Heart & Cardiology/Heart probs

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Question
My husband is 56 yrs old, 5'11" 195#. Has been experiencing chest pain, middle of chest, constant pressure like 100# weight on chest. About every 1/2 hr gets real sharp pain takes breath away and pain radiates down left arm. He has been experiencing some dizziness, blurred vision n slurred words. This has lasted over a week now. He's an OTR truck driver. Originally he thought it was anxiety as my health is not well - brain surgery for chiari now have tethered spinal cord  he figured he was just worrying about me.  Anxiety meds did not touch his pain.  Only meds he takes is 20mg of prozac daily and occasional .5 klonapin  Once home, he made appt himself to see family dr (which means he's scared)  Ekg looked normal. BP 150/120. Doc sent him to hospital as he has extensive family history with heart probs. Ekg at hosp normal. BP came down slightly. Xrays good, enzyme tests good. Next day after echo stress test drs said he passed "per se".  Echo showed good blood flow after over 12 min on tm.  However stress test showed some "valvular issue that isnt causing his pain." Father died of heart attack at 76. Brother had same tests 2 yrs ago passed them all but persisted until they did heart cath. Findings - 100%/70%/70% blockages. Both are marathon runners. 32yo niece also cardiac nurse starts w chest pain, passes all same tests but they do stress test with dye and medication. Test shows nothing til HR gets to 140. Found she had 90% blockage of left main. Before DH stress test he was given Toradol at 8am  By noon, chest pressure was somewhat relieved tho not completely.  We were sent home after speaking w cardiologist after stress test  Dr agreed to heart cath husband next week. Question if cath shows no blockages could this valvular issue not really explained cause his pain?  What probs can valvular issues cause?  Pain woke him at 330 this morning. Very worried. Any suggestions as to how to proceed if cath comes back good?  Thank you.

Answer
Hello Worried Wife,

Valve disease would not cause chest pain.

His cath will probably show severe narrowing of some major coronary arteries.  If not, there's a heart trouble called poor small-vessel  function that can cause exertional chest pain.  Not easy to treat but doesn't lead to heart attack or sudden death.

Please write back if this doesn’t answer all your questions, and PLEASE let me know what you find out.

David Richardson

Heart & Cardiology

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David 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.

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