Heart & Cardiology/Chest Discomfort


QUESTION: Hello Dr. im 27 years old male , 10-15 kilos overweight , no family history of heart disease the problem is i have chest,jaw discomfort mainly when sitting or in bed its not worse when moving/climbing stairs sometimes is gone when active sometimes is the same but not worse,on scale from 1 to 10 its like 4-5.Last year i had Stress ECG(i wanted this test the doc say its not needed) it was clear, 7 months ago i had resting echo and blood tests which were normal except the echo report slight mitral valve prolapse (According to Dr. nothing worrying),last week i rushed to the ER again for chest/jaw pain in the ER they took BP and did resting ECG and consulted with cardiologist who said that in his opinion it is not the heart and send me home.But i cannot stop thinking its angina what is your opinion could it be this ?
Total Cholesterol - 5.6 mmol/L,HDL - 1.11 mmol/L,Blood Glucose 4.5mmol/L , BP ranges between 110-130 over 65/80,i have smoked cigarettes till last year (started when i was 16) last year i switched to E-Cig. Im sorry for the bad english and thank you for your response.

ANSWER: Hi, i doubt you have any significant heart blockages (http://blog.myheart.net/2014/06/08/heart-blockage-explained-with-pictures/) based on the information you have given. Some reading that you may find useful is http://blog.myheart.net/2013/06/18/angina-or-some-other-chest-pain/, http://blog.myheart.net/2013/06/20/what-kind-of-chest-pain-is-it/, http://blog.myheart.net/2013/06/20/still-more-types-of-chest-pain/.

The good news is that you are in a low risk group. Your age, no family history of premature disease, good blood pressure and normal stress test all place you in this group. Its excellent you stopped smoking. Also during your symptoms an EKG and blood tests argue strongly against heart disease. The symptoms you are having therefore are unlikely to be related to heart disease, and its reassuring to me that you have been seen by a cardiologist that has reviewed these tests and given you the OK. Im not sure what the symptoms are, however the good thing is that many of the serious causes of chest pain appear to be ruled out. I would concentrate on a healthy lifestyle and continuing to pay attention to risk factors for cardiovascular disease.

Hope that was helpful

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for the informative answer.
But i want to clear couple of things.
1- By the time i arrived in the ER i did not have the chest pain.
2- In the ER the just take 2 BP readings (left and right arm) and 1 resting ECG that`s it.
3- The blood tests and resting echo was taken 7 months ago becaus of different complains (documented sinus tachy 150 bpm),the ECG stress test 1 year ago was because of similar complains of chest and left arm pain.

The pain is tightness in chest with no jaw (sometimes left arm not every time)discomfort with different durations last time it was a mix like tightness and sharp pain together but when i get up from the bed and start rushing to the ER the pain starting to go away and by the time i was there 30 minutes later was completely gone.
In every test there was cardiologist present and they all say the same (you are too young to have CAD and your test are normal live your life) and also " I would concentrate on a healthy lifestyle and continuing to pay attention to risk factors for cardiovascular disease." The same thing you said. So after this does your answer still apply for me ?

PS:Im just so confused every time there is different type of symptom.
And again thank you for your kindness and great advises you are a truly great person for helping people here.

Hi, http://blog.myheart.net/2014/11/20/troponin-levels-the-heart-attack-blood-test/, http://blog.myheart.net/2014/03/17/do-i-need-a-stress-test/

Its very difficult to give you advice in this setting without having seen you and taken a history etc. What does appear clear is the following. You are in a low risk group, given multiple factors including your previous tests. There are two scenarios here, the first is that you have underlying blockages that are severe enough to cause symptoms, the other is that you are having unstable events. In the first case, you are unlikely to have obstructive disease because of your low risk and also the normal testing indicating no blood supply problems. in the second case, you are unlikely to be having unstable events because your blood tests are normal and your tests show no evidence of damage. These are the reasons people are not worried. In the past you have had some of these tests while the pain was present, and the normal results of the ekg and blood tests make spasm unlikely.

hope that was helpful,  

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Mustafa Ahmed MD


Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease


Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology


Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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