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Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 8630
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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This is about my 75 year old dad. Background... Never seen a

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Hi, this is about my 75 year old dad. Background... Never seen a man in such good shape. 150 lbs, still works on the the farm from morning till night. He still water skis on one ski, last summer he still barefoot water skied. (no skis). His pulse is usually about 65. Just a couple of weeks ago he was lifting 50 lb bags of seed up a ladder to a seed tank.
Any way, he told me a few days ago that he had been having a discomfort below his rib cage, sort of discomfort or burning up the middle of his chest and into his jaw. (for 3 weeks). He said the chest and jaw discomfort came with PHYSICAL EXSERTION, the gut was there a lot more of the time. A couple of days later we went to ER. They did blood work, chest Xray and EKG. Everything 100% normal.
Did Stress test today. May 30. Dr. said as the stress test went on, as dad got more physically tired on the treadmill, his blood pressure went lower.
So they said this was BAD news, and that he needed an angiogram.
So we are waiting on that now.
He has not had shortness of breath, no chest pain that people always talk about, like pressure. Just that feeling from his gut to his jaw.(including the jaw)
Today in the evening he said that the indigestion feeling in his gut and feeling in his chest was gone, but his jaw was now bothering him.
He even had a phone call that made him anxious this evening, and he said
the jaw felt worse with the anxiety.
Yet he feels ok. He has been told not to lift anything or not to exert himself. That drives him crazy. He said, "I guess I'll plant flowers tomorrow".
The symptom on the stress test, "blood pressure lower" as the test went on, is that bad? Or could this be anything else?
Like I said, blood work , Xray and EKG, 100%.
We just don't want to believe it's heart or artery related. But maybe it is? He does have Nitro just in case.
If the jaw is heart related, (which it can be) is this instead of having a chest pain? Should he be taking Nitro with this Jaw discomfort?
Please help. Jonathon

HI, Thanks for your question. My name is***** and I am here to help you today. I will be happy to help you with your follow-up questions also. I am sorry for the delay but I need few details.

Has he tried nitro during this jaw discomfort and did he feel relieved with nitro?

Where exactly in the jaw, he feels the discomfort?

Any pain on pressing the jaw?

The discomfort he felt in chest was in midline of chest in straight line or to the right or left side of chest?


Customer: replied 4 years ago.

Hi, Thank you so much for your time.

Even if this is bad news coming, please be honest. I just had a long talk with my dad and will try and answer your questions.

He told me today that his gut discomfort that ran up his chest has not come about for a few days. Now it's mainly in his jaw, it can come any time, but more with exertion. He says the jaw discomfort starts sort of

where you swallow (adams apple) to underneath the jaw in the meaty part. He says it feels sort of like it gets big. He mentions sometimes he also has a little tingling in his tongue. He also has had what feels like a quivering bot***** *****p, It's not actually quivering but felt like it.

The chest symptoms he had for a while and ended a few days ago were in the center in a straight line. Not to right or left. Not with pressure. just sort of burning.

No pain pressing the jaw.

He says the Nitro seems to help after a couple minuets.

He told me he feels like he could run to the road, (which is a couple hundred feet.) He feels good, other than getting this jaw symptom.

Don't worry he will not run to the road, he is taking utmost precaution right now.

He has had no arm pain, no back pain, (ever) and for a few days now, no chest or gut discomfort. Just jaw. No shortness of breath at all, ever.

Remember, his blood pressure had gone down during stress test, that immediately concerned the doctor.

He has been a health conscious person all his life. Vitamins, cholesterol a little high side of normal, very conscious of what he eats.

If this is heart related, it must be genetic. Because he has done things right. They had done EKG at stress test, they want to compare that to stress test a 4 or 5 days earlier, have not heard about that. But

last Sunday night, blood, Xray, and Ekg were normal. I do not know what it showed Thursday.



Jonathon thanks a lot for your input. I am sorry to hear about your father's problem. First of all i would like to clarify that on history only sometime nothing can be said with confidence. That is the place where the role of investigations begins. There are certain aspects which are in favor of heart related problems and certain which make other causes more likely. Fortunately there is just one symptom which is in favor of heart and that is help with nitro. Other than this everything else is in favor of other causes like GERD or isolated jaw problems. He don't have typical symptoms of heart problem and it's very rare to have heart problem without chest pain and isolated jaw involvement is not very consistent with heart. yes jaw pain can be symptom of heart problem but in that case it should be a severe chest pain radiating to jaw. Normal EKG and other test are reassuring. Lastly stress test getting BP down is not much in favor of heart diseases. Stress test should have initiated jaw pain or chest pain so it's more likely that a low BP was a coincidence not related to heart problem. To conclude if you ask my opinion in percentage, the chances of having heart problem is 20% only out of 100 and there are 80% chances that he has GERD or a muscular problem. I wish him all the best and wish that his investigations come out to be perfect and i am quite hopeful about this. Pay my regards ***** ***** dad and rest of the family. Please ask if you have any question because our discussion always remains open so you can always ask more till you are satisfied, You can click the smiley to rate the answer. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.
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