? What other tests should I demand? I think it's highly unlikely I'd get anyone to agree to a catheter test -- isn't that considered invasive?

I should add that my husband has survived an aortic dissection at age 41 (I plan to post something about that -- he has just been told he needs surgery again). Given that information, the doctors are convinced that ALL my symptoms are in my head. I'm worried I'm being overlooked!

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cutup
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posted 09-10-2003 10:34 AM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by amarra:
Wow. As a woman, I've been researching this and have also found that women's symptoms are often not the same (and less severe) than men.
I'm considering seeking a female cardiologist -- what are your thoughts on that?
What other tests should I demand? Given that information, the doctors are convinced that ALL my symptoms are in my head. I'm worried I'm being overlooked!

I too was diagnosed with anxiety prescribed Xanax, breathing problems given inhaler to use, costochondritis given Vioxx, and gastro problems prescribed at least 5 stomach medicines. I kept telling them it's my heart and I'm afraid somebody is missing something and I'm going to go home and have a heart attack and die. I was 41 when it affected me to the point that I felt like I needed to call 911. For them to say that the stress echo was good for 2 years doesn't even make sense. You are correct that it would probably be difficult to get a doctor to do an angiogram. There are serious risks involoved. I honestly think they finally did one on me to prove to me that it wasn't my heart because I kept going back to the ER complaining with heart attack symptoms.
I don't know whether you could have chest pain from a blockage and be able to go on for a year or not. I had symptoms for 2 years but it was an occasional thing. I agree that pushing on an area did not cause pain. Sometimes the usual tests also miss something called small vessel disease which involves blockage in the small vessels of the heart which I believe can't be treated with stints and bypass but can be treated with medication. My risk factors were also very low. As for seeking a female cardiologist I don't know that the sex of the doctor will make a big difference except that women may be more clued in to how heart disease symptoms are different for us. I prefer women doctors myself because from my experience they are better listeners although the cardiologist I'm now seeing is male. He was the one who originally discovered my blockage. I do see a female internalist. Hope this answers some of your questions.

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amarra
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posted 09-10-2003 11:41 AM     Click Here to See the Profile for amarra     Edit/Delete Message   Reply w/Quote
One last question, cutup. Did anyone explain to you exactly why the blockage didn't show up on the nuclear stress echo? It just seems so incredible that NOTHING showed up and you had a 75% blockage! This is definitely freaking me out! Thanks.

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momofmany
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posted 09-10-2003 11:45 AM     Click Here to See the Profile for momofmany     Edit/Delete Message   Reply w/Quote
Cutup,
So far, the tests that I have had done are 3 or 4 ekg's, a stress test with a echo, and a 24 hr holter moniter...all of which came back normal. Something else also, I took ephedra for 18 or so months to lose weight. I am wondering if I have done some damage to the heart by using it for so long. I can't seem to find anything on the internet about the long-term effects of ephedra. I know it can cause heart attacks while on it.

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cutup
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posted 09-10-2003 12:31 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
Amarra the only explanation I was given was that sometimes the tests just don't show accurate results in women. You know the really sad thing is that when they put in my stint and I began having problems again it was like I had to go through all of it again. Some of them still didn't take me serious when I told them the symptoms I was having. My former physician even said "Do you think maybe you are just freaking out because of all the heart stuff?" That was the last time I saw that doctor.
The last cath I had after my stint they had me walk to the cath lab. I had 97% narrowing from scarring around my stint at the top of the LAD and was immediately sent to OR for emergency bypass surgery. So it goes to show that they still did not take me serious or I certainly would not have been walking to the cath lab.
Momofmany I don't know anything about whether ephedra can do damage to the heart. I would definitely post that question and see if you get any responses. I sounds like a very legitimate concern.

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amarra
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posted 09-10-2003 01:20 PM     Click Here to See the Profile for amarra     Edit/Delete Message   Reply w/Quote
Momofmany, look up Phen-phen on the internet. Try a search of phen-phen + heart valve problems. I, too, was on that (only 3 months), but there definitely is cause for concern. Even having been on it only 3 months, I have to get an EKG every year.

Cutup, seems your symptoms were very mild for such a huge problem! I'm hoping you're the exception and not the rule. Because if after having the nuclear stress test, I'm told I'm fine, only to be worrying about the "what if's", I'm going to go completely mad! And like I said before, there is no way a NY doctor would order the catheterization for me! Not that I think I want that -- I want to believe the results of the other tests -- a friend of mine had that and I know it's very painful/uncomfortable. Are you 100% better now?

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cutup
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posted 09-10-2003 02:32 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
[QUOTE]Originally posted by amarra:
[B]Cutup, seems your symptoms were very mild for such a huge problem!

a friend of mine had that and I know it's very painful/uncomfortable.


Actually my symptoms weren't mild, but the worst of it would stop by the time I saw the doctor. Then when I would be in a hospital bed not doing anything the worst symptoms didn't show up at all.

A cath really is not all that bad. You just feel some pressure and it's stressful because you know they are running a wire through you body to get a look at your heart. There was some pain when they put the stint in though.

I'm doing really well now but it took over a year after my bypass. In the meantime I sold my business(Beauty Salon) & quit working for 6 months. Just couldn't seem to get well. I went back a few months ago working for someone else. (Not so much stress) I am doing fine so far. I try to eat right most of the time and I exercise.

I'm sorry if I scared you. That is not my intent at all and I don't know whether what you are feeling is related to blockage or not. I hope someday they come up with a better way to diagnose blockages in both men and women. Good luck and please let me know how things go with you.

[This message has been edited by cutup (edited 09-10-2003).]

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yahweh
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posted 09-10-2003 05:13 PM     Click Here to See the Profile for yahweh     Edit/Delete Message   Reply w/Quote
Hi, Catup okay I am sorry and glad at the same time about your diagnosis and recovery. Okay, I am a
33 year old woman who is having pains in the left side area of my breast. I am also having shortness of breath and in my opinion severe anxiety. I know I need to see a shrink but aside from that, I just know that I need help with my heart.

I have already had a stress test and a nuclear Thalium test. The stress test shows fine but the nuclear test shows that I do not have enough blood flowing through my heart or something.

I was just wondering what was the test that you had that can accurately diagnose if I have either
heart disease or a blockage? What is the actual name of it.

Is there a risk in taking this test and does this test hurt? I look forward to hearing from you soon Catup. Thanks

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momofmany
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posted 09-10-2003 06:36 PM     Click Here to See the Profile for momofmany     Edit/Delete Message   Reply w/Quote
Amarra,
Is Phen-phen and ephedra the same thing? I have already told the doctor about the ephedra and he just shrugged it off. I think that he probably doesn't know a whole lot about it and the side effects. What a high price we pay to lose a few pounds! Cutup--did you have problems with your blood pressure before they found your problem? I am on 50mg toprol XL and it still will shoot up during the day. I know if I call the doctor he will "up" the meds and I am already tired enought!

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cutup
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posted 09-10-2003 09:12 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by yahweh:
Hi,
I have already had a stress test and a nuclear Thalium test. The stress test shows fine but the nuclear test shows that I do not have enough blood flowing through my heart or something.

I was just wondering what was the test that you had that can accurately diagnose if I have either
heart disease or a blockage? What is the actual name of it.

Is there a risk in taking this test and does this test hurt? I look forward to hearing from you soon Catup. Thanks



Why have they not done anything if they can see that parts of your heart are not getting good blood flow?

My blockage was found during a catherization. It is an invasive procedure which has risks including death. Heart disease or heart blockage is normally referred to as CAD, coronary artery disease which is where plaque forms in the arteries narrowing them and then sticky blood platelets cling and then cause the artery to block and cut off blood supply to parts of the heart.

The catherization or angiogram is not painful but there is pressure. You are given drugs to sedate you a bit, but you must stay awake during the procedure. They ask you to breathe at certain times during the test plus they want to know if you are feeling any chest pain. I've had 6 or 7 catherizations and I hope I never have to have another one but they are not terribly unpleasant. It is scary going through it though.

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cutup
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posted 09-10-2003 09:23 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by momofmany:

Is Phen-phen and ephedra the same thing? !

Momofmany, don't quote me on this but I don't think phen-phen and ephedra are the same thing. I think phen-phen is actually two drugs. One being phentermine?, but I believe it is the other part of the phen-phen that causes the problem and I can't remember what that part is called. I think it was causing mitral valve prolapse, but again I'm not sure.
No, I did not have high blood pressure. It has always been about 110/70 or 120/80. After my bypass I was put on 25 mg Toprol XL because I was told that it would keep my heart from working as hard. I can't really tell that it lowers it anymore than it was except that sometimes it will really bottom out. That is usually when I'm slightly dehydrated like you would be before surgery.
I don't think the ephedra effects you after you've stopped taking it. I think the thing with ephedra is that it speeds up your heart and while on it some people have experienced severe heart disturbances.

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momofmany
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posted 09-10-2003 09:36 PM     Click Here to See the Profile for momofmany     Edit/Delete Message   Reply w/Quote
Cutup--I think you are right. From what I have read, Phen-phen has ephedra in it but it is the other part that caused all the problems, including Primary Pulmonary Hypertension. I think that that is irreversible. That's interesting that your blood pressure wasn't part of your problems. I just assumed that they went together. High blood pressure was the first symptom that they discovered with me. Everything else just kinda followed. Do you think that I should push the doctor into more tests? I did have the chest pains again today. They did'nt go into the back this time...only into the shoulder.

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amarra
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posted 09-11-2003 08:06 AM     Click Here to See the Profile for amarra     Edit/Delete Message   Reply w/Quote
Ephedra (or ephedrine) was the ingredient in Phen-Phen, which is why both Phen-Phen was taken off the market. Interestingly enough, ephedra has even been taken off the shelves of a good many NY health stores because people are abusing it. I was also told that unless you really did abuse it -- using more that you were supposed to -- you SHOULD be o.k. That said, I still have to go for EKGs every year and I was monitored by a doctor the whole time I was on it and it was only 3 months!

Cutup, I think I have to believe (for my own sanity) that your case is the exception and not the rule. I didn't know you didn't have high BP either! Wow -- someone up there was really looking after you to make you so persistent! I'm still floored that they did a catherization -- a very risky test by your own admission -- when you had virtually NO risk factors and all tests showed up clear!! Wow again. I just don't know what to say except I'm so happy things worked out for you -- you were lucky!

I talked to my doctor yesterday. I told her about the chest pains and pain between my shoulder blades and down my left arm. She said that it's all anxiety (again). She won't order another test. She said again (for the umpteenth time) that I have regulated BP (on meds), normal cholesterol, 36 years old, stress echo from 2 years ago was good. I said to her, "don't women's symptoms get overlooked, and aren't they less obvious than men's symptoms?" She said yes, that's true, but I still don't have enough risk factors to be worried about this. I really do hate doctors.

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cutup
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posted 09-11-2003 09:02 AM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by amarra:
!

Cutup, I think I have to believe (for my own sanity) that your case is the exception and not the rule I talked to my doctor yesterday. I told her about the chest pains and pain between my shoulder blades and down my left arm.

She said that it's all anxiety (again).


Amarra I did have a family history and had slightly elevated trigs and a little low HDL so I can't say I had absolutely no risk factors, but I know I puzzle the doctors even now. I can tell by the way the talk to me about my heart disease and the questions they ask.

I just can't believe that a doctor is dismissing your symptoms and calling it anxiety when the anxiety meds are not working. I'm not a doctor by any stretch of the imagination, but I think there is something going on besides anxiety.

Amarra one other symptom that I remember having a was curious if you've ever felt it is kind of like a band wrapped around your arms and tightening causing you to have a tingly feeling in your upper body? I don't know if you've gone for a second opinion or not but it might be worth it. Do you know exactly what your lipid levels are?

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cutup
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posted 09-11-2003 09:10 AM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by momofmany:
[BDo you think that I should push the doctor into more tests? I did have the chest pains again today. They did'nt go into the back this time...only into the shoulder. [/B]

I don't understand why it wasn't pursued further when ischemia showed up on the nuclear scan. You might just tell them that you are not convinced that something isn't wrong and that you are continuing to have chest pain and ask them about further testing.

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yahweh
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posted 09-11-2003 04:44 PM     Click Here to See the Profile for yahweh     Edit/Delete Message   Reply w/Quote
Thank you Catup for your reply this is Yahweh again. Okay, you are absolutely right. I do not know why they did not do anything about my Thalium Test result that clearly states that I am not getting enough blood flow to my heart according to the report.

But according to the Cardiologist, he is saying that the Thalium test result is in-conclusive because the excercise part of the Thalium test came out fine, and then the second part of the Thalium test which is taking pictures of my heart came out bad. So my Cardiologist says the test results are supposed to match for it to be a definate diagnosis and he also said that many people fail the Thalium test. He says most people fail the Thalium test and that the test is really inconclusive. He says the excercise part and the Thalium test itself is supposed to match. He says one is not supposed to pass and the other one fail. If I pass the excercise test, I should have passed the Thalium too.

But Catup I am having chest pains on the left side of my breast and also in addition to this, recently I have been having shortness of breath, and I have been having head pains in the lower right side of my head going to my neck. I have also been feeling a little bit dizzy too.

What should I do Catup? I really believe that I need help and I really believe that my heart needs tending to immediately but this Cardiologist which is a man is saying something different. What should I do? I was thinking of taking an aspirin a day in the mean time until I get some real help. What do you think? And what should I do about this sitation. Thanks Catup and I look forward to hearing from you very very soon. Bye.

[This message has been edited by yahweh (edited 09-11-2003).]

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cutup
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posted 09-11-2003 06:48 PM     Click Here to See the Profile for cutup     Edit/Delete Message   Reply w/Quote
quote:
Originally posted by yahweh:

What should I do Catup? I really believe that I need help and I really believe that my heart needs tending to immediately but this Cardiologist which is a man is saying something different. What should I do? I was thinking of taking an aspirin a day in the mean time until I get some real help. What do you think? And what should I do about this sitation.

]


Yahweh First off it not recommended to take an aspirin a day with a doctor prescribing it.

You just have to go with your gut feeling. I was persistent because I just knew something was very wrong. I don't know what to tell you except maybe get a second opinion. I just don't know all that much about thallium stress test results. I just know they were useless in my case.

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