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Heart & Cardiology/Undiagnosed Chest Pain / Racing Heart


Hi Doctor Richardson,

I have experienced over the last three years a variety of strange symptoms.  I am 35 but as I said it started a few years ago, chest pain, pressure, head pressure, tingling in my hands and left foot, and the feeling of a racing heart.  The symptoms have come and gone over the time span, but never really gone away.  I have had a few trips to the ER (one last month), have had several echos, a stress echo, several heart monitors, blood work, etc. All have came back general doctors, who unfortunately retired, was an internist as well as a cardiologist, was at a loss...he considered a possible cath or a calcium scan (which my insurance rejected)...I am curious if there is anything else than can be done?  I do have posture issues due to sclerosis and kyphosis, but have spoken to two ortho specialists and they see that as a non issue...I am also doing physical therapy, and yesterday after a light strength training routine I felt my heart is a daily struggle currently...I feel pressure under my sternum and pressure in my left pectoral, sharp pains from the center to my chest to my armpit, and as I said sometimes it feels like my heart races, even at rest.  I was on a multitude of drugs for symptoms, including metotoprol, zoloft, cympalta, pristiq, lorezapam, etc.  I, over the span of a year, weaned myself off these drugs, noting they did not really help the cause, whatever that is, and typically made me feel worse.  Now I don't know what to do.  I am 35 years old, 5'6", about 180 lbs.  Any advice or help would be appreciated.  Also, I am curious if I should possible consider going to a vascular surgeon and/or a gastro. for an upper GI?  Thank you.

Hello Mr. Malley,

You have no need for other tests in my opinion.  I don't think you will benefit from seeing a vascular surgeon or a gastroenterologist.

Chest pain in a young person is usually cramping of muscles in the chest wall.  If pushing on the painful area modifies the pain (makes it better or worse), or if the pain is relieved by bending the body away from the painful area, that proves the pain is from chest  wall.  Even if these maneuvers donít affect the pain, itís still probably chest wall.  Pain caused by narrowing of the coronary arteries that supply blood to the heart is extremely rare below age 40. Chest wall pain is no threat to life or health, just a big nuisance.  Safest management is just to ignore the pain, though Tylenol, aspirin or ibuprofren usually help.

A racing heart should be helped by metoprolol, 50 mg twice a day.  It races because of anxiety, I guess.

Please write back if this doesnít answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


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.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

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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