AboutDavid Richardson Expertise Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.
Experience Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.
Organizations Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..
Publications Circulation, American Heart Journal, Hypertension.
Education/Credentials M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.
Awards and Honors Gold Heartt Award from American Heart Association in 1995.
Question Hello Sir,
7 months ago i was with a friend at the theatre watching a movie after having a dinner and while i was at the theatre i started sweating and had short of breath left hand pain and behind left breast bone chest pain, i went to the bathroom washed my face but i could not continue , i directly went to the ER did not drive took a cab and waited 20 minutes they let me in, ekg blood test physical test and all came normal and they sent me back , did not give me any medicine. Next day i went to my family doctor and i told him what happened he ordered for me a blood test and ekg stress exam also all came fine and did not give me any medicine, 3 days later i started feeling better and back to my normal status and life energetic, i am a 33 years old male athletic swim play tennis walk...etc,
45 days ago while walkig with my friend and in her car i started feeling tired even going up the stairs feeling dizzy and my head pressure numbeness sweating short of breath pain in chest so i started going to bed earlier than before like not my age or even my nature, i felt and started loosing my energy like at least 60 percent than before, so 43 days ago i was playing tennis indoor playground no sun nothing and my heart started pumping hard and strongly and fast and i became short of breath numbess chest pain 4th 5th rib behind breast bone left side, i wanted to go directly to the ER but my friend took me to a clinic because of the waiting time in the ER, the doctor checked me physically and my breath and blood pressure and told me your heart and breath seems ok and also your blood pressure. She told me it is just the co2 while breathing caused you to become anxious and then this happened...etc but i told her i am not and i have been feeling like this for a week , she said dont worry it is nothing and did not give me any medication. The next day i still did not feel ok i went to my family doctor told him everything and he ordered blood test urine and again ekg and all came normal later on but he told me your blood pressure is high, so he told me come back in 3 days to check it back, the same day i went to pharmacy in the evening to check my bp i was not feeling ok at all and my blood pressure was 148/101 i then directly went to the ER short of breath high bp, burping a lot, dizzyness pain behind left breast bone like pinches or squeezing and shots of burning , they did blood tests ekg and x rays and again all came normal, i was sent home again with nothing and no medicine, then after 3 days i went back to my family doctor and he cheked again my bp and it was still high and he put me on Atacand 16 mg one pill a day, after few days my blood pressure began to improve but my energy was still low short of breath on exercising even daily activities , walking up hill, stairs, i used to play tennis not anymore like before and swiming full length for 45 minutes not anymore, just walking , then a week passed and went back to my family doctor to check my bp and he said your bp is improving, and it is ok now, i told him i am not feeling ok and i know my body and i am burping a lot and i am getting tired and fatigue a lot, he then told i will order a looper for you to record when the symptoms appear to record and also an echcardiogram, so i did the echocardiogram at rest and a week later i recieved the results and also gave them back my looper since i recorded what was happening with me for just 6 times out of 10, i still did not get the louper or holter results yet since igave it back only a week ago , but my doctor recieved my echocardiogram results and my results came normal all normal measurements and normal lv and valves with mild or some traces and summary results was normal study. My EF was 70%. My doctor told you are ok and he gave me acid reflix medicine and he will book for me an appointment for an alergy doctor but i dont have asthma so i dont know why he asked that and he told the louper results did not come yet , will call you. I told him i am still not feeling ok really and i told him and short of breath even sometimes after walking and relaxing it happnes and i have always shots of pinches and burning like feeling left side breast bone and 4th and 5th rib and also air hunger when i walk not like before or even when i eat i sweat and can not continue eating and become short of breath , i showed him again my chest and told him you see there is some redness here and also a green yellow colour in this area like someone hit you and i told him maybe all is related and even the shot of burns and pinched are also expanding to the right side of my chest near the 4th rib not only left side. And he did not say anything.
2 days ago i went to the subway station to use it i went to 3 stations and could not continue i became short of breath sweating and my head and ears like exploding and pressured and my eyes became red so i went out. And yesterday i went to try to run and jog i used to do that for like 40 minutes and yesterday i did 10 minutes slow running i could not continue. I also bought 4 weeks ago a blood pressure machine called Omron and i check my bp after i walk and before in the morning and i do it 3 time continously and then take the avaerage for that moment with my heart beats and to be more accurate and my bp sometimes go to 135/93 while sitting and having short of breath and sometimes after i come from a walk , and sometimes at ngiht or after a walk or in the morning it goes down to 90/60 and most of the time it is 115/77 or 110/82 or 105/75 or 122/85.
What worries me is that i am afraid i am under diagnosed or wrongly diagnosed and i wonder what do they check at the ER can they diagnose COD or any heart disease or with the EChocardiogram and why i am still having the same symptoms and pain in that area with different color like red and yellow green like someone hit me, why i can not eat like before no appetie or going to restaurants..etc, can all this be connected and cause my sudden high bp short of breath numbeness fatigue chest pain.....etc, what are possibilites that i have chest wall something or nerve that affects all this or lung or heart...etc.
I really would like to know what i have what other exams should they do for me to really know the problem before it is too late, that they can do to me to diagnose my symptoms well, because i know my health and i am not ok nor anything like before and not changing to the better for sure since 45 days ago. Like now i am having this shots of pain or burning in my chest in that area while sitting and typing this!!! any possibilities and or diagnosis and advices.
Thank you
Answer Dear Mark,
The most common cause of pain like yours is cramping of the muscles in the chest wall. If you can modify the pain, make it better or worse, by pressing on the area that hurts, then you have proven that the pain is coming from your chest wall. Chest wall pain is a nuisance but no threat to life or health. At age below 45, chest pain is very unlikely to come from clogging of the coronary arteries that supply blood to the heart.
The other symptoms may be from anxiety about your health. Ask for a stress test monitored by radioisotopes or echo. A negative test of that kind offers 95% probability of no heart attack or cardiac death for at least 7 years, and may reassure you enough to relieve your other symptoms.
Please write back if this note doesn't answer all your questions.
