Expert: David Richardson - 6/25/2009

Question
hi i have asked questions before in the past. I am 33yr old male. I have chest pain on the left side above my nipple. it happens quite often , not from excerise just anything the pain will be there. i have tried ant acids, had a heart stress test, echo and ekgs  and 24 hour montor.. i was found to have sinus tachy given atenenol 50mg which i have taken for 2 yrs . all the tests were 2 yrs ago when this 1st started and there is nothing found i am fine is the answers. here are my questions ..
1- how long are the test results good for ??
2- can this be heart related ? when i get the chest pain sometimes my tounge feels numb , occasionally dizzy but then in a day or so it passes.
3- Im afraid something bad will happen. can a person suffer from stress and anxiety that makes the heart rate above 100bpm daily for 2 years?
and advice will be greatly appreciated.
Matt

Answer
Dear Matt,

The most likely 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.

1. Echo is good for decades.  A negative stress test monitored by radioisotopes gives 95% freedom from heart attack or cardiac death for at least 7 years.  Although a stress test monitored by EKG only doesn't have such strong predictive accuracy, it still must be good for at least 5 years.

2. your heart is VERY unlikely to cause your pain,  Very, very unlikely.

3. Yes, stress and anxiety can make your heart rate high for 2 years,  100 mg of atenolol daily may help.

Please write back if this note doesn't answer all your questions.

David Richardson