Chest pain by walking but not by Exercise 🤕

[Hearty21]

Hello all. Many of you know me. I’m 41 year old male and had an MI in Feb this year. Since then 2 stents fitted and still have two narrowings in small arteries which my cardiologist is trying to control with medication.

This question may be silly but I’m still going to ask anyway.

As you can see in the picture, I can do workout on exercise bike for hours without any chest pain. I keep my heart rate around 120 -130 BPM during this workout. This is the highest intensity I should aim at as was told by cardiac rehab nurse.

However, any upper body workout knocks me down with severe chest pain. Even when I walk, I get chest pain.

Anyone have / had any similar experience or can shed some light on it. ?

[Chriswood79]

Hi Hearty21. I’ve never had any chest pain even when I had my heart attack (I’m 42). I have always had good lower body but terrible upper body strength. I’m 3 month post-stent and I’ve found the cardio rehab fine, save for a slightly higher than target HR (up to 135) but still have good stamina / lung capacity and it comes down after 30 seconds stopping - so all good . Upper body conditioning-wise with weights though I’ve started feeling tightness across my chest this week I’ve not felt before and am a little concerned - I don’t know if it’s muscular or I’ve been pushing it too hard or too often (3kg weights though only). I’m going to ask the rehab nurse this week so will report back. Have you used your GTN for it?

[Hearty21 in reply to Chriswood79]

I avoid GTN spray as it give me heart palpitations sometimes but in the past it never helped me. I also do 3kg weights but keep it really modest.

I have now included very low intensity 10 minute rowing and try to build from there.

Muscular pain can’t last for 8 months (in my case, I’m having these pains since MI)

[Chriswood79 in reply to Hearty21]

I also row for 10 mins and was initially finding I had a tightness across my chest which was definitely muscular from the pulling. The tightness I feel now seems to be from the lateral lifts with the weights (held outwards). I find this exercise the most difficult as it’s a stretch across my chest and it affects my blood pressure as I sometimes feel light headed after a couple of sets from the exertion. I’ve also recently stopped my Bisoprolol. Not sure if any of this relates with you. Apologies if not.

[NotAllWhoWonder]

Daft question, but can you touch where the pain is in your chest? And if you can, does it hurt when you touch? Old trick the cardiac nurses taught me: if your chest hurts when you touch it, it's probably an intercostal muscle, not your heart.

[Hearty21 in reply to NotAllWhoWonder]

I was that was the case. I always moved my shoulder when I have pain behind my shoulder blade, but it does not go away. Also, pain on left side of chest is really deep down. My cardiologist said, some of the pains are not cardiac related.

[Hidden]

Sounds muscular to me, but I'm a farmer not a doctor!

[Wingnutty]

I don't have an answer, but I have some similarity. Background is that in 2013 I had a quad CABG and aortic valve replacement with an On-X mechanical valve so I am on warfarin permanently. I try to exercise every day. I can just about jog 600M around the block and I can do 30 press ups and a number of other exercises including upper body. I find that the 600M jog makes my chest tight and I will get a couple of missed beats as my heart rate comes down, but not really any angina. All my other exercises don't cause any angina despite being quite intense. What does cause angina is walking. I only have to walk for a couple of minutes before onset and this upsets me because I have spent my whole life walking, sometimes as much as 10 miles or more. I can still walk but the angina spoils any joy from it and I find myself walking less and less because of it.

[Hearty21 in reply to Wingnutty]

The pain you described is so similar to mine. I have been to 2 private cardiologists and no one had the answer. My pain is not typical angina pain. I can keep my HR on 130 BPM while on exercise bike (I sweat while exercising ) but no angina pain comes. My pain only comes when walking or doing exercise while involves whole body 0 mostly upper body - very strange

[Heartattackvictim in reply to Hearty21]

Is the walking outside? Are you walking when it's cold and/or windy? These latter two can be triggers for my angina when walking outside although I do also jog outside but I do that when it's not windy or not too cold. But I can also get angina at rest but I think I've narrowed it down to anxiety and thinking about stuff I've got to do on a mental checklist - so I rest when that happens and if my jobs (around the house) don't get done, so be it. It's taken me ages to sort out this anxiety-inducing angina, but I now know the triggers.

[Hearty21 in reply to Heartattackvictim]

Hi Heartattackvictim - i had an HA in Feb 21 and since then I have suffering from constant chest pain which resulted in another angiogram and 2nd stent (no HA).

Last Month I went to see another private cardiologist in Central London who listened carefully about my chest pain. He ruled it out as cardiac pain or Angina. I was taken off all angina medication (Isosobride mononitrate and Ranolazine). He asked me to strengthen my upper core muscles and put me on a nerve pain relief tablet. He said it is a muscle or nerve being pulled in chest. Upper body exercise didn’t help but I’m pleased to say that this new medicine has done wonders and I’m almost now pain free. Yesterday I done over 21k steps

[Wilko110150]

Hi Hearty21. Your question is certainly not a silly one. I am interested in it and the replies because I get something similar. I have two stents since April this year. At cardio rehab, I can ride an exercise bike without any difficulties and I use the rowing machine and some very small weights - also without problems. However, I try to walk 3 - 5 miles a few times per week ( quite slowly) and I find that as soon as I start my chest tightens up and my breathing is a little more difficult. I also feel very slightly dizzy. However, after 10 to 15 minutes, everything gets easier which is why I manage to walk so far. My cardiologist says that this is perfectly understandable because something opens up. ( I couldn’t catch the word he used). He said that he wants to do another angiogram to see if something else needs to be done. My point is that you shouldn’t think anything is silly and you should put your question to your MI nurse, a cardiologist if you can or even the nurses at the BHF. They may have an explanation or know if more investigations are needed. Finally, please note that I am NOT recommending that you try to ignore chest pain when walking or doing anything else.

[madfox]

Hi Hearty21, ask your Cardiologist about Pericarditis. I had my HA back in January this year. Then I was back in hospital in March, again in June and again in July. The cardiologist at the local hospital was baffled by the pains in my chest. I was sent back to the original hospital for an angioplasty in August and had two more stents ftted, the cardiologist who did the procedure told me that I had a viral paricarditis. This is an inflamation of the tissue that surounds the heart to protect it from injury. Apparently it is very common following a HA. I have the pain in my chest but don't have trouble with my breathing most of the time, it is better when I sit up and lean forward. I have also found, after talking to others on here that having a wedge shaped pillow helps. There are drugs out there if you can take them not everyone can. I can't, so do ask about pericarditis. All the best and I hope you find a solution soon.

[Hearty21]

Hello everyone - just wanted to share an update with you all. I went to a private cardiologist after reading a lot about him on social media. He listened very carefully, checked my records and came to conclusion that the nasty pains I’m getting in chest are not heart related.

He will still go through my two angiography CD’s and call Me next week about his findings. Such a relief since yesterday even though I still get pain when I walk. Still don’t any pain when I do workout on exercise bike 🚲- been doing 45 minutes every evening

[benjyboy]

My experience post CABG 19 years ago has been very similar. I have (since the op) always had chest pain problems which radiate to the middle of my back between the shoulder blades and down both sides of the rib cage and also affect the stomach muscles with a kind of cramp at times. The pain can start just whilst sat watching television and at the start of a walk. Riding my bike with heart rate at about 130 - 140 bpm is fine with almost no pain at all but it takes about 15 - 20 mins for the pain to ease whilst walking with heart rate around 105bpm. I too have had CT scans and which show nothing that could cause this issue and my GP quite frankly is pretty disinterested. A few weeks ago the pain was really nasty and just would not budge even with paracetamol so I eventually went to A&E and was found to be having another heart attack which resulted in an emergency ride to the nearest Cardiac centre and had a stent inserted to open a narrowing in the artery just below the point where the bypass ended. Since then I've still been getting the same pains and been back to the GP who maintains that since I've just had all the checks done it can't be a heart related issue. He said that there were some pain medications available but would not prescribe them as I had just started new medications prescribed by the hospital. A while back I stopped doing kettlebell classes and weight training to see if they were aggravating the issue - not sure they were so may take them up again in a week or so. It really does mess with your head - but for the moment it's just grin and bear it!!