Does GERD Cause Chest Pain Over Heart?

Posted on Wed, 25 Jun 2014

Question: I am a 55 year old male. I have been getting chest pains over my heart that hurt really bad. I have had stress tests which came out fine, met with a Pulmonary Specialist who said thing were fine so don't know where to turn. Could GERD be causing my chest pain. It feels like the left side of my sternum ( looking straight ahead) like someone is holding a blunt object against my chest with pressure.

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
More tests!

Detailed Answer:
Dear friend,
Welcome to Health Care Magic

The description of the pain is suggestive of heart pain indeed!
You have the risk factors – Blood Pressure, Diabetes
You are under appropriate treatment - including antiplatelet and cholesterol medication
Stress EKG is reassuring and Pulmonologist has excluded …

As you rightly point out, it is perplexing both for the patient and the physician too
     The next step in such situation is to do an endoscopy as you have suspected – to rule out problems of the food pipe and stomach….
     CT chest may show some XXXXXXX at times…
     If that is normal, the next step is to repeat the TMT with thallium isotope. It is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.
     Subsequent step is to see the ANATOMY (structure) – CT angio is non-invasive study for the anatomy.

The treating doctor alone can suggest further based on his assessment of the situation. A second opinion may shed light at times...
Over The Counter anxiolytics / Muscle relaxants / Proton pump inhibitor like Omeprazole – may be useful in the meanwhile...

Take care
God bless

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (3 hours later)

Had a CT Scan performed, nothing new was found from a CT Scan and Biopsy performed 10 years ago. I had a Upper and Lower GI one year ago with a few small nodes removed but nothing out of the ordinary. The pain feels like somebody pushing a finger hard to the left of my sternum. When I sleep on my left side it seems to aggregate it. Note: My blood pressure is normal.

Answered by Dr. Anantharamakrishnan (7 hours later)

Brief Answer:
CT may be repeated /

Detailed Answer:
Hi

Aggravation by position does not relate to heart pain / rather typical of muscle pain

10 years is too long a time; repeating the CT – particular focus on the spine – to exclude compression or irritation of the nerve roots – is a good option
Muscle relaxants help / Some antidepressants (like tricyclic) and antiepileptic (like gabapentin) elevate the threshold of pain perception and could help

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar