HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Chest Discomfort On Exercise?

Posted on Mon, 29 Dec 2014

Question: I'm a 58 year old female with long time hyperlipidemia (245 Chol/135 LDL but good HDL 77), family history of heart disease, former smoker and recently diagnosed with small thoracic aortic aneurism (4cm) and PFO. Cannot take statins so doctor has prescribed only exercise/diet. Recently started exercise regime (basically walking, ellipticals) and experience some chest discomfort once heart rate gets to 130 and upward. Have done stress tests and calcium scoring before but all with normal results. Doc wants to do nuclear stress test. Given last stress test (not nuclear) in 2008 was fine, is it worthwhile?

Answered by Dr. Saumya Mittal (3 hours later)

Brief Answer:
cag is best

Detailed Answer:
Hi, I am Dr Mittal. I have read your query. I think I would be able to agree with the doctor.

The fact remains that you have
A. Chest discomfort on exercise.
B. Dyslipidemia, or in other words, raised cholesterol.
C. A family history of heart disease.
D. Your probable age greater than 50 makes you a risk case.

All 3 signs are suggestive of a possible cardiac lesions. I would have ideally suggested cardiac angiography. The test gives best response. If not, better to get next best tests.

I hope that the information helps you. Please feel free to contact us for more information. Best of luck .Dr Mittal.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Saumya Mittal (29 minutes later)

Thanks, Dr. Mittal

Would cardiac angiography provide any proof as to whether there is any problem with the heart's microvessels? (I don't believe a nuclear stress test would; but I'm not sure) Since my cardiac calcium score in 2012 was zero, I would assume that my major arteries are not blocked in any way. Wouldn't it take longer than two years to build up significant blockage to cause chest discomfort? Or are there other causes of blockages other than plaque? And if so, would there be any correlation to evidence of small aneurism on ascending aorta and aortic arch?

Answered by Dr. Saumya Mittal (4 hours later)

Brief Answer:
cardiac angio is the gold standard

Detailed Answer:
Hi,
Cardiac angiography is the best test. All other tests like nuclear test and calcium scores are a rough estimate.
Coronary angiography or CAG will show all the vessel details best as can be seen including the other possibilities like aneurysm, if present in heart vessels.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.

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

Above answer was peer-reviewed by : Dr. Yogesh D