Chest pain - diagnose me?

[RockinD]

For a while now I’ve been getting episodes of chest pain. When a nurse colleague saw me in the middle of one, she nagged me into going to see my GP. I have now seen two GPs, neither of whom has the faintest idea what is causing these episodes. An ECG at rest and a chest x ray have shown nothing and, after I pushed for this, I have now been referred for a CT scan. I’ve rung up to chase this today and have been told it is a CT scan of my shoulder, whereas I was expecting it to be a heart/chest scan.

Symptoms as follows:

Rapid onset
Severe pain across back and around sides of rib cage leading to
Shallow breathing
Crying with the pain
Pain/sensation going up into my jaw
Strange taste in mouth
Clammy and sweating
Lasts about 15/20 minutes
Not connected to stress or exercise
Variable frequency – can go months between episodes or have several in quick succession

It certainly doesn’t feel as if it is musculo-skeletal to me. GP gave me a thorough physical examination and remarked on my lack of response to his poking and prodding given my age (I’m 59)

Any ideas?

Acid reflux type? I had that once and it was excruciating, sweating with pain and I got the funny taste in my mouth too

It can be a muscular spasm in your back that is causing it. There is a name for this- can't recall what it is- but I've had similar symptoms and was worried it was a heart attack, but according to info online it's caused by major muscles in the back and shoulders cramping. Mine has been brought on usually by a small movement such as reaching behind or similar.

hiatus hernia?

The OP has already had heart checks though?
In any case- it's hopeless really to be telling a GP where to refer- FGS- what are they trained and paid ££££s for if they can't refer to the right specialist for something like this?????

Your list of symptoms makes me think of coronary vasospasm which is also known as variant angina or prinzmetal. It is basically a temporary constriction of the arteries.

I was diagnosed with this having had a heart attack at 46 out of the blue.

Of your list

Rapid onset
Severe pain across back and around sides of rib cage leading to
Shallow breathing
Crying with the pain
Pain/sensation going up into my jaw
Strange taste in mouth
Clammy and sweating

all could be heart symptoms

Lasts about 15/20 minutes
Not connected to stress or exercise
Variable frequency – can go months between episodes or have several in quick succession

are all seen in vasospasm which is not caused by exertion.

The problem with vasospasm is that it is very difficult to diagnose. If you have heart tests, they will no show anything wrong unless a vasospasm occurs at the time which is unlikely.

When I had my heart attack it took the cardiologists a long time to work out what had happened, and in the end they could only say - we think it was vasospasm (because no heart disease risk factors, no atherosclerosis etc) but we can't be 100% sure.

I have made a full recovery, just take medication (statin, aspirin) to reduce risk of artery disease and another medicine to keep my arteries relaxed. Also I keep a GTN spray in case of another attack - but four years on have had no further symptoms.

Sorry for long post. I wanted to give you this information because it might be worth you asking your doctor about this possibility - and it would fit with why tests so far have shown nothing. Also it is uncommon, most health professionals I meet know little or nothing about it and it is not usually at the front of their minds as an explanation for heart symptoms.

Just so as not to panic you, if it is this, what you would have been getting would be just angina (i.e. heart pain), just not caused by the usual factors, and not a heart attack, but you should get it looked into to reduce the risk of a heart attack in the future.

I hope that helps.

Just wanted to add, ECG shows up any damage to the heart, even if it happened in the past (if I understand correctly) so if it is vasospasm, the constriction of the arteries would have been causing you symptoms, but would not have caused any damage to your heart - the ECG would have shown abnormal results if damage had taken place.

I do hope it is not this and is something less serious like a muscle problem, but wanted to give you this information as this is a potentially very serious condition. That said, now I am on treatment I can honestly say that it doesn't really have a negative impact on my life although the heart attack was a bit scary at the time!

And also to clarify, vasospasm usually occurs periodically as angina, and doesn't usually just go straight to a full heart attack scenario as in my case.

Thanks everyone.

DH is a physio. He has checked me over during an episode and found no sign of muscle spasm, which is initially what I thought it was.

Acid reflux? I don't think I have this. Isn't it basically heartburn?

Veracity thank you for your long and helpful post. I had wondered about unstable angina, which is a bit scary.

I am surprised that the NHS don't take chest pain more seriously.

@ShowYourVeracity I am OP Unser another name. You were spot on. I was diagnosed in August. It seems to be a little understood condition.

how are you now