Heart & Cardiology/heart attack?


I am a 24 year old female. For about the past 12 months I have had left arm and shoulder pain, trouble breathing/shortness of breath, hot flashes, jaw pain, chest pain and slight dizzy spells. I went to a cardiologist around May of last year and he did an ekg, blood work, and an echo. He said all of my resuts were great and that my arm pain was not heart related. He wrote me a script for tranquilizers. this was my second visit to him over the past 4 years with the same tests and the same results. I was bulimic for a period of time but both tests were after I stopped. I was a casual smoker, have not touched one in months since I am pregnant now. My insurance would not cover any further testing since I do not appear to have any risk factors. Should I be worried? Could this really just be anxiety? Should I demand further testing?

Hello Spencer,

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.

Not anxiety, but a normal occurrence.

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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