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Question: I went to the er yesterday for chest squeezing in center of chest and a little bit of numbing it stays in the center right above pecs and under throat area and has been going on for a month now doesnt spread they said I have gastritis ive had ekg, echocardiogram, ekg stress test heart enzyme test and chest x ray they said its not my heart its gastritis or erosion in the esaphogus can that cause this constant feeling that doesnt go away at all from morning untill night that constant feeling stays there or is it my heart and they havent caught anything opinions please
Brief Answer:
More likely from the esophagus or stomach
Detailed Answer:
Hello,
Chest pain of any kind first makes one think of the heart. A coronary artery disease is very unlikely at your age unless you have Familial hypercholesterolemia or a congenital abnormality of the heart. A normal tread mill test ( Stress EKG) is very unlikely in a person who has significant coronary artery disease to produce a constant chest pain and normal troponin ( heart enzyme) rules out an injury caused by decreased blood flow to the heart. If you want to exclude a coronary artery disease completely you could do a CT scan of the coronaries.
The esophagus lies behind the heart and many patients with esophageal inflammation come to me with chest pain. An upper gastrointestinal endoscopy will visualize the esophagus, stomach and the duodenum and one can see if there is a lesion in these areas causing the pain.
Till this can be done, you can take a proton pump inhibitor like Losec twice a day and it may give relief.
I am interested in knowing the progress of your symptoms and you are welcome to contact me for any query.
Hope you get well soon
Dr. Noble Zachariah
More likely from the esophagus or stomach
Detailed Answer:
Hello,
Chest pain of any kind first makes one think of the heart. A coronary artery disease is very unlikely at your age unless you have Familial hypercholesterolemia or a congenital abnormality of the heart. A normal tread mill test ( Stress EKG) is very unlikely in a person who has significant coronary artery disease to produce a constant chest pain and normal troponin ( heart enzyme) rules out an injury caused by decreased blood flow to the heart. If you want to exclude a coronary artery disease completely you could do a CT scan of the coronaries.
The esophagus lies behind the heart and many patients with esophageal inflammation come to me with chest pain. An upper gastrointestinal endoscopy will visualize the esophagus, stomach and the duodenum and one can see if there is a lesion in these areas causing the pain.
Till this can be done, you can take a proton pump inhibitor like Losec twice a day and it may give relief.
I am interested in knowing the progress of your symptoms and you are welcome to contact me for any query.
Hope you get well soon
Dr. Noble Zachariah
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
does the echocardiogram check for that as well because mine was normal
Brief Answer:
No
Detailed Answer:
Hi again,
Echocardiogram is to visualize the heart mainly , chamber walls, chambers and the valves mainly. Echo does not visualize the coronary arteries well.
CT coronary angiogram involves injecting a XXXXXXX into the arm vein and the CT scan visualizes the coronary arteries which supply the heart muscles and is the ones affected in the coronary artery disease. If there is a congenital abnormality or narrowing of the arteries or thickening with calcium deposit, all will be visible. The same is conventionally visualized with coronary angiogram in which a catheter is introduced into the coronary arteries and the XXXXXXX is injected. This is an invasive procedure and is associated with a higher risk of complications.
Dr. Noble Zachariah
No
Detailed Answer:
Hi again,
Echocardiogram is to visualize the heart mainly , chamber walls, chambers and the valves mainly. Echo does not visualize the coronary arteries well.
CT coronary angiogram involves injecting a XXXXXXX into the arm vein and the CT scan visualizes the coronary arteries which supply the heart muscles and is the ones affected in the coronary artery disease. If there is a congenital abnormality or narrowing of the arteries or thickening with calcium deposit, all will be visible. The same is conventionally visualized with coronary angiogram in which a catheter is introduced into the coronary arteries and the XXXXXXX is injected. This is an invasive procedure and is associated with a higher risk of complications.
Dr. Noble Zachariah
Above answer was peer-reviewed by :
Dr. Raju A.T
can I still rule out coronary artery disease since everything I told you about earlier came back good and I have no family history of any heart related problems and im 24 year old healthy male
Brief Answer:
Most probably
Detailed Answer:
You do not have coronary artery most probably. But to be absolutely sure you may get a CT coronary angiogram. An upper GI endoscopy would probably visualize the lesion that is causing the pain. Then you can stop worrying and get on with your life.
If you are satisfied with my answer, please close the discussion with your comments. You are welcome to get back to me at anytime if you have any further queries.
Wish you good health
Dr. Noble Zachariah
Most probably
Detailed Answer:
You do not have coronary artery most probably. But to be absolutely sure you may get a CT coronary angiogram. An upper GI endoscopy would probably visualize the lesion that is causing the pain. Then you can stop worrying and get on with your life.
If you are satisfied with my answer, please close the discussion with your comments. You are welcome to get back to me at anytime if you have any further queries.
Wish you good health
Dr. Noble Zachariah
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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