Chest Pains

[Gloria]

I've hesitated to post this because it's not related to MC, but hey, we're family.

I just had my third episode of chest pains this morning. I first experienced them in Jan 2006 and went to the hospital immediately. After all the tests, they found nothing.

I had another episode in April 2008. That time, I didn't go to the hospital right away, but called my doctor from work the next morning (after being scolded by my co-workers). He told me to go the hospital. Whenever you go to the hospital with chest pains, they do an auto-admission. More tests, nothing again. They wanted me to stay overnight, but with MC, I knew I wouldn't be able to eat anything. Plus my doctor told me that the stress test only shows if there is an 85% blockage or more. So I went home without taking all the tests.

This morning I had the pain in the same location, on the left side of my chest, lasting for about the same time, about 10 minutes. I always have it in bed, after I wake up, so it's not due to over-exertion. I didn't go to the hospital but I'll probably call my (new) doctor tomorrow. If he tells me to go to the hospital, I might argue with him.

I think the heart testing is in the same category as the testing for food intolerances. The medical community refuses to accept that there is a more accurate test available, the heart scan for calcium (plaque) deposits. I had the testing done 9 years ago and the test showed that I had mild plaque burden in my left anterior descending artery. I had more calcified atherosclerotic plaque than 84% of the people my age and gender at that time. My doctor put me on the statin because I had a high cholesterol and I've been on one since. My cholesterol numbers are much lower now, but this chest pain is causing me some concern.

On my first visit with my new doctor, he told me it might be a good idea to get another scan. I asked him if he would give me a prescription so that my insurance might cover it, and he said "Well, the medical community doesn't really recognize the test." So I'm on my own for the tab, which is about $350.

Have any of you had this test? It's call Heart Check America in Illinois. Do you think the hospital tests are worthwhile? My husband had the test and his showed that he had no plaque deposits, but that was 14 years ago. He's on a statin now, too.

A nurse at the hospital said she thought I had angina, but no doctor has ever given me any diagnosis. It seems like a waste of money to keep going every time I have chest pain. Comments?

Gloria

[tex]

Hi Gloria,

That's a tough one to respond to, but here are my thoughts:

Angina usually occurs during exertion, severe emotional stress, or after a heavy meal. That's not a very good fit for the situation you describe. If you experience any shortness of breath or tiredness, along with the chest pain, you should get it checked out.

A common cause of chest pain under the conditions you describe, is acid reflux, or heartburn.

Maybe your new doctor has better insight into your symptoms than the other doctors you've been to about it, (well, we can hope).

Remember, I'm not a doctor. Good luck tracking this down.

Tex

P. S. I know nothing about the test you mentioned, unfortunately.

[Dee]

Hi Gloria!
First off, women don't have the same symtoms as men when it comes to a heart attack.
I have always been told to demand further testing if I'm not satisfied with an ER's response.
Second, I throw away those papers that come in my mailbox pertaining to the body scans.
Have you had all of this bloodwork when you had these episodes of chest pains.

These 2 are a must:
Creatine Kinase
When muscle or heart cells are injured, CK (a blood product) leaks out, and its levels in your blood rise. There are different types of CK. CK-MB is released when the heart muscle is damaged.
High CK levels can mean that you've had muscle damage in your body. High levels of CK-MB can mean that you've had a heart attack.
Doctors order CK tests (such as CK-MB) when patients have chest pain or other heart attack signs and symptoms.
Troponin
This is a muscle protein that helps your muscles contract. Blood levels of troponin rise when you have a heart attack. For this reason, doctors often order troponin tests along with CK-MB tests when patients have chest pain or other heart attack signs and symptoms.

Blood Tests To Assess Heart Disease Risk
Abnormal levels of certain chemicals in the blood may mean that you’re at higher risk for heart disease. Your doctor may want to test the levels of these chemicals to assess your risk and to suggest ways to reduce it.

Lipoprotein Panel
This test can help show how high your risk is for coronary heart disease. A lipoprotein panel looks at substances in your blood that carry cholesterol.
The test gives information about your:

Total cholesterol.
LDL ("bad") cholesterol. This is the main source of cholesterol buildup and blockages in the arteries.
HDL ("good") cholesterol. This type of cholesterol helps decrease blockages in the arteries.
Triglycerides. These are another form of fat in your blood.
A lipoprotein panel measures the levels of HDL and LDL cholesterol and triglycerides in your blood. Abnormal cholesterol and triglyceride levels may be signs of increased risk for coronary heart disease.
Most people will need to fast for 9 to 12 hours before a lipoprotein panel.

High-Sensitivity C-Reactive Protein
This is a fairly new test for heart disease risk. It looks at blood levels of C-reactive protein (CRP). High CRP blood levels can be a sign of inflammation.
Doctors use standard CRP tests to check for inflammation and autoimmune diseases. Your doctor may order an hs-CRP test, along with other tests, to see whether you’re at increased risk for heart disease.
However, CRP tests aren’t routinely done, because it’s still unclear how useful they are for showing heart disease risk.

Homocysteine
High levels of this chemical in the blood can mean that you’re at higher risk for heart attack or stroke. This isn’t a routine test for heart disease risk. But some doctors may use it, a long with other tests, if they think you’re at increased risk.

Please don't shrug your symptoms off.

Love
Dee~~~~

[Jan]

Gloria,

I had the scan done twice now. Once 10 years ago and then last year. The hospital here that does them had the Dr. giving out a $100 off coupon so mine was $140. My insurance won't pay for it even with a Dr. order (FYI).

Now I had these done in two different places. The first one showed very little but the second one showed a significant increase. Went to a cardiologist and had a nuclear stress test. It showed nothing. I kind of feel it was a waste of $$$. Then they put me on Crestor which I had a nasty reaction to so as of right now I'm off all statins. I start on pravocol next month but they are now going to have to do monthly blood tests because it has affected my liver as well as the muscle problems.

I would encourage you to get ahold of your Dr. It may be acid reflux or angina but chest pain is nothing to shrug off.

Jan

[JLH]

I hope you called your doctor. That would make us all feel better, Gloria. Let us know, please.

[Gloria]

I have an appointment with my PCP today at 12:45 p.m. I will let you know what he says, but I have a feeling he'll order more tests. Like Jan, I felt that the nuclear stress test was a waste of money.

Gloria

[tex]

Gloria,

Haven't they been checking your troponin level, when you made the previous visits to the ER? The first thing they did, was to check mine, when I went to the ER a couple of weeks ago. Fortunately it was normal, so that's probably why they didn't seem very concerned.


Jan,

Was it the Crestor that caused liver damage and muscle problems? That sucks.

Tex

[Jan]

Tex,

That's what they are thinking. I've had problems with every statin that I've taken and I've had every brand now but one. The reaction in 6 months on Crestor was much worse than any thing else. I've been off them for 4 months now and have made such progress of feeling better it isn't even funny. I am to try pravacol (?) starting next month and then have to do monthly blood work, rather than every 3 months. I know that my total cholesterol is on the high side, which diet doesn't affect, but I am pretty sure this is genetic. I will try this one for a short period of time. If I start anywhere feeling bad, off I'm going. After that I don't know what we'll do; maybe try non-statins.

Thanks for asking,
Jan

[JoAnn]

Hi Gloria, I'm so sorry to hear about your chest pain and hope you can get some answers. I'm glad you're getting in to get it checked out. What statin are you on? My cholesterol has been high since mc and I'm trying red yeast rice now. My doctor will check next month. If it hasn't done anything, I'm sure I'll be put on a statin. Good luck, JoAnn

[Gloria]

Thank you for your concern and interest.

I took my DH to the PCP with me so that he'd remember what I didn't. We both got lost on our way to the X-ray and blood testing center after the visit. So much for combined memory power.

The Dr. took an EKG in his office and it was normal. I don't know about the X-ray and blood work tests yet, but I expect them to be normal also. I don't know exactly which blood tests he ordered, but the lab called him on the phone to double-check which tests he wanted. I just had blood work in February, but he ordered another cholesterol test, primarily to check my liver.

In February, my cholesterol was 154, triglycerides were 89, and HDL cholesterol was 62. VLDL Cholesterol was 18, LDL Cholesterol was 74. These numbers are considerably improved from what they were before I began taking a statin. Back in 2002, before the statin, my cholesterol was 331, triglyceride was 160, HDL was 50 and LDL was 254. I really do need to take a statin. My brothers have and my mother had high cholesterol and my dad had and brothers have high blood pressure. My blood pressure has always been low. Today it was 90 over 60. You may recall that both my parents had strokes. My dad was 67 when he died of a stroke and my mother had her stroke at 69. I'll be 64 in October.

I showed him the Heart Check America coronary artery scan test results. He gave it cursory attention and said that a newer, better test is a CT Angiography (CTA). My insurance won't cover it. My private pay cost would be $750, about double the cost of the Heart Check America test.

He wants me to take a stress test. I'm inclined to wait until the beginning of the year when we'll have a new flex benefit balance. Then I might order the CTA test.

I told the Dr. that I thought my symptoms sounded like variant angina and he said he was thinking the same thing. I have an appointment to get an ECHO test on Wednesday.

Gloria

[mbeezie]

Hi Gloria,

Sorry to hear about your chest pains - I know how scary that can be. I had a few bouts of chest pains over the last few years. Whenever this happened I also felt like I couldn't take a deep breath. I had a stress test and ECHO and numerous EKGs and nothing cardiac turned up, so they thougt it was GERD. Well, I am not sure it was GERD because I never felt refulx or heartburn, but I do beleive it was food related . . .foods that cause bloating and inflammation. One time when I was in the ER watching the EKG machine I could see blip in the reading when I would get this funny little pain. The ER doc told me that the nerves that are invloved in GERD can also trigger chest pain. So, if nothing cardiac is found, pay attention to your food diary and see if certain foods cause a problem.

Take care,

Mary Beth

[MaggieRedwings]

Morning Gloria.

So sorry to hear abot what you are going through. From one with a heart condition, this is not something to ignore and you are definitely not ignoring it and taking control of the situation. I think the Echo cardiogram will be a good thing and it will rule out any "questionable" areas and concerns.

Good luck and keep us posted.

Love, Maggie

[starfire]

Gloria,
I truly agree with Maggie. The echo-cardiogram is just about the only external test that is really worthwhile in my opinion (which may not be worth much but I did live with a man with heart problems for many years and I did pick up some info).

Wishing & praying for the best outcome for you.

Love, Shirley

[ant]

Dear Gloria, wishing you all the best. Ant

[Gloria]

I think I've had every inch of my body tested this year.

I saw a cardiologist after I had the echogram in September. She did a scan and also a stress test. She seemed pretty impressed with my physical condition. I passed all the tests with flying colors: low blood pressure, heart rate reduced very quickly after the stress test, etc. My cholesterol was down to 152; blood work was normal; I don't smoke or drink. She told me that I had an extremely low risk of having a heart attack - 1-3%. I mentioned Prinzemetal's angina, which seems to fit what I have. She said it was very rare, and brushed off the possibility. I decided I wasn't going to worry about it anymore.

Until Sunday, when once again I had chest pain, only this time it was in the evening. I'd been resting all day, due to pneumonia, and I could feel them coming. I expected them to go away after 15 minutes, but they didn't. The pain lasted for 30 minutes and I would describe it as pretty strong, though I was able to walk and move around. The pain is always in the same location, directly under my left breast. I don't have any other symptoms besides pain. I didn't go to the ER because I had just been to InstaCare that afternoon. I knew they would check me into the hospital and I didn't want to spend the rest of my time there, plus I have a $150 copay.

I'm kind of sorry now that I didn't go but as DH says, by the time I arrive at the hospital, the pain is gone. I called the cardiologist and she said after looking at my file, it was likely due to pneumonia. She never asked about the type, location or duration of the pain. She apparently thinks that since I'm low risk for a heart attack, she doesn't need to take the pain seriously. I think I should have some nitroglycerin on hand to see if it makes the pain go away. Then I would at least know that it is angina. I'm not getting any explanation from her about the cause.

I honestly don't know what to do the next time I have chest pains. They are getting more frequent and are more intense.

Gloria