I Have Chest Pain But Had A Normal EKG And Stress Test Why Is It So

Posted on Thu, 17 Mar 2022

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 17 Mar 2022 Answered on

Wed, 8 Jan 2025 Last reviewed on

Question : I have chest pain but had a normal EKG and stress test. The chest pain is worst at night. I walk at least 1 1/2 miles daily and do not have chest pain as severe as I do at rest. in 1999 I had a heart XXXXXXX which revealed a cone shaped enlargement of left coronary artery. I have not been under the care of a cardiologist.

Answered by Dr. Ilir Sharka (21 hours later)

Brief Answer:
My opinion as follows:

Detailed Answer:
Hello,

I understand your concern and would explain that the fact that the chest pain is worst at night is not typical of a cardiac issue.

Nevertheless I would recommend performing a stress cardiac MRI in order to determine if there is presence of myocardial ischemia.

A gastroesophageal reflux can not be excluded either. For this reason I recommend performing a fibrogastroscopy.

Hope you will find this information helpful!

I remain at your disposal in case of further questions whenever you need!

Kind regards!

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

Follow up: Dr. Ilir Sharka (2 hours later)

So the cone shaped enlargement of left coronary artery is not something I should overly worry about? I do have a grade1 left ventricular diastolic impairment and I live in a rural area when access to health care is limited. The local hospital doesn't do coronary artery MRIs so I will have to travel 2 hours to a hospital where the testing is available. And hope I get a referral to another physician. I appreciate your help on clarifying some issues.

Answered by Dr. Ilir Sharka (20 hours later)

Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I think that this test would give more information on any cardiac issues.

Anyway, as the physical stress test is normal, I don’t think that this is anything serious.

I would just recommend taking daily baby aspirin ( blood thinner) and periodically check your blood pressure values.

I would also recommend trying omeprazole during the evening and see if this chest pain is related to your stomach.

Hope you will find this information helpful!

Wishing all the best,

Dr. Iliri

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