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Q. I have been experiencing on and off chest pain and my heart feels congested with dull pain. Please help.

Answered by
Dr. Tanmai Yermal (jain)
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 09, 2021

Hello doctor,

For the past two years, I have been experiencing on and off chest pains and discomfort. There are times when I will just be sitting down and my heart just feels congested with dull pain. Especially when trying to exercise, even fairly mild exercising, I have had episodes of what seems like mini heart attacks with chest pain and hard, racing heartbeats and breathlessness that causes me to stop and try to calm down. The doctor recommended to do electrocardiogram, echocardiogram and stress tests, the results of which will be attached.

#

Hello,

Welcome to icliniq.com.

I have gone through your query.

It seems that you have had multiple episodes of chest pain and discomfort in the past couple of years.

I need to know some more details about your complaints.

First of all, I would like to know your age.

What all cardiac risk factors do you have? Any history of diabetes, hypertension, dyslipidemia, smoking?

Also, describe your chest pain which is the exact location, is it radiating, and what is the nature of your chest pain crushing, squeezing, heaviness, pinprick type, dull aching?

Also, attach all your available reports.

Kindly get back with the above details for further discussion and management strategy.

Hello doctor,

Thanks for your response.

I have now attached the report for the ECG. I am a female and turned 30 yesterday.

I have no cardiac risk factors - no diabetes, hypertension, etc. I also do not smoke or drink.

The on and off pain I feel is over my heart area, but more to the right side of that area, although I would not say I always feel pain and discomfort in the same place all the time.

The pain is often dull, though not severe. It only becomes more noticeable or serious with activity. Other than that, it is dull, throbbing pain. My heart area also tends to have feelings of being congested, even without activity.

I also did a stress test, which has been considered abnormal because I reached the maximum heart rate mid-way into the test and was unable to continue because of fatigue and breathlessness.

I would really appreciate your feedback.

#

Hi,

Welcome back to icliniq.com.

Your ECG shows (attachments removed to protect the patients identity) T-inversion in leads III, aVF (arteriovenous fistula), V4-6.

Apart from that, it seems to be fine. The chest pain you are describing is not typical of cardiac, but since you have it very frequently, we should respect it and analyze it. I would also like to know if you had any history of trauma or injury in your chest area or any history of heavy weight lifting recently? Do you get gastritis or indigestion very often? And also whether your chest pain is localized or diffuse? And if your pain increases if you press over that area? It would be better if you share the ECGs taken during your TMT (stress test). I would also suggest you get a 2D echo done along with few blood investigations like thyroid profile (T3 (triiodothyronine), T4 (thyroxine), TSH (thyroid-stimulating hormone), hemoglobin, vitamin D3 levels done. Meanwhile, you can take tablet Paracetamol 650 mg twice a day after food for three days along with Pantoprazole and Domperidone (40 or 30 mg) once in the morning before breakfast for three days. And observe for your symptoms.

Kindly get back with the above details and even let me know your symptomatic relief with these medicines.


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