Heart & Cardiology/Heart Distress


Hi, my name is Dominik, I'm a 19 year old athletic male, I'm 5'9 and 175 pounds. For the past 6 months I've been having some problems with what I believe to be my heart. I play high level hockey and recently had to quit because my heart has not been responding well to even the slightest exercise. I can walk a couple of steps and my heart rate will spike to 140 and with even the slightest exercise my heart rate will jump to 180. Most of the time I have a pressure on my chest dead centre of my sternum and a squeezing feeling of my heart which gets worse during exercise. After even a little exercise, I will begin to feel very light headed when I rest and I will be VERY fatigued aswell as a very full feeling in my chest. I have no history of sudden death or heart disease in my family before the age of 60. I have had a chest x ray, an ECG, an exercise stress test aswell as an echocardiogram and a full set of cardio logical blood tests including a d dimer. My cardiologist reviewed all the tests and he says my heart is perfectly healthy and there is nothing to worry about and my GP says its anxiety related. My question is, is it possibly cardiac related and the cardiologist missed something or can it be due to some anxiety that I don't even feel? I really want to play sports again but my heart does not allow it at the present time and it's really putting a damper on my life. Is there any chance of sudden cardiac death or anything of that sort with such apparently perfect test results? Thank you sir.

Hello Dominik,

With normal echo and stress test, heart trouble is an unlikely cause of your symptoms, but there is one heart trouble that might cause your symptoms.  It's poor function of the tiny branches of the coronary arteries that supply blood to the heart.  Treatment is difficult, tho the outlook for life is good.  See if nitroglycerine melted under your tongue will help, and try long-acting cousins of nitroglycerine like isosorbide and a nitroglycerine patch applied to your skin above the waistline.  The only way to make the diagnosis is an EKG during severe chest pain, but I presume the stress test didn't show EKG change even though you had chest pain during the test.

Please write back if this note doesnմ answer all your questions, and PLEASE let me know if you find a good explanation for your symptoms or if nitroglycerine and its cousins help.

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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