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What Causes Intermittent Chest Discomfort While Resting?
Question: Hi
I have chest discomfort comes and goes for like 6 month now . I went 4 times to ER and I did nuclear stress test at rest and while running on treadmill , ECHO , EKG , chest x ray and two CT chest and all were normal. The cardiology want do last test CT coronary ango and he said if this test is normal means my heart is fine but i am concern about the radiation because i did many tests and the side effect of this test . Is it necessary to do this test ?
I forgot to mention the chest discomfort always at rest
I have chest discomfort comes and goes for like 6 month now . I went 4 times to ER and I did nuclear stress test at rest and while running on treadmill , ECHO , EKG , chest x ray and two CT chest and all were normal. The cardiology want do last test CT coronary ango and he said if this test is normal means my heart is fine but i am concern about the radiation because i did many tests and the side effect of this test . Is it necessary to do this test ?
I forgot to mention the chest discomfort always at rest
Brief Answer:
should not be necessary if all other tests are normal
Detailed Answer:
HI, thanks for using healthcare magic
No, based on the different tests that you have already done which have given normal results, the CT angio is not necessary.
If any of the previous tests showed significant abnormal results then this test may be needed.
The nuclear stress test would have shown if there were any areas of the heart that were under stress during activity or rest, any areas with reduced blood supply.
The echo would have shown the structure and function of the heart ,looked at the sizes of the different heart chambers and how they pumped blood
The chest x ray would have given a general idea of the size of the heart and also check out the lungs.
The same for the chest CT though these would have given more information.
The EKG would have looked at the heart rate and looked at the conduction of impulses through the heart. Abnormalities can also occur if there are areas of reduced blood supply because these areas cannot conduct blood properly.
The fact that the pain occurs at rest also makes it less likely to be the heart.
Chest pain can be related to any structure in the chest from the skin inwards: skin, muscles, bones, esophagus, lungs, heart
The CTs would have shown if there was a structural cause (abnormal shape or size or presence of a mass)
I hope this helps, feel free to ask any other questions
should not be necessary if all other tests are normal
Detailed Answer:
HI, thanks for using healthcare magic
No, based on the different tests that you have already done which have given normal results, the CT angio is not necessary.
If any of the previous tests showed significant abnormal results then this test may be needed.
The nuclear stress test would have shown if there were any areas of the heart that were under stress during activity or rest, any areas with reduced blood supply.
The echo would have shown the structure and function of the heart ,looked at the sizes of the different heart chambers and how they pumped blood
The chest x ray would have given a general idea of the size of the heart and also check out the lungs.
The same for the chest CT though these would have given more information.
The EKG would have looked at the heart rate and looked at the conduction of impulses through the heart. Abnormalities can also occur if there are areas of reduced blood supply because these areas cannot conduct blood properly.
The fact that the pain occurs at rest also makes it less likely to be the heart.
Chest pain can be related to any structure in the chest from the skin inwards: skin, muscles, bones, esophagus, lungs, heart
The CTs would have shown if there was a structural cause (abnormal shape or size or presence of a mass)
I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for detailed answer but another doctor here recommend me to do it he said "You are 30 years old with pain in chest - discomfort in heart area. This is sufficient reason for the test and the most important is that it is advised by your Doctor as he/she would have a suspicion.
Best to rule out so that nothing remains in mind about cardiac problem being the possible cause of your symptoms.
Please discuss with your Doctor about the availability of other forms of cardiac angiography like MRI angiography in which there is no radiation or the conventional one in which there is not much of radiation.
Infection, irregular heart beats and bleeding are very rare complications so not to worry about these much.
Please discuss again with the Doctor who has advised and follow his advise as he has done the clinical evaluation in your case"
but i am concern about radiation and side effect of the test . what do you think ?
Best to rule out so that nothing remains in mind about cardiac problem being the possible cause of your symptoms.
Please discuss with your Doctor about the availability of other forms of cardiac angiography like MRI angiography in which there is no radiation or the conventional one in which there is not much of radiation.
Infection, irregular heart beats and bleeding are very rare complications so not to worry about these much.
Please discuss again with the Doctor who has advised and follow his advise as he has done the clinical evaluation in your case"
but i am concern about radiation and side effect of the test . what do you think ?
Brief Answer:
risk is low
Detailed Answer:
HI
You mentioned that you had a chest x ray and 2 previous CT. X rays use a small amount of radiation.
CT scans are associated with higher levels but still both imaging techniques are associated with a low risk of cancer.
Acc to one medical article, a CT scan with a dose of 10 msv (dose of radiation) is associated with a risk of 1 in 2000 of fatal cancer occurring, the risk to the population without exposure to radiation is 1 in 5 which is a lot lower.
This means that there is a risk due to exposure the radiation, the risk is low so if you are still unsure, you can have the test done.
As you mentioned, the discomfort is in the chest but the heart is not the only organ in the chest and you have been tested re your heart multiple times.
When a person is at rest, the heart does not need to work as hard as when a person is active.
This is the reason that heart related pain tends to occur with activity.
The fact that your pain occurs with rest reduces the chance that the heart is involved
risk is low
Detailed Answer:
HI
You mentioned that you had a chest x ray and 2 previous CT. X rays use a small amount of radiation.
CT scans are associated with higher levels but still both imaging techniques are associated with a low risk of cancer.
Acc to one medical article, a CT scan with a dose of 10 msv (dose of radiation) is associated with a risk of 1 in 2000 of fatal cancer occurring, the risk to the population without exposure to radiation is 1 in 5 which is a lot lower.
This means that there is a risk due to exposure the radiation, the risk is low so if you are still unsure, you can have the test done.
As you mentioned, the discomfort is in the chest but the heart is not the only organ in the chest and you have been tested re your heart multiple times.
When a person is at rest, the heart does not need to work as hard as when a person is active.
This is the reason that heart related pain tends to occur with activity.
The fact that your pain occurs with rest reduces the chance that the heart is involved
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok, i already make appointment because some time i feel discomfort in the chest near heart area and bothered me . the doctor seem didn't have another option without doing this test . and he want to rule out any heart issue before doing another tests. i forgot to mention also when i have chest discomfort and when i take propranolol 20 mg i feel better . I take propranolol only when i need it . Do you recommend doing this test and is it safe ? because i heard have side effect like radiation , increase heart bear and others
Brief Answer:
can have it done
Detailed Answer:
HI
You can have it done if it will reassure you regarding the chest pain. It would have a low risk.
Propanalol has a number of different uses, it is used to help with tremors, control heart rate in those with abnormal rhythms due to intrinsic heart disease, those with abnormal rhythms due to thyroid disease or controlling heart rate in anxiety.
can have it done
Detailed Answer:
HI
You can have it done if it will reassure you regarding the chest pain. It would have a low risk.
Propanalol has a number of different uses, it is used to help with tremors, control heart rate in those with abnormal rhythms due to intrinsic heart disease, those with abnormal rhythms due to thyroid disease or controlling heart rate in anxiety.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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