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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severe Radiating Pain In Chest And Jaws. Suspecting Coronary Artery Spasm. Earlier Had Oesophagal Spasm And GIRT. How To Diagnose?

I have had esophagus spasms for many years, along with GIRT, and in 2007 I was tested by a heart specialist for ischemia. The testing was extensive and included a myocardial SPECT study. The findings were: no scintigraphic evidence of significant adenosine-induced ischemia. Normal LV wall motion. LVEF approximately 55%. I do not know exactly what that all means, except that the doctor said my heart was ok. Now, 7 years later the pain is not only in my chest, but sometimes starts in my jaws, or throat--the pain radiates into my jaws, ears, tongue and sometimes the roof of my mouth. The pain is intense and all I can think to do is take the nitro that was prescribed for the esophagus spasms. Recently I went to a specialist to check on the increased pain in the throat, ears, jaws and tongue and the specialist told me that those locations have nothing to do, and do not tie in with the esophagus spasms. My son looked into angina on the internet and found a type of angina that is caused by coronary artery spasms. This type of angina occurs while at rest---which fits my symptoms. My question now is would the tests done in 2007 Cardiac Pharmacologic Stress/Rest Perfusion SPECT with Gated Wall Motion/LVEF Analysis have been able to detect this type of angina? Also, how can Coronary Artery Spasms be diagnosed unless I am having one?
Sat, 16 Nov 2013
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Cardiologist 's  Response
Hi,
I read your query and would like to say that:
You have to do a complete heart check up (ECG, ECHO, stress test, Coronary CT, stress SPECT scan).
If all the things are normal i would say don't worry, if any thing is wrong than you should do the angiography.
If cornary spasm is documented (variant angina) than the best treatment option is to use Calcium blockers (nifedipin, amlodipin ect)
Hope i answered your question?
Dr. Benard
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Severe Radiating Pain In Chest And Jaws. Suspecting Coronary Artery Spasm. Earlier Had Oesophagal Spasm And GIRT. How To Diagnose?

Hi, I read your query and would like to say that: You have to do a complete heart check up (ECG, ECHO, stress test, Coronary CT, stress SPECT scan). If all the things are normal i would say don t worry, if any thing is wrong than you should do the angiography. If cornary spasm is documented (variant angina) than the best treatment option is to use Calcium blockers (nifedipin, amlodipin ect) Hope i answered your question? Dr. Benard