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Chest pain, normal ECG and BLOOD WORK. Cause.

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I have been having chest pains for a Month and it's taking a toll on me. I have had several ECG's, blood work etc. it's been on going for 5 years but has become really strong the last three weeks. 5 years back I had Echo and Stress too. All clear. I am 34, 5'11 and 230lbs. Non smoker and Nom Drinker. What could this be??

Category: Cardiologist

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Category: Cardiologist
 20 Doctors Online

Thank you for your query at
I need a few more details from you before giving my opinion :
1) Where exactly is the chest pain?Center or left/ right sided?
2) What are the aggravating factors?
3) Is it anyway related to food intake?
4) Do you have problems with digestion and acidity?
5) Any history of breathlessness, pedal edema? What's your current BP in case you got it checked recently?
Since you're slightly overweight you are prone for GERD. So features of reflux needs to be ruled out.
Another common cause of chest pain in absence of cardiac causes is constochondritis, or inflammation of the ribs area.
Once you give me answers to the above questions, i will guide you further.

Patient replied :

The chest pain is all over, mainly in the upper chest/Neck area now, aggravating factors would be moving something heavy or sitting in a particular position or when I start thinking about it.. I do ahem some Acidity when I eat hot/Spicy foods. No history of Breathlessness and the last time my BP was checked was a month back and it was 120/80, as part of my physical. No history of Pedal Edema.

With no history of breathlessness and pedal edema, the other serious cardiac causes of chest pain can be ruled out.
Even your BP is within normal range, and that is a great sign.
Now we need to give you prophylactic treatment for GERD. At times the only presenting symptom in GERD will be chest pain, which can mimic a heart attack. There won't be any symptoms of reflux. 2 weeks of GERD treatment will resolve the pain completely. The only way of confirming is UGI scopy, which can be avoided until and unless it is absolutely necessary.
So i want you to try the following medicines for 2 weeks, and update me in a week's time :
1) Cap. Omeprazole 20 mg once daily before breakfast.
2) Syp. Sucralfate 2 teaspoons twice a day ( after lunch and dinner ).
3) Tab. Advil 400 mg twice a day, after food - can be stopped after 5 days, provided the pain reduces.
Kindly continue the medicines for a week, and update me about your symptoms.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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