What causes chest discomfort with a normal ECG?

Question

Hello doctor,

I am a 36-year-old man. For the past six to seven months, I have been feeling discomfort on the left side of my chest. I visited a doctor who performed an ECG, which was normal. However, after a month or two, the discomfort returned. I began waking up early in the morning at around 4 AM, feeling uneasy and unable to go back to sleep. My doctor then conducted a 2D echo, which was also normal, and recommended a CT angiogram, which came back normal as well. But again, after seven to ten days, the discomfort reappeared. I have had an ECG three times, a 2D echo twice, and a TMT twice, all of which were normal. I am unsure whether this is a cardiac issue or something else. I quit smoking last year.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

Your repeated cardiac tests have all come back normal, according to your reports (attachment removed to protect patient identity), so it is highly unlikely that this is a cardiac issue. I recommend undergoing an upper GI (gastrointestinal) endoscopy to rule out GERD (gastroesophageal reflux disease), as it can also cause similar chest discomfort. In the meantime, you can take a combination of Pantoprazole and Itopride once daily before breakfast for the next two months to see if it helps improve your symptoms.

Wishing you a speedy recovery.

Answer 2

Hello,

Welcome back to icliniq.com.

Your cholesterol levels are elevated. I recommend taking Atorvastatin, one capsule after dinner. Please consult your specialist doctor, discuss this with them, and start the medication with their approval. Avoid junk food, as well as spicy, fried, and fatty foods. Focus on consuming plenty of green vegetables, fresh fruits, whole grains, and salads.

You also seem to be experiencing anxiety and stress. Manage these by practicing deep breathing exercises for five minutes, twice a day. Incorporating yoga and brisk walking for 30 minutes daily will also be beneficial.

For the pain in your left chest and numbness in your left hand, you can take a combination of Methylcobalamin, Levocarnitine, and Folic acid, one tablet daily for 10 days. Additionally, I suggest getting an X-ray of your cervical spine in anteroposterior and lateral views. Once we have the reports, we can discuss the next steps.

I hope this helps you.

Thank you.