Q. I have chest pain and shortness of breath. Why do I get this?

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 26, 2020 and last reviewed on: Apr 02, 2020

Hello doctor,

I have chest pain and shortness of breath. It started on 16th March. Since then, it is still present, continued discomfort in chest and back.

I am on 5 mg of Atorvastatin.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome to icliniq.com.

I have gone through your reports. (attachment removed to protect patient identity).

Resting ECG and echo showed no abnormalities, and stress test does not show any abnormalities, although could not be completed. So, we cannot be certain that this is not cardiac pain, but appears to be less likely. So you should undergo further testing with either pharmacological stress test or CT (computed tomography) coronary angiography. Now normal BNP (brain natriuretic peptide) level is against cardiac cause for shortness of breath.

Your thyroid shows significant abnormalities, you need to be on thyroid supplements like Eltroxin and should begin as soon as possible. Now do you get this chest heaviness at rest or on exertion? If this heaviness occurs at rest only then possibility of other causes like acid reflux should also be considered especially if you have other symptoms. You should try antacid then. If heaviness classically occurs on exertion and relieves with rest then strongly suggest cardiac cause only and then should undergo further cardiac resting.

So possibility of non-cardiac cause should also be suspected, however, should undergo further cardiac evaluation.

I hope this helps.

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Thank you doctor,

I was put on Levothyroxine. Would Eltroxin be better? For the pain, I feel a weight in the chest area all the time, but I feel a pain in my chest, back and shoulders when I exert myself. For example, if I try to pick up and carry any amount of weight, or go up or down the basement stairs. At the bottom of the ECG report under the final result narrative, it describes it as an abnormal ECG, and that it cannot rule out an anterior infarct. Does this mean that I could have had an attack at some point in the past?

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine


Welcome back to icliniq.com.

It is fine to have Levothyroxine. So your symptoms are suggestive of cardiac cause. So, it should be treated as cardiac until further evaluation rule it out. You should avoid heavy activities and it is better to have Baby Aspirin along with Atorvastatin.

Regarding ECG, it was mentioned normal in summary attached (attachment removed to protect patient identity). Whatever you are mentioning is machine generated report and is not reliable. So, as of now we will consider it normal. Also, previous attacks would be picked up on echo. But anyways, you will need further evaluation with CT coronary angiography or pharmacological stress test.

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