Suggest Treatment For Chest Pain And Breathing Difficulty

Posted on Mon, 8 Aug 2016

Question: I do a trendmill 5 days a week for 40 minutes and cover 1 1/2 miles and feel fine. No chest pains or pressure. I shower and dress and then maybe go out on errands. I walk from a parking lot into a store and i get chest pains and strained breathing. So why would i get no pains on the treadmill and and get pain when I'm just out walking. The pain goes away when i stop walking. What are the differential possibilities?

Answered by Dr. Benard Shehu (2 hours later)

Brief Answer:
Following advice

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Based on the data you provided the first thing to be excluded are chest pain of cardiac origin.

Since you are diabetic with previous heart attacks (you jave done coronary intervention and stents) you may do chest angina with or without chest pain and dyspnea.

This is why I strongly recommend that you should do a stress test (echo stress test, or stress test cardiac schintigraphy) to definitely rule in/out cardiac issues.

If it's negative for induced ischemia than other causes are to be blamed especially lung disorders and stress.

Hope this will be of help!
Wish you health!
Dr. Shehu

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

Follow up: Dr. Benard Shehu (10 hours later)

Not useful. That I already knew. What I was interested in was what else could it be. Why no pain on the treadmill but pain when I'm walking outside?

Answered by Dr. Benard Shehu (18 hours later)

Brief Answer:
Following advice

Detailed Answer:
Hi back,

Let me explain you again. Diabetic patients with previous hostory of ischemic heart disease may do silent cardiac ischemic events including silent myocardial infarction.

Since walking on treadmill may have different speeds from walkin this may explain why you don't experience pain on treadmill.

Moreover the chest pain on exertion depends on the following factors:
- the speed of walking,
- HR
- Blood pressure
- and on the time of exercise.
All these parameters are measured during stress test to evaluate heart ischemia.

If the stress test exclude silent ischemia than your symptoms are associated with the following disorders:
- Osteocondritis, spondyloartrosis and other chest muscle and joints disprders
- Lung disorders
- Stress and anxiety

Hope this will be of help!
Wish you health!
Dr. Shehu

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

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