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zip2play 04-30-2003 06:08 AM

My problem is a severe burn in the middle of the chest that comes on with sudden exertion, like a run for a bus, or a 1 block SPRINT on the bike. I have no trouble walking long distances at a moderate speed (3 miles/hour) or biking for miles at a "lollygag" pace. The pain/burn stops about 5 minutes after the exertion stops.
I had a stress test with echocardiogram about 2 years ago and in spite of developing pain during the test, with the doctor (cardiac specialist) urging me on to finish the 12 minute test. ("Can you work through the pain?) I finished and was echo-grammed.

His diagnosis was "much better tolerance for excercise than expected for a man his age, 58, despite ischemia and high blood pressure and high heart rate during and after stress test."
He told me "I don't think your pain is cardiac."

The pain continues to worsen- it's scarey! It actually feels like the pain is coming from scorched airways (bronchi or lower trachea), but that's highly subjective.
Besides heartburn (or GERD) are there any other conditions I should look into.

In spite of the stress test, I think I will push my PCP to order an angiography when I next see him. (My mother died of coronary heart disease with multiple blockages, one of which MAY actually have been congenital.)

Any ideas for me- let your imagination run wild...I'm up for anything.
(I really don't want to put myself through the pain of another stress test).

What I'll do today is ride my bike hard and see how long it takes to get pain. THEN tomorrow I'll do the same after having taken about 40 propranolol (Inderal) and see if there is a large difference.
Hey, I'm an engineer- testing is in my blood and I'm tired (and scared) of ignoring this issue.

Thanks for listening guys.

[This message has been edited by zip2play (edited 04-30-2003).]

MickeyC 04-30-2003 03:33 PM

HI ... I'm new here and am NOT even close to being an amateur about heart disease ... HOWEVER I did have a couple of thoughts. Besides continuing to press for a definitive diagnosis through any and all testing I have some personal experience with a couple of other conditions that can mimic angina pain.

One you already mentioned ... GERD .... which quite difinitely can. I know that from personal experience as I have had it for about 7 years. The other is a hiatel hernia (sp?). My husband has this and has been rushed to the ER twice because the EMT's thought he was having a heart attack each time. He wasn't. But it DID mimic the pain .... so I'd get that checked as well. He had the pain, the sweating, the rapid pulse, bp going high .... ALL the symptoms.

Good luck with getting diagnosed! I wish my husband was like you! You carry your 'testing' into your personal life ... my hubby is a chemist and he DOESN'T! He fights every test tooth and nail even though he comes from a family smothered in engineers!!! LOL

NMc 04-30-2003 04:43 PM

Hi Zip2play:
May I ask, was the cardiologist supervising your stress test a complete and utter idiot? Sometimes, they actually come pre-stamped with "idiot" on their foreheads. My suggestion would be to take the results of that stress-echo and (no, not do the obvious) discuss with a different cardiologist. Preferably one who didn't graduate at the bottom of his class. You had ischaemia, but it wasn't cardiac-related?? I hesitate to ask what he was imaging, if not your heart.
Biking till you reproduce the pain doesn't seem an appropriate "bench test" (I think you engineers coined this one) to assess coronary blockage. And because Inderal (beta blocker??) wouldn't kick in with one dose, it's doubtful it would have any impact on your symptoms during post-testing. Get a referral to a different cardiologist and discuss the possibility of an angiograph with him/her.
Just suggestions from a non-engineer!

zip2play 05-01-2003 05:28 AM

Thanks to both of you.

I know about the GERD/angina connection since my mother had both- as seemingly LOTS of people. I guess the MD's are often diagnosising one for the other. I really DO have clear symptoms of both.

You are absolutely right and I will not rest until I have some sort of angiography done. I guess the choices are with or without a cardiac MRI.
I disagree on only one teeeny point. Since I've taken propranolol years ago for high blood pressure because I hated all the other long-long lasting beta blockers. I know that it is fast acting and kicks in within an hour (and out within about 6- thus making it a rotten drug for blood pressure control) but a good angina blocker for a specific, anticipated stress effect.
(I've sort of noticed that after one I can sprint up several flights of stairs with no discomfort.)

The whole realization of likely angina (after several years of denial) has, unfortunately, thown me into a sudden deep funk that I hope passes quickly since I'm in the process of an ear surgery. TOO much doctoring in a short period of time is definitely one of life's bigger downers.

NMc 05-01-2003 03:12 PM

Hi again Zip2play:
I wasn't aware there was such a thing as a short-acting beta blocker - you're right, pretty useless as a blood pressure med. Thanks for the info.
About this funk...I can relate. I stay away from the doctor's office for a good 20 years and go in about a little problem with my blood pressure and "wham", they find all kinds of goodies to tinker with. I feel like my car (at least it goes in once a year whether it likes it or not). More tests on Monday and no end in sight. At least it gets me out of the office now and then :)
Best of luck!

zip2play 05-02-2003 08:50 AM

Another wrinkle...OY.

I noticed from my search of symptoms, there's a condition called esophageal spasm which hurts mid chest and you really won't believe what they use to treat it:

Right, BETA BLOCKERS!!!!!! (Talk about complicating matters!)

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