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I Was Wondering If I Should Seek A Second Opinion

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Posted on Mon, 5 Aug 2019
Twitter Mon, 5 Aug 2019 Answered on
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Question : I was wondering if I should seek a second opinion. I experience on and off chest pain (mild and seemingly random locations can be upper left, upper right, lower right, lower left but usually stays there for an hour or so or until I "stop noticing it"). I have periods of these intermittent pains flaring up every month or so and I'd say for a week at a time and then it won't happen until the next month. I have seen a cardiologist and was told it was just musculoskeletal pain as it was very unlikely I had heart issues at my age (25) and passed a stress test fine and my EKGs came back good. This is what was presented to the cardiologist in my case:
1. I am currently 240 pounds 5'11, recently lost 28 pounds and no drop in blood pressure (was high at 268 and stood about the same at 240) and a slight drop in cholesterol when losing the weight.
2. I have had high cholesterol since I was 13 years old (main reason why I am concerned with early heart disease).
3. My family has a history of heart disease with my uncle and grandfather both dying suddenly of a heart attack around age of 55 (one was very overweight and the other was a heavy smoker).
4. I do not smoke
5. My EKG was normal both times at 268 pounds and 240. And I passed the stress test at 268 pounds.
6. I have recurring lower back pain every three months or so that pretty much debilitates me for a day (never mentioned this to cardiologist but I just recently learned this can also be a sign of CVD).
7. Always had an issue with lockjaw when yawning too hard (may be irrelevant but also learned jaw pain can be an indicator).
8. When I was heavier I would have dizzyness when I stood up too fast after sitting for a long time but this seems to have disappeared after losing weight.
9. Pain gets slightly worse some of the times when I apply pressure or when I bend my upper body to left or right, this isn't consistent though.
10. Not on any blood pressure or cholesterol medication, I asked if I should last time and he said not at my age despite me having pretty high cholesterol since I was 13 (usually ranged from 210-230 if I remember correctly).

What would you diagnose this with the information given? Should I push for further testing? Is there a way to definitely determine if it is musculoskeletal pain? I have a yearly appointment with the cardiologist coming up with a full lipid panel etc. Is there anything specific I should bring up to him?

Thank you!
doctor
Answered by Dr. Bhanu Partap (46 minutes later)
Brief Answer:
Nothing to worry

Detailed Answer:
Hello

After going through the medical details provided by you I can understand your concern for your health and well being and I would like to assure you that all the symptoms which you are experiencing or not because of any cardiac issue as your stress test was negative.

All these muscle aches and tenderness could be due to your changing body Pattern and your changed diet.

The only test that can confirm the presence or absence of coronary artery disease is angiography. But that is not required in your case.

Just continue your weight loss journey in a bit easy more and maintain healthy lifestyle routine with proper diet and regular exercise.

Feel free to ask if you have any other doubts.

Kind Regards
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Bhanu Partap (41 minutes later)
Thank you for the insight Dr. Partap. What type of doctor/specialist would you recommend to address this widespread pain? It is mild like I said and doesn't really hinder my everyday activities other than setting my anxiety off which probably exaggerates the chest pain. My main concern with the pain is that apparently most of these musculoskeletal issues resolve themselves in a decent amount of time but this pain has never failed to constantly show back up every month for a good 6 years at this point even before I started losing weight which is why I thought it was angina originally.
doctor
Answered by Dr. Bhanu Partap (8 hours later)
Brief Answer:
Hello again

Detailed Answer:
First of all stop worrying as this is not angina.

Secondly for proper pain management you can consult with a pain therapist or a psychologist personally.

Hope to have been helpful.

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

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Bhanu Partap

Cardiologist

Practicing since :2010

Answered : 4733 Questions

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I Was Wondering If I Should Seek A Second Opinion

Brief Answer: Nothing to worry Detailed Answer: Hello After going through the medical details provided by you I can understand your concern for your health and well being and I would like to assure you that all the symptoms which you are experiencing or not because of any cardiac issue as your stress test was negative. All these muscle aches and tenderness could be due to your changing body Pattern and your changed diet. The only test that can confirm the presence or absence of coronary artery disease is angiography. But that is not required in your case. Just continue your weight loss journey in a bit easy more and maintain healthy lifestyle routine with proper diet and regular exercise. Feel free to ask if you have any other doubts. Kind Regards