Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

Regarding your concern, I would explain that, facing your young age, and all the performed cardiac tests (resting ECG, cardiac ultrasound, stress test), it may be concluded that your pain is much less likely to be cardiac related.

In your case, other possible alternative causes should be sought.

A comprehensive medical evaluation (physical examination coupled with additional medical tests) may help to reveal the exact reason for your pain.

After concluding normal cardiac tests, and judging your excellent physical performance, major chest syndromes (acute coronary syndrome, acute aortic syndrome, pulmonary embolism) are excluded first.

I would be more suspicious about chest wall structures and other extra-cardiac thoracic disorders as a source of pain.

A thorough physical exam of intercostal muscles for possible injuries, costochondral joints for inflammation, backbone for possible inter-vertebral disc abnomaly (protrusion, herniation, etc);a chest X ray study for possible pleural inflammation, adhesion, pulmonary and bronchial serious lesions, like rupture of a bullous emphysema, or other specific imagine test to reveal possible esophageal spasms, sometimes even an abdominal ultrasound to reveal possible gallbladder stones which may be experienced as chest pain, sometimes a skin inspection for possible shingles (herpes Zoster), blood tests like complete blood count and PCR to rule out inflammation, etc would be helpful in the differential diagnosis of chest pain.

You need to discuss with your attending doctor (GP or internist), to find the best modalities for ruling in/out the above potential triggering factor of your pain, by checking one by one.

Eventually more complex imagine tests, like chest CT or MRI, fibrogastroscopy, etc. may be used to clarify the diagnosis.

Hope to have been helpful to you!

Feel free to ask me whenever you need! Greetings! Dr. Iliri

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Brief Answer:
You need to consult a neurologist.

Detailed Answer:


Hi XXXXXXX

Serious cardio-pulmonary disorders seem to be excluded by your preliminary performed tests.

I mentioned above several extra cardiac sources of a thoracic pain. Seems that you need to investigate first a possible implications of your backbone structure on pain symptomatology.

Frequently, degeneration of cervical-thoracic backbone structures (disc protrusion, herniation, vertebral degeneration, etc) may lead to important pain irradiating to the chest, arms and neck.

A strenuous physical activity as you described, may yield similar symptoms by imposing an increased tension to affected structures.

I recommend you to consult with a neurologist for a medical review of your cervical disc protrusion, and deciding the best therapeutic option (physiotherapy, painkiller medication, cervical collar, etc).

Best regards,

Dr. Iliri

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Brief Answer:
A thorough investigation is necessary.

Detailed Answer:


Hello!

Ischemic angina may be present for seconds, minutes or even for hours.

If it were angina, your cardiac tests, would have revealed it with a great probability (especially cardiac stress test). The same is true for your frequent exertions (climbing stairs or pushing ups, etc)

There is strong suspicions that your cervical disc abnormality may be a source of pain.

Nevertheless, it remains to be thoroughly investigated. That's why I recommend you to discuss with your neurologist.

At the end, I would like to reassure that your complains do not seem to be heart related at all.

Greetings! Dr. Iliri

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Brief Answer:
There is nothing to worry about your heart.

Detailed Answer:

Hi XXXX!

Your cardiac tests have excluded any serious heart disorders.

You are actually on healthy heart conditions. So relax!

Whether your complains are related to a protruding inter-vertebral disc or an acid reflux, it remains on your attending doctor's decision, after comprehensively reviewing all the medical information gathered by prior and current complains history, physical exam, and medical tests as well.

Best wishes! Dr. Iliri

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Brief Answer:
It is quite a normal heart response.

Detailed Answer:

Hello XXXX!

Increased heart rate is normal when performing physical activity. Facing your young age, as far as your heart rhythm is normal sinus one, there is nothing to worry about your heart rate.

It is quite a normal response. So relax!

Regards,

Dr. Iliri

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