I understand that probably a lot of people post on here asking for a diagnosis which is most likely not possible, but I could do with some advice if you don't mind.
I've bee struggling with intermittent chest pains for around 6 months now, sometimes with a few weeks between not having an issue then getting a couple of days where the pain is intense, in the left side of my chest, radiating to my back, shoulder blade and sometimes down arm. It's bloody uncomfortable but I wouldn't call it a squeezing pain, it's almost right in between a sharp and dull pain but is fairly acute in those areas i.e. it's not right across left side of chest, but in one or two particular spots... If that makes sense.
Anyway, after these episodes I naturally get very anxious which probably doesn't help and feel like I have a more dull discomfort spread more widely across my chest, radiating to upper back, mainly in the left side and centrally.
My question was - does this sound like any symptoms anyone has had relating to angina? I've been dismissed by my doctor, quite a lot, I've had ECGs which have been fine, I've also had a chest X ray (the pain wasn't present then). I'm 35, not really overweight but probably have a bit of a body fat problem (nothing major at all) and haven't been exercising regularly for about 2 years now.
I'm bloody worried and I need some guidance. If not from doctors then possibly from people with experience that could maybe help direct my investigations.
Honestly, any help, anything would be so helpful. My life is relatively speaking at least, bloody awful and I feel so hopeless, it's having a real impact on my mental health which obviously doesn't help anything.
I'm obviously not an expert but to me it feels wrong, I don't feel right at all and feel like what I've read, it could be some sort of angina. If so do you have any advice, what tests could I ask for or even pay for? I just need to get a handle on it so I can lead a normal life again.
Thanks so much for listening and sorry for the long post.
'Squito.
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Mansquito
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Hi mansquito. So sorry to hear you are struggling at the moment. I personally think the most important line in your post is "to me it feels wrong. I don't feel right at all". If your body is not behaving normally for you, you need to investigate this. Angina and heart problems present very differently according to the cause, whether male or female etc.etc It is definitely not a one size fits all diagnosis.
Please consider returning to your GP (or a different one if appropriate)and outlining what you have said above again. If you are worried.consider 111 and also a call to the BHF nurses is definitely an option many of our members would recommend.
With best wishes and hope you can come to some sort of resolution soon. X
Hi I agree with Nettekin, if something doesn’t feel right you need to question why that is.I have now been diagnosed with angina and my only symptoms were pain in left upper chest, mainly down my left arm and into my shoulder and neck. After 2 query cardiac events( which my GP was worried were heart attacks) I was sent off to A&E. Chest x-ray fine, ECG normal, bloods ok.. however it was my family history which suggested there may be a potential issue, so I was referred to my local chest pain clinic at the local hospital.
Cut a long story short I’m now booked in for an angioplasty!!
My ‘not feeling right’ was the first wake up call really. Speak again to the GP or next time you experience those pains, take yourself to A&E( if severe call an ambulance of course!!) listen to your body, you know what’s normal for you. Take care
Thank you ever so much for your reply, I really appreciate you taking the time to give me your story and advice. I'm glad you have made some progress and good luck with your operation, I hope it all goes well.
I will certainly do as you suggested. I have gone to A and E a couple of times for this, one time I managed to get a chest x-ray but they said it was completely fine. I think I had normal blood tests and normal ECGs on that occasion as well. I guess my next issue is do I continue, maybe use my own money (limited, lol) to pay for investigations through a cardiologist? I think that's what I'm going to try to sort out today.
HiMy experience of A&E is that they are exactly that. I have been sent there by my GP several times. They do an ECG, possibly a heart x ray and 2 blood tests to assess troponin levels (troponin is a marker which accurately shows if you have had or are having a heart attack.)
In my case all were negative as in your case. so they sent me home.
You really need more extensive diagnostic tests (e.g. an echocardiogram) for which you need to see a cardiologist.
I realise it's difficult to see cardiologists through the NHS and I have seen one privately.
An initial consultation is typically £200-250, and an echo cost me £400. If they find anything significant, then the NHS route is there. In fact you will probably find that some of the cardiologists in your local hospital also see private patients
Honestly this has made me almost certain that I will book said tests through a private cardiologist, even if just for the reassurance. I've been umming and ahhing about it for a while as I wasn't sure if I was just being silly or anxiety-driven, but it's probably really short-sighted to think about the money or how I might be perceived (my family basically think I'm stupid and offer no support for any of it, not even a bloody 'are you ok' kind of thing!!!).
I have a lot to do now as there is a wealth of advice on here.
Hi Mansquito If it was me I would go back to my doctor . Then go to A & E next time you feel unwell. Without boring you I have been told by cardiologist that there is nothing wrong with my heart and sent home , missed diagnosed with angina , had a few hearts attacks , had a stent fitted , seeing a consultant in two weeks. Once they know what’s happening you can deal with it and move on so to speak . Good luck
Very interesting listening to your short story and glad that you have at least made some progress. It's not something you want to be diagnosed with but you'd rather know about it if you have it than not!
I'll persist and persist and persist, that's the feeling I'm getting from most of these replies. Will update you all once I know more =)
Your welcome Rory I think a good way to look at it is you are getting it sorted even though you are going around the houses . I have been the exact same but hopefully yours won’t take 2 years to diagnose and throwing cancer in between didn’t help lol . Onwards and upwards
Crikey, I can only imagine that being very difficult. I hope you are ok?
I think it says a lot about your character that with all of that you're still happy to come on here and provide advice and suggestions to others. Really appreciate it and feel like I've already made progress since coming on to ask the questions.
Hi Rory To be honest I wasn’t jumping up and down about the delayed cancer diagnosis but went on macmillan web site and met some amazing people who put me at ease. Which helped me big time . We are blessed to have this web site . All the Best 👍
GPs are human and can get it wrong. I think I’d go to A&E when I had the pain, straight to reception and that way you stand a good chance of this being looked at when it’s happening. Surely your ECG when there are no symptoms could be giving a misleading result? Sometimes we have to make a nuisance of ourselves to be noticed.
Absolutely 100% agree with all you said. Thanks for the reply Classicfan.
I have been dogged in my pursuit but this enthusiasm comes in ebbs and flows. It's not always easy to persist, sometimes you're convinced and other times I'm not. Given the intermittent nature I do sometimes let my guard down when I'm feeling ok. Then when it happens again I try to pursue answers.
I think I'm now at the point where I need to persist beyond the current 'episode'.
I'll try to keep this thread updated so others can maybe get some information from my investigations.
I had a heart attack last August when ambulance turned up (1hr 15 mins later) there was no sign of it happening and paramedics were happy to leave me, but I knew what happened was real and I wanted a follow up blood test to confirm what I knew. Lucky I did as troponin levels were high. But each time they did ECGs once at home and seven in hospital it was showing normal readings. Echo was clear, angiogram was clear no blockages or signs of cholesterol build up and MRI only found one tiny bit of scaring on tip of heart so no damage to heart. But I had had a heart attack with no apparent reason or cause. My only indication was the blood test. I have an explanation, it was a heart attack, but no answers as to why it happen what caused it. So if you can next time it happens go to the hospital and ask for a troponin blood test. Hope all goes well for you and you get your answers or at least an explanation
MINOCA? About 10% of heart attacks are Myocardial Infarction non obstructive coronary arteries.
Common causes are microvascular dysfunction, coronary vasospasms, spontaneous coronary artery dissection SCAD, a small area of plaque breaking off or a blood clot blocking an artery.
It's important to know why you had your heart attack so you receive the appropriate treatment to help prevent another event.
Prior to having my heart attack I was checked out as having less than 5% chance of heart attack or stroke! So when I had the troponin levels checked I was really surprised.
My hospital dagnosis was NSTEMI. Whilst I agree with you about knowing or understanding the cause, I have questioned this many times, my case has the cardiologists stumped and have me down as totally unexplained with my heart fully functioning.
Lucky for me I have low cholesterol and the majority of that is good cholesterol. I have low to normal blood pressure, VO2max is that of 45-49 yr old. I am in my 60’s. Good resting pulse of mid to high 50’s, My latest appointment the Dr reduced my medication and that felt really good.
I am aware of this and have asked my GP to arrange a holter monitor (I keep referring to that but it might be called something else). However, they say they arranged it and I never heard anything back about it. I am at the point where paying privately for investigation is almost my only option.
I have had one, have you tried ringing the relevant department at the hospital? Or PALS.I got my mine through quite quickly. It's a shane that they forgot to send the results to the relevant doctor for 3 months and things have moved on.
The best opinion you will get about your own specific health conditions will be from a health professional such as your GP. People on here are usually not health professionals and therefore mostly comment on medical conditions based on their own experience or something they have read on the internet. I suggest you return to your GP. If you are unhappy with the consideration you receive, ask for a second opinion . And if you have a significant and sudden deterioration in your situation get yourself down to A&E.
I think my issue is that I have had some serious stomach complaints around the same time which really made everything so convoluted. I think getting stressed and anxious has helped perpetuate all of it and created something of a vicious cycle. However, I do feel like this has maybe made my GP more inclined to dismiss these issues and I don't want to end up being another number, tbh.
I have had a second opinion (and a third) but none of them follow any real investigations, so I'm still left with discomfort, pain and anxiety about it all.
I'll call the BHF today and book in some investigations.
Hello, I agree with what everyone else is saying. When you get the pain, get seen at that time. If it's very severe and you have associated symptoms, like breathlessness, sweating call 999. Good luck
I have gone to hospital when I've had the pain and had some ECGs when the pain has been present but there was nothing to report, apparently. Thankfully though I haven't had any other symptoms accompanying it, which I guess is positive? I'd much rather me be completely wrong and it all be fine, but the not knowing is really disconcerting.
I think given the replies I'll continue to pursue some tests to get some answers and try to update people on here.
It could be a case of anxiety running wild, but when you're waking up with the pain or feel that any kind of physical activity makes it worse then I do question that logic.
I am probably going to book in a holter monitor test privately, that last for 5 days, not that I have much money to throw at it, but can use savings and thought it'd be better to have the reassurance.
Hi I would consider calling your GP practice again and see if they have a copy of the referral or letter they can share with you, or ask to whom the referral was made and you could contact them directly to see what’s happening about getting you an appointment.
Is there any reason why you have not been referred to a cardiologist by your GP?
It may be different in different areas - for me I called GP initially who was happy to refer me to cardiologist as all tests etc are done at the hospital and cardiologist Has to requests them As far as my experience tells me I.e ambulatory monitor, CT scan.
So my cardiologist Made the requests to the Cardiology Diagnostic department At hospital Who sent results back to him for his review and next steps.
Hi fishface, thanks so much for taking the time to reply. I honestly am so grateful for your advice.
I think I am a bit of a pushover at the doctor's to be honest. I am quite polite and try not to be much of a burden, which is probably why this has persisted for so long without any concrete answers. It's hard to be so blunt with them, but I'll try harder going forward.
Given what you said, I might ring my GP today and see if I can get some advice and possibly some appointments to discuss this in more depth.
Next time you are struggling with the pain, call an ambulance. The paramedics will carry out a blood test and an ECG in situ which can give a strong indication if it is heart related. I too was worried about calling an ambulance but we are advised to do this with chest pain.
I've done this, reluctantly and had some tests in the ambulance which were clear. Mental how I've had such a wide array of tests with no conclusion. I don't want to be the guy leeching all of the resources and taking them off of potentially other people, but sometimes there is no choice.
Anyway, your advice is welcome and inline with what other people have said. I think I should take this onboard and really persist until all avenues are exhausted.
Yes, do persist. My ambulance tests came back clear, but when I went to hospital (reluctantly), their more detailed tests showed a heart problem. Despite me thinking I had rib pain (I do have connective tissue pain due to a separate problem) I was having a heart attack. It seems likely I'd had several before and dismissed them as muscle pain. One pointer I was given was that if it is difficult to pinpoint exactly where the pain is coming from, or it tends to move around, it could indicate a heart problem. However, indigestion can also do this so best not to jump to conclusions and get in a state over it. I hope you are able to get proper diagnosis soon.
I only know I'd had previous heart attacks when they told me what I was experiencing was a heart attack and I knew I'd experienced those symptoms before. It was painful, but I'd been dismissing it as something else. I was even doubting it right up until the point I was on the operating table and the surgeon said he could see the 95% blockage. Quite a surreal experience.
I think some of my heart muscle has been permanently damaged, however it is not something I have noticed so suspect it is a small area.
Well I am glad you're ok and also extremely grateful for you passing on your knowledge. To have sound advice is in some ways reassuring and just lifts a weight off of my (and others') shoulders. Sometimes before I joined this forum I felt like I was just shouting at a brick wall.
Thanks again Alfred, stay well.
Rory
Hi, my personal experience was that all the usual hospital tests came back as normal, despite intermittent pain/discomfort similar to which you describe.It was only when I eventually had an angiogram that they found a 90% blockage in a main artery !! Happy to say it was fixed with a stent and ongoing advice re lifestyle and diet. Good luck !!
Hello, there’s lots of good advice above. I’d like to add - keep a diary. Note down your symptoms as and when they happen, the duration, what you’ve doing each day, monitor your BP & heart rate at home twice a day for a week or two to establish what’s normal for you and then when you're feeling unwell, also oxygen level if you have an O2 monitor (the one that clips onto your finger). The meds you’re taking, any supplements etc - dose and time.
It sounds a lot, but it shows your GP that you’re serious about how you’re feeling and gives them an objective record of what’s normal for you, what’s happening, when it’s happening, what it’s like each time and for how long. It may show up a pattern or may help in getting tests done. I’ve heard of some people using a spreadsheet or a graph for their BP and heart rate.
Good luck in getting sorted out sooner rather than later.
This is great advice, I think I will do this. Thanks ever so much Shar28.
We bought an O2 monitor during Covid lockdown so I can use that and like you said, try to note everything down to see a pattern.
I've tried to recognise patterns myself but there's so much going on that it's really hard, I've not really been able to identify anything other than that a sort of sore, dull discomfort seems to last for a few days after I get the intense pain episode (which usually lasts for over 24 hours, but ranges in severity throughout that time).
I think your suggestion is fantastic, thanks so, so much. I'm honestly gobsmacked at how many people have responded and all of the advice I have received. Certainly makes me realise how many great people are out there.
Great advice shar! so difficult to remember all the little (but possibly very important) details when you are in a clinical setting. In the past I have had everything memorised then the minute I'm asked a question it all flies out of the window! It maybe that's just me? X
You're definitely not the only one. Even if I do well reciting what I tried to remember there's normally one or two things that I leave out. Then that sort of plays on your anxiety and then it just makes everything worse and harder to diagnose (at least for me).
Yeah it's though to know is t it. You do t want to overreact but at the same time you want make sure you don't want to miss something potentially fatal. Probably always best to air in the side of caution but I often don't. I'll definitely do this the next time it happens.
Hi I haven't been here for awhile and had a different name before. Anyway your story sounds familiar to many others. If you get to the rapid access chest pain clinic and see a cardiologist perhaps they can do a CT angiogram or a myocardial perfusion scan. I don't think paying for a holter montiter test is helpful in diagnosing angina unless it's a heart rythm problem you've got. Best wishes
Update - managed to get to a rapid chest pain clinic only to be given another ECG and be told I'm not in any at risk categories. I had another episode this week, got woken up by pulsing jolts of pain in the centre and left side of lower chest and have had the dull discomfort since.
I managed to get a stress test booked and *another* chest x-ray, so we'll see where that takes me, but as of yet, no real progress and more dismissals by GPs.
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