Are Severe Fatigue And Chest Pain Signs Of Heart Problem?

Posted on Thu, 17 Mar 2016

Question: Hi, I am a 47 year old healthy female, and I recently went to Urgent Care due to fatigue and chest pain on exertion (like climbing the stairs). EKG and chest x-ray were normal. Blood work normal, aside from slightly high MPV (14.1). I'm feeling better currently but am wondering if anything else on CBC (or combination of results) might show sign of heart problem?

Answered by Dr. Saddiq Ulabidin (2 hours later)

Brief Answer:
You need to have cardiac enzymes and ETT for further reassurance

Detailed Answer:
Hi! Welcome to health care magic!

Thanks for sharing your concerns with us, and we will try to help you in best way possible. Based on the history you have shared, it is always good to get evaluated for symptoms like exertional dyspnoea and chest pain as both can be related to any abnormality with vital organs like heart, lungs or kidneys.

However since EKG and Xray was normal, so bigger issues relating to acute or aggressive ischemic heart diseases or lungs pathologies are essentially ruled out. However further reassuarance can be achieved if symptoms persist despite normal EKG through echo cardiogram, cardiac enzymes and ETT. Since in your case symptoms have decreased you can wait a while and monitoring for future trends in your symptoms.

Increased MPV that you are concerned about is probably an incidental finding and is not likely to be related to heart ailment. Further there are no factors in complete blood count which specifically indicates heart disease. Only way high MPV can contribute is by making clots in your blood vessels which doesn't seem to be the case on EKG. You may only repeat CBC after three month to see the fate of MPV. It isn't alarming at this stage. You can have peripheral film with CBC in next labs to look for atypical or immature platelets in blood stream. You can also discuss using low dose aspirin regularly for antinplatelets treatment which can keep blood vessels open and avoid formation of clots.

Wishing you good health. If you have any more questions, feel free to ask. Regards.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Saddiq Ulabidin (8 hours later)

Thank you for you thorough response. Other things I forgot to mention--I have started going through menopause and have not been sleeping well. Also dealing with some major stressors like planning a wedding and buying a house. And last Aug. I did the hcg diet. I lost 13 lbs. and kept it off. I'm at 112 now, which was my old normal weight. I'm not dieting anymore but I'm probably on the low end of calories. Would any of this be related to chest pain?

Answered by Dr. Saddiq Ulabidin (2 hours later)

Brief Answer:
These are nonspecific associations with chest pain

Detailed Answer:
Hi!
Thanks for the appreciation.

Though all these associated issue which you have mentioned, have no direct correlation with chest pain but stress or anxiety induced fast heart beats or palpitations can explain mild chest pain, but then again normal EKG rules that out. None of other issues are any worrisome. For stress and anxiety leading to disturbed sleep you may consult a psychiatrist for appropriate anxiolytics as none of those can be prescribed without proper evaluation by a psychiatrist. Try to take sometime out for yourself and get some refreshing activity like hanging out with friends or drive out. These all may help with your symptoms.

Regards.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj