Sunday chest pains

[Cogcog]

For the past year my OH has had periodic but severe night time chest pains (so bad they sometimes make her vomit). She had been in hospital twice for the first 2 incidents and has been on the ECG and since then has had various tests and treadmill sessiions but they cannot find the cause. Happens about once a month or 6 weeks. I have noticed that they occur mainly on certain days(mainly Sunday Night to Monday normning) and at critical stress periods (Mum in hospital, pets ill, major doctors appointments, Christmas day, new years eve) but mostly an obvious cause of any anxiety or stress isn't evident. She doesn't work in the traditional sense (does odd bits of office work for me but not regularly). Her doctor just suggests anxiety/stress but often an obvious cause of any anxiety or stress isn't evident.

We are now at a loss as to where to take it. How do you deal with stress/anxiety which mostly isn't overt?

[E21_Ross]

some things which may help:

age, how long this has been going on for, description of the pain, anything which relieves the pain (certain positions e.g. leaning forwards, pain killers etc), has she had recent infection, has she ever had rheumatic fever, is it getting worse over time or staying the same in severity and frequency etc., any family history of cardiac and/or pulmonary disorders, how physically active is she etc etc

i'm assuming your GP did a cardiac exam, including the use of a stethoscope, and nothing abnormal was found?

[Cogcog]

E21_Ross said:

some things which may help:

age, how long this has been going on for, description of the pain, anything which relieves the pain (certain positions e.g. leaning forwards, pain killers etc), has she had recent infection, has she ever had rheumatic fever, is it getting worse over time or staying the same in severity and frequency etc., any family history of cardiac and/or pulmonary disorders, how physically active is she etc etc

i'm assuming your GP did a cardiac exam, including the use of a stethoscope, and nothing abnormal was found?

Not much seesm to relieve it, even morphine at hospital. She had all of the blood testss when she was last in hospital and has since had the treadmill tests with the consultant actually watching and interpreting results: nothing.

[LBird]

Could it be reflux? It can produce vomiting and pain that is often mistaken for a heart attack. Is there any correlation with the food she's eaten? Do she go to bed less than two hours after she has eaten? You mention that it occurs mostly on Sunday nights - is Sunday a particularly 'foodie' day for her?

Might be worth keeping a food diary for a while to see if there any obvious triggers.

HTH - horrible for her to be suffering like this and no doubt both you and she are worried sick about it.

[Bridgewaterfalls]

Chest pain is a very common manifestation of stress/anxiety. Oesphageal reflux and spasm are also contenders.

It sounds as though ischemic heart disease has been excluded, I assume structural heart problems were excluded (eg valve problems), and respitatory examination and CXR were normal.

One thing to ask your wife is the association with her menstrual cycle, as episodic chest pain (execeptionally) rarely is caused by endometriosis. The pain ought to be at time of her menstration.

[Cogcog]

Bridgewaterfalls said:

Chest pain is a very common manifestation of stress/anxiety. Oesphageal reflux and spasm are also contenders.

It sounds as though ischemic heart disease has been excluded, I assume structural heart problems were excluded (eg valve problems), and respitatory examination and CXR were normal.

One thing to ask your wife is the association with her menstrual cycle, as episodic chest pain (execeptionally) rarely is caused by endometriosis. The pain ought to be at time of her menstration.

I had thought about a 'cycle' to the pains but there is none evident in the dates which we have been keeping since June last year. She did have something for Oesphageal reflux when it started but I think that was a speculative punt on the part of the hospital doctors pending the treadmill tests. I am not sure what you mean by CXR but her GP and the hospital have had numerous examinations and can find nothing physical. We have now changed GPs as her GP's attitude was that she should count her blessings snd stop worrying, at the same time as having not asked for some key blood tests. Anyway, we are trying a few sessions of hypnosis/CBT pending a chat with the new GP when we can clarify exactly what tests have and haven't been done.

[E21_Ross]

CXR means chest x-ray. i assume they have done one...