Heart & Cardiology/Chest pains


44yo female with family history of heart disease.  I experience chest pains that radiate to neck, usually on right side.  Have had this wake me in the middle of the night once.  Internist had me go,for full work up. Cardiac echo, ultrasound, EKG, holter monitor (1900 pvc's in 48 hrs.) nuclear MRI /CT scan, stress tet all showing "normal". Why am I experiencing this?  Last night happened again, started on left side intense pain with burning feeling ( for first time) lasted about 20-30 mins. Moved to right side and radiated up neck.  Taking Lopressor Hcl,, Fenofibrate, Simvastatin, Effexor and Valtrex. Frustrated and wondering if we are missing something?

Hello Lisa,

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.

Reflux of acid from stomach to esophagus is the other possibility.  Drink some milk - cream if you have it - then get Maalox or Gelusil and see if that helps.

Please write back if this note 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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