How to manage heartburn or burning sensation in the chest?

Question

Hello doctor,

My father is 63 years old. He felt some heartburn or burning sensation in his chest while walking. During rest, there was no problem. So we went for an electrocardiogram (ECG) and echocardiogram. The reports were normal, and the doctor said that he has no problem and has a strong heart. My father has a high blood pressure problem. On that day, his blood pressure (BP) was about 170/100 mm of Hg so the doctor changed his blood pressure medication. He took that medicine at night after the checkup.

On that night, he had low blood pressure with a low pulse rate, and he experienced the same heartburn. We took him to the hospital, where the doctor considered it a heart attack and gave a clot buster injection after examining him and took an ECG, too. Trop-T test was positive at that time. After one hour, everything went right, and we got discharged in the next two days.

On discharge day, ECG and echo were completely fine according to the doctor, and my father is currently is on medication. Now, after two to three days, he sweats at night but not cold sweat. He feels like he has gastritis; otherwise, he is completely fine. Now, I want to know if this sweating is fine or if should we be concerned.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your father's history is suggestive of either coronary artery disease (caused by the buildup of fat or cholesterol in and on the walls of coronary arteries) or gastroesophageal reflux disease (acid from stomach move up into esophagus) (GERD) with esophagitis and heartburn.

Electrocardiogram (ECG) and 2nd echocardiogram (echo) are baseline tests of cardiology with a sensitivity of about 65 percent, hence they can miss coronary artery disease in 35 percent of cases.

You said that the doctor gave him a Streptokinase (clot buster) injection, and on discharge his ECG and echo were normal, but this is not possible.

Fibrinolytics are given in ST elevated myocardial infarction, and changes in the ST segment will take hours to days to settle down post myocardial infarction and echo cannot be normal.

Please attach a copy of his ECG after your father received the clot buster injection. I would like to have a look. Sweating can be a symptom of gastric ailment as well as angina.

Advice:

A Thallium stress test needs to be done to rule out coronary artery disease.

Regarding follow up:

Kindly send all sets of ECG and echo reports.

I hope this helps.

Thank you.