Cardiologist Questions Supraventricular tachycardia

Chronic Chest Pain

Hello,

I’m a 40 year old male who was prescribed blood pressure medication (Amlodipine and Olmesartan) to keep my BP within the normal range in 2011. Since beginning on both I have experienced constant chest pain. My cardiologist performed repeated blood work, EKGs, ECHOs, Stress ECHOs, two Coronary CTAs and a Coronary Cath (without Sten) without determining a cause of the pain. I am able to workout (walk/runs) but I’m hesitant to move to more physical activities like basketball.

This past June I was diagnosed with SVT pending ablation surgery TBD.

While I understand SVT can cause chest pain, I need advice in determining how to move forward with working with my cardiologist on determining what’s causing the chest pain rather then being prescribe additional medication to treat the symptoms.

I fear there may be structural damage to my heart that is going undiagnosed.

Male | 40 years old
Complaint duration: 7 years
Medications: Amlodipine Olmesartan
Conditions: HBP

4 Answers

Get the SVT taken care of. Make sure your thyroid is not overactive.
It is highly unlikely that the chest pain is cardiac.
Other causes of chest pain that should be investigated including esophageal inflammation or spasm; musculoskeletal discomfort; and pulmonary disease.
I would recommend further testing to try to determine the cause of you pain, including non cardiac causes of the pain. However if your stress test was normal then it is less likely that it is due to a significant blockage in coronary artery. Consider other causes of chest pain
Hi 40yo male (man, I assume),

Several things strike me about your story:

-Firstly, you seem to date the onset of pain to when you started the bp meds. Have you tried stopping the meds to see what happens to the pain?

-Secondly, you do not characterize the pain either as to quality, severity, inciting factors, relieving factors, exact location, or radiation. This is obviously important in trying to figure out the cause.

-Thirdly, although coronary artery disease has been thoroughly ruled out as well as microvascular disease, you suggest a possible connection with SVT. Have you had a Holter monitor or longer term monitoring to see if there is an association between the pain and the arrhythmia?

-Fourthly, have you had a GI work up? Since the most common cause of non-musculoskeletal chest pain is gastro-esophageal reflux. (I assume musculoskeletal issues have been excluded.)

Another cause of pain anywhere could be neurological. Is there anything that suggests a neurological cause of this pain? Of course, any pain is complicated by emotional factors. Are there any issues in your emotional life that might exacerbate pain? Finally, I do not think that you have anything to worry about as far as basketball is concerned. Based on the almost complete work-up you have had, the likelihood of your having a heart attack or damaging your heart during physical activity is remote.

Good luck.