What are the causes of pricking pain near the chest area?

Question

Hello doctor,

I am a 61-year-old male, weighing 176 pounds and standing 5 feet 4 inches tall. I have been diabetic for the past 18 years and am currently following a low-carbohydrate, high-fat (keto) diet. I am taking Sitagliptin 100 mg, one tablet twice a day. Two days ago, I experienced a pricking pain on the left side of my chest and went to the hospital. They performed an ECG, echo, and blood tests, all of which came back normal. They have advised me to undergo a CT coronary angiogram. Please find the CT angiogram report attached. Could you please advise me on the medications I should take to help prevent a heart attack in the future?

Answer 1

Hello,

Welcome to icliniq.com.

The report (attachments removed to protect the patient’s identity) shows only minor diseases, so the focus should be on maintaining a healthy lifestyle, which I assume you are already following. This includes a healthy diet, such as avoiding oily, fatty, and high-calorie foods, as well as regular exercise like walking or brisk walking, according to your capacity. Pricking pains are usually related to gastritis and reflux disease rather than being cardiac in origin. However, you may experience some exertional pain due to myocardial bridging, which is typically benign. Blockages of 20 to 30 percent usually do not cause any pain.

In my opinion, you should consider taking an antiplatelet and statin combination, such as Atorvastatin along with Aspiri at bedtime, for long-term preventive purposes. Please discuss this with your treating doctor. If you experience pain on exertion that relieves with rest, it may be due to myocardial bridging, and in that case, you may need beta-blockers, such as Metoprolol. Additionally, it is recommended to undergo an echocardiogram and a treadmill test (TMT) every two to three years to monitor the blockages.

I hope this information helps.

Feel free to reach out if you have any further questions.