Patient's Query
Hello doctor,
I have chest pain and shortness of breath. It started last week and has persisted since then, with continued discomfort in my chest and back. I am taking 5 mg of Atorvastatin.
Please advise.
Hello,
Welcome to icliniq.com.
I have reviewed your reports (attachment removed to protect patient identity). The resting ECG (electrocardiogram) and echocardiogram showed no abnormalities, and the stress test did not show any abnormalities, although it could not be completed. Therefore, we cannot be certain that this is not cardiac pain, but it appears less likely. You should undergo further testing with either a pharmacological stress test or CT (computed tomography) coronary angiography. A normal BNP (brain natriuretic peptide) level reduces the likelihood of a cardiac cause for your shortness of breath. Your thyroid shows significant abnormalities, and you need to start thyroid supplements like Thyroxine as soon as possible.
Do you experience chest heaviness at rest or only with exertion? If the heaviness occurs only at rest, other causes, such as acid reflux, should also be considered, especially if you have additional symptoms. In that case, you should try taking an antacid. However, if the heaviness occurs primarily with exertion and is relieved with rest, this strongly suggests a cardiac cause and further cardiac evaluation should be done.
While we should consider the possibility of a non-cardiac cause, further cardiac evaluation is recommended.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I was put on Levothyroxine. Would Eltroxin (Thyroxine) be a better option? As for the pain, I constantly feel a weight in the chest area, but when I exert myself, I experience pain in my chest, back, and shoulders. For example, if I try to pick up and carry any weight or go up or down the basement stairs. At the bottom of the ECG report, under the final result narrative, it describes the ECG as abnormal and states that it cannot rule out an anterior infarct. Does this mean I could have had a heart attack at some point in the past?
Hello,
Welcome back to icliniq.com.
It is fine to continue with Levothyroxine. Your symptoms suggest a cardiac cause, so it should be treated as such until further evaluation rules it out. You should avoid heavy activities, and it is advisable to take baby Aspirin along with Atorvastatin. Regarding the ECG (electrocardiogram), it was reported as normal in the summary attached (attachment removed to protect patient identity). What you are referring to is a machine-generated report, which is not reliable. Therefore, we will consider the ECG normal for now. Previous heart attacks would typically be detected on an echocardiogram. However, you will still need further evaluation with either CT coronary angiography or a pharmacological stress test.
I hope this helps you.
Thank you.
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Answered byDr. Sagar Ramesh Makode
Medically reviewed byDr. Vinodhini J.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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