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DrThomasMd, Board Certified Physician
Category: Cardiology
Satisfied Customers: 64074
Experience:  Classical homeopath also board certified in integrative and holistic medicine. Many years of practice, also all of medicine.
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I am a 37 yr old Male. Height 5'10” & Weight 115kg approx

Customer Question

Hi, I am a 37 yr old Male. Height 5’10” & Weight 115kg approx. I have type 2 diabetes and I take 1 metformin tablet daily (500mg). Currently, I am having chest pressure intermittently throughout the day. Sometimes It happens during the night , sometimes during the day while sitting on desk working on computer etc. It all started on 15th July @ 1:30AM when I woke up with similar sort of chest pressure / heart palpitations / left arm numbness (which may have been caused due to neck pain I had since few days ago or sleeping at wrong angle). I called 911 and the operator told me to chew 4 low dose aspirins while paramedics arrived. After the arrival of paramedics, I was asked standard question if I had any dizziness / shortness of breath etc (which I didn’t) so they asked me to chew 2 more low dose aspirins and I was given 2 sprays of nitroglycerin (maybe 10 min interval in between) and that caused some light headedness (I was told by paramedics that is one of side effects of nitro glycerin). I was then taken to ER where they did blood tests and ECG and I was told that blood work or ECG didn’t show and signs of myocardial infraction and I discharged around 7AM. Chest x-ray showed slight hilar adenopathy and to confirm that I have been called back for a CT scan on 22nd July. Same day (15th July) around 5PM I started having same pressure in chest and I was trying to get answers from 24hrs nurse helpline but they asked me to call 911, operator asked me to chew 4 low dose aspirins while they sent paramedics again. This time the paramedics showed me that my BP & pulse was unusually high at 169/103/125 (reading taken at 7:28 PM) and right after that they gave me a spray of nitroglycerin and I had instant chest pressure relief and my BP / pulse rate also dropped (I don’t recall exact readings). Paramedics took me back to ER and this time since my status was “resolved” so they didn’t cart me in and I had to wait in the ER for rest of the tests. While I was waiting in the ER, I seemed to have chest pressure buildups every hour (5-10 min duration) well past mid night and every time I took a sip of water and swallowed it gave me relief. They ran 2 blood tests at 2 hr intervals as well as ECG and they were negative for myocardial infraction and I discharged around 2AM (16th July). I had a graded treadmill stress test at 1:50PM (16th July) which was clean but by the end of the test I had same chest pressure so the tech told me that I should talk to the attending cardiologist, I updated him whatever transpired in the past 2 days and that I climb 30 floors of stairs on most weekday mornings and swim frequently in the evening and never had any issues with the heart etc. Cardiologist advised me to wear a chest holster for 48hrs (17th 10:40AM – 19th July 10:40AM), plus asked for another bloodwork (to check for Cholesterol which I don’t have as per my yearly blood tests since past 3 years and my diabetes is well under control as per my family doctor who does my bloodwork every quarter) + Stress Echo to be done (on 22nd August) and another consult with him.
Since 16th July, I have had several occurrence of same chest pressure buildup (with no other signs of dizziness / shortness of breath etc) and on all instances this chest pressure buildup happened while I was sitting on desk working on my computer or sleeping. I was checking on web and my symptoms match prinzmetals angina (I maybe wrong). I have been monitoring my BP & pulse using a digital monitor whenever I have similar chest pressure and it is always at good level i.e. Systolic 120+-5 / Diastolic 80+-5 / Pulse 80+- 5. Since my cardiologist consultation is quiet far off I was wondering what else I could do to diagnose my condition and get relief? I have scanned images of all the blood work that was done by ER + all the previous tests dating back to march ‘2012 + even a stress echo done in march’2012 and it was clean, so I can upload all these files if the cardiologist wants to review them. Right before I posted this question online, I had pressure buildup again around 6:50PM ET and I took ENO (it’s an ayurvedic antacid manufactured GSK in India) and the pressure went down immediately and it hasn’t come back as of yet (1 hr later, current time is 7:55PM ET)
Please advise.
Submitted: 1 year ago.
Category: Cardiology
Customer: replied 1 year ago.
I am a non smoker and casual alcohol drinker (3 X 331ml 5% beer or 150ml 40% scotch).
Customer: replied 1 year ago.
I have uploaded following 3 files, let me know if I should upload the remaining quarterly blood test results for the past few years + stress echo results done back on Mar'2012? -
1). Nishant blood test results from centenary hospital 15jul15
2). Nishant ECG 15jul15
3). Nishant ECG readout just before paramedics gave NitroGlycerin spray 20150715_200203
Customer: replied 1 year ago.
I forgot to add that this morning when I had chest pressure in the morning, I also had left arm pain and numbness which lasted for few hours.
Expert:  DrThomasMd replied 1 year ago.
We answer questions on the site
What is your exact question?
Customer: replied 1 year ago.
Dr. Thomas, I have put all the details regarding my situation and my specific question was - Since my cardiologist consultation is quiet far off (21st August) I was wondering what else I could do to diagnose my condition and get relief in the interim?
Expert:  DrThomasMd replied 1 year ago.
Absolutely nothing that you can do to diagnose your condition in the interim.
We also do not diagnose or treat on line, or replace your doctor visit.
We answer specific questions.
There is no evidence of heart disease here.
So, what is your specific question
Customer: replied 1 year ago.
Do my symptoms match prinzmetals angina?
Expert:  DrThomasMd replied 1 year ago.
It is possible.
However, that should respond to a calcium channel blocker.
They could just as likely be esophageal spasm, which will respond to the same drug.
However, there are no EKG findings to support angina.
Microvascular angina can not always be diagnosed even with a stress test.
Stress echo is better, but not totally reliable.
If there is a major concern on the part of the cardiologist, an angiogram should be done.
please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.