What causes severe chest pain despite clear cardiac tests?

Question

Hello doctor,

I have been experiencing chest pains whenever I engage in activities like talking or doing anything active for more than 10 to 20 minutes. Despite being 21, I have been having severe chest pains, which does not seem normal. I have undergone various tests like EKG, Echo, stress tests, and even a Cardiac MRI, and all the results have come back clear. I am unsure if a CT angiography is the next step, and I am feeling lost, and no one has been able to help me in the past two years. I have also had a CT scan of my lungs, which showed no issues. I am currently taking 3x10 mg of Propranolol, and my life is deeply affected by this ongoing issue. Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Chest pain triggered by exertion typically hints at cardiac ischemia, but it is not always the case. Lung conditions like exercise-induced asthma, pulmonary hypertension, aortic valve stenosis, and hypertrophic cardiomyopathy can also cause similar symptoms.

Your comprehensive tests like ECG, Echocardiography, and stress tests have provided reassuring results. Just to clarify, your pain arises during talking rather than exertion, correct?

If the chest pain only occurs during extended talking and not during physical exertion, it is advisable to see an ENT specialist. They can evaluate potential issues with your vocal cords.

If the ENT assessment is clear, it is likely that the pain is related to anxiety. Additionally, muscular pain can manifest, particularly during activities like prolonged speaking or singing, causing discomfort. Given your normal stress test results, a CT angiography might not be necessary at this stage.

I hope this helps. Feel free to contact me if you have any further queries.

Thank you.