Dad has heart pain?
July 10, 2010 2:13 PM   Subscribe

My 58 year old dad has been having a squeezing pain in his heart. It has happened a few times, and then just goes away. He went to the emergency room, got a lot of tests done including the stress test, and they determined that his heart is healthy. He has healthy blood pressure and has a manual labor job, and so gets a lot of exercise. The doctor said it might be stress. Does anyone have experience with this? My dad is ready to just try to relieve his stress, but I am worried that it could be something else that the doctor may not have picked up on. Any solutions, including alternative medicine? Thank you!
posted by tessalations999 to Health & Fitness (18 answers total)
Was he tested for angina?
posted by Solomon at 2:14 PM on July 10, 2010

Does he drink? Smoke?
posted by Guy_Inamonkeysuit at 2:15 PM on July 10, 2010

Any solutions, including alternative medicine?

The heart is an important organ. Your dad shouldn't waste his time on unproven "treatments" that are almost always scams.
posted by Inspector.Gadget at 2:15 PM on July 10, 2010 [3 favorites]

He does not drink or smoke. I think he was tested for angina and it was negative. I will double check though.
posted by tessalations999 at 2:17 PM on July 10, 2010

I have had disturbing chest pain that turned out to be costochondritis.
posted by Ruki at 2:21 PM on July 10, 2010

You mention that he went to the emergency room. Has he seen a cardiologist on an appointment (i.e. non-ER) basis?
posted by ErikaB at 2:38 PM on July 10, 2010

No he has not, I believe the doctor he saw was not a specialist but his primary care doctor. should he see a cardiologist too?
posted by tessalations999 at 2:43 PM on July 10, 2010

A friend of mine had a blocked artery which would manifest as chest pain, but every visit to the ER would turn up nothing. After 4 trips to the ER within a year, it wasn't until they finally caught something on a blood test (something was elevated and that indicated heart damage) that they finally looked further. He ended up with a stent to correct the blockage.
posted by cabingirl at 2:45 PM on July 10, 2010

He should get a second opinion from a cardiologist. If his heart turns out to be okay, I'd second the guess that it's costochondritis.
posted by rhartong at 2:48 PM on July 10, 2010

Chest pain could be due to stomach reflux. Thus, "heartburn".
posted by TheGoodBlood at 2:56 PM on July 10, 2010

Definitely see a cardiologist.
posted by Wordwoman at 2:59 PM on July 10, 2010

He should go to a cardiologist and get a work up (I work at a cardiology office, but I have no medical training). From what I've seen, they'll probably do a stress echocardiogram along with some other tests (if he hasn't already had them done). They'll want to know how often he has the pain and when it occurs and where it seems to be in his chest- pain that he can locate with two fingers (in a small area) and that occurs only with exertion is less of a concern, from what I understand.

Does he have high cholesterol? His risk factors will inform how they approach his case- if he doesn't smoke, drink, have high blood pressure or high cholesterol, has a negative family history for cardiac problems and gets physical exercise, basically his only remaining risk factor is being a 58 year old man, which is pretty minimal. It's definitely worth getting checked out with a cardiologist, but if they haven't found anything yet his symptoms may well be unrelated to his heart. If he is under a lot of stress, they'll advise him to try and reduce that because it could certainly be causing his symptoms.
posted by MadamM at 3:17 PM on July 10, 2010

I agree with all the suggestions above but for me, it was severe vitamin D deficiency - affecting calcium absorption causing bone pain. So he should have that checked.
posted by andreap at 3:34 PM on July 10, 2010

Another datapoint: My mother had terrible, terrible chest pains, and it turned out to be a virus that was also affecting a muscle that goes around the heart/ribs - so her heart was fine, it was the spasming muscle she felt. It wore off in a couple months.

Only a specialist will be able to tell you.
posted by smoke at 4:47 PM on July 10, 2010

Hi there, IANYD.

A few points to add.
- There is no test for angina. Angina is a symptom, it is chest pain associated with heart disease. You cannot be diagnosed with angina unless you have already been diagnosed with coronary artery disease and it has been determined that the pain you're having is heart-related.
- If your father had a treadmill stress test, it is not conclusive that he does not have heart disease, although this is the standard first test that is typically ordered. If he had a persantine thallium stress test (a "p-thal" or a stress test that uses a nuclear tag to image the heart), then you can be fairly certain that the heart is getting good oxygen/blood supply, and this is not heart disease/angina. The only ultimate test for looking at the blood flow to your heart is a cardiac catheterization, but that is not done unless suspicion levels are high, because it is an invasive test, expensive and can result in complications.

There are certainly plenty of other things that can cause chest pain, including panic attacks and costochondritis, but as emergency doctors we are trained to consider the life-threatening diagnoses first, and only diagnose someone with these other benign diagnoses if we feel certain there is not something else going on. I will not list the possibilities because it would just sound scary, but if the pain is more intense, occurs with exertion/exercise, is accompanied by shortness of breath/sweating/nausea, I would have him return to the emergency department. If not but it is still there, follow up with his primary care within a few days to see if a referral to a cardiologist is warranted. Have to be careful and play it safe with something as serious as chest pain!
posted by treehorn+bunny at 6:33 PM on July 10, 2010

My Dad had terrible chest pains, collapsed at work, was transported to the ER... at first the doctors thought it was angina. He was given medication for this, and was not improving. Follow-up tests discovered that my Dad's pancreas had large tumours on it.

Pancreatic symptoms vary - your Dad's doctors might want to investigate in that direction as well.
posted by seawallrunner at 6:40 PM on July 10, 2010

PLEASE encourage your Dad to see a cardiologist.

The "squeezing" pain sensation is what concerns me (IANAD).
Mr. Batik had squeezing pains that were downplayed in the E.R. Granted, he was in E.R. for something else, but was presenting extremely high Blood Pressure and the squeezing pains as well. They treated what turned out to be gallstones ... and told him to see his family doc about the other. He didn't. The squeezing pains continued, usually lasting a few minutes to an hour, then subsiding. Four months later, he had a massive heart attack, and ONLY due to being near an excellent hospital for heart disease (dif hosp than the ER he visited) is he still alive. However, he is now (4 years later) disabled, weak, and has some brain damage and much heart damage.

PLEASE walk your Dad through having this fully diagnosed, better always to be safe.
posted by batikrose at 6:52 PM on July 10, 2010

IANAD(Y), but I echo the above comments that it might be a good idea to consult a cardiologist at some point. It could be something like Prinzmetal's angina, which won't necessarily show up on a regular stress test.
posted by greatgefilte at 8:42 PM on July 10, 2010

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