Not All Chest Pain Comes From The Heart

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DEAR DR. DONOHUE: I am a 38-year-old woman who has a very stressful job. It is also very well-paying, so I don’t want to give it up. I think it might be giving me chest pain. The pain comes and goes unpredictably. Sometimes I am just sitting at my desk, and I get a squeezing sensation in my chest. At other times, I had been hurrying around.

I have had several EKGs, been examined by three doctors, had a stress test and a radioactive stress test. The doctors say my heart is healthy, and the chest pain could come from stress. In speaking with people I trust, I have been told to have a heart catheterization. What do you think? — P.A.

ANSWER: None of your three doctors told you that. Don’t you think they might know more than your friends? You have to be guided by advice given to you by those who have had experience in assessing people’s complaints. There’s no pattern to your chest pain. Heart pain, in contrast, causes chest pain when a person is physically active. That pain goes when the person rests. Your kind of pain is not suggestive of a heart disorder.

Your doctors have told you that your heart is healthy. You have had EKGs, stress tests and even a radioactive stress test. Those tests would have disclosed a heart problem if you had one.

Furthermore, you are only 38 years old — not an age for heart problems to occur. You mention no family history of heart trouble at early ages.

With a catheterization, a thin, pliable tube is inched from a groin blood vessel to the site where the heart arteries are found. There, dye is injected so doctors can visualize the health of heart arteries. The doctors can spot any obstructions, like cholesterol buildup, in those arteries. It’s an amazing test. However, complications can arise from any procedure that invades the body. When the detection of heart disease can be accomplished in no other way, information from a catheterization is justified. In your case, it’s not.

Stress is the most likely cause of your chest pain.

Coronary artery disease is the No. 1 cause of death in most of the world’s countries. The booklet on that subject explains in detail its symptoms and its treatments. To order a copy, write: Dr. Donohue — No. 101W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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