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Exercises for Chronic Chest Pain?
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ACerulean posted:
I have posted on this forum before about the fact that I have severe chest pain after almost any form of physical exercise. I have undergone numerous ekgs, two stress exercise tests, an event monitor test, and numerous echocardiograms. All of these tests have come back normal save for a slight case of aortic valve stenosis. I am scheduled to see a adult cardiologist and to take a stress echo test in the next few weeks. My doctor has come to the conclusion that what I am experiencing is muscle related and has arranged for me to begin physical therapy. I want to know if there are any exercises that I can do at home that might help with the chest pain. I am quite alright with anything suggested, but I would expect that it would be something like stretches. I have no idea if it is really muscle related or if this is a case of angina which has not been properly diagnosed. I find it difficult to believe that I have any sort of blockage because I am only eighteen. I do however lead a very sedentary life and I do consume and have been consuming more fat and calories than I should since I was very small. My main question is what are the exercises that I can do to deal with the pains?
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brunosbud responded:
If you are "sedentary" and eat a high fat, high calorie diet, assuming that just because you're only 18 is going to protect you is a big mistake. Huge.

You are smart in thinking that an exercise program can bring you back. You're also smart in working closely with your doctor.

No be smart and direct your exercise question to Rich Weil on the "Fitness and Exercise" community since he's expert on the matter.

Finally, if you suffer chronic pain, please, read and obey the following...

  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
  2. Do you feel pain in your chest when you do physical activity?
  3. In the past month, have you had chest pain when you were not doing physical activity?
  4. Do you lose your balance because of dizziness or do you ever lose consciousness?
  5. Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?
  6. Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
  7. Do you know of any other reason why you should not do physical activity?
If you answer YES to any of the questions on this list, you must check in with your doctor and get cleared for exercise before you start.

Chest pains, whether you're 8 or 80, means all bets are off. In other words, no assumption is safe. Please start eating "smart", now.
 
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ACerulean replied to brunosbud's response:
Thank you very much for the suggestions. The only reason that I made any assumptions is because I have been thoroughly chastised before for even beginning to think that I might have some sort of coronary or cardiac disease. I will be sure to repost my question in the exercise forum.
 
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billh99 responded:
I am more familiar with PT for hip and lower back problems. Although I had LOTS of PT after rotator cuff surgery.

In general the PT will look for range of motion of the neck, shoulders, and back. And for both the absolute and the relative strength of the muscles.

For stretching, besides just using your body, you might use things like a foam roller and an exercise ball.

And often the muscle exercises can use just the body weight, an exercise ball, light hand weights, and stretch bands.

Going to a PT can be an educational exercise where you learn to listen to your body.

BTW, cleaning up your diet will help reduce/control the inflammation whether you pain is muscular or cardiac.
 
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ACerulean replied to billh99's response:
My only other question is whether or not I should speak with my doctor about the possibility of doing a cardiac cath to completely rule out the possibility of coronary artery disease. Am I too young for coronary artery disease or should I suggest it?
 
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billh99 replied to ACerulean's response:
While young people can have heart disease, in most case it is of different types than problems than CAD.

Now there are cases of young people with CAD, but they have genetic cholesterol problems that would have shown on standard cholesterol test.

Unless something shows on the stress/echo I doubt that they will do a cardiac cath. But talk to your cardiologist about this.

I don't know if you are familiar with the stress echo or not. But you will have an echo and then do the stress test. IMMEDIATELY after the stress test they do another echo.

If there is a restriction in blood flow it will often show as an area of reduced motion of the heart wall. They will also look for valves that appear to be OK, but don't work as well as they should under load.

And you might ask about a nuclear stress test. In that you are given a radioactive tracer and the uptake is measured in the heart muscle. Then it is repeated after the stress exercise. That also shows areas of the heart that get blood at rest, but not enough under load. Don't know the details of the benifits of that verse the stress/ech.

You might also ask about getting a CT calcium scan (Cardio Scan). That is a specialized CT that looks for calcium deposits in the arteries. And the calcium deposits are related to plaque.

While a high calcium deposit does not prove a blockage, it does show that you are at a higher risk for one.

The cardio scans are not covered by insurance and can cost $200-300. But many places they are available for $50-100.
 
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billh99 replied to ACerulean's response:
should I suggest it?

You always want to be an active part of the processes. Ask questions. And tell him your concerns. That way he can give more specific answers about what he sees and what areas to look at - rather than just "the test didn't show anything".

The more information that you have the better that you will understand the problem, if you have a problem, or be more re-insured that you don't have a problem.

Remember that you are your own best doctor.
 
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ACerulean replied to billh99's response:
I know have a new question. I recently, as in just last night, experienced some worrying symptoms including but not limited to cold sweat, racing and pounding heart, chest pains across the breast, and shortness of breath. I know that what I am describing sounds like a heart attack, but it could also be an anxiety attack and because of that I am worried about speaking to doctors about it. I spoke with a physician from my health care provider about it on the phone and she wrote it off as a indigestion or anxiety, but when I spoke to my primary care physician she thought that it might be a rhythm issue. I was also told to go straight to the ER if this happened again. Please bear in mind that I am terrified of the ER and therefore do not want to have to be in there. Does this sound like a heart attack, a rhythm issue, indigestion, or what?
 
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billh99 replied to ACerulean's response:
I am not a medical professional and wont' directly answer your question.

And even if I was a medical professional I would not/could not answer your question.

That is not always an easy question to answer and often a battery of test is needed to tell the difference.

but when I spoke to my primary care physician she thought that it might be a rhythm issue.

At your age a rhythm problem is much more like than a heart attack.

If it was me and my heart rate was over 120 (and I was not just exercising) it would be time to head to the ER.

But it is possible that you can also have those same symptoms from anxiety.

But over time body reacts to the stress with hormones and can cause damage to the body as much as a real disease.

So whether the anxiety is causing the symptoms or you have some medical condition and those symptoms are causing the anxiety you clearly have an anxiety problem.

And that amount of anxiety is really a serious problem.

I AM REALLY SERIOUS ABOUT THIS. YOU NEED HELP BREAKING THE ANXIETY CYCLE.

Tell your PCP that you want (no need) a councilor to work with that can help with the anxiety and learn some relaxation methods.

I know that you said that any exercise cause pain. But if you can just walk then find a place that you can walk in someplace like a park or nature trail. Do that several times a week.

Even that little amount help both the anxiety and improve your heart.

Please let me know how it is going.
 
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ACerulean replied to billh99's response:
Thank you for the prompt reply, I will see to it that I ask my psychologist about anxiety and the possibility of anti-anxiety medications. I do rather wish that you could have answered my question about it being anxiety or a heart attack, but I can completely understand why you would not.
 
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deadmanwalking57 replied to ACerulean's response:
You should use a heart rate monitor when you exercise.

Always more up gradually to first improve circulation to your heart. With your chest pain problems, slowly increase your exercise pace, in 3 minute increments to see what your heart will tolerate pain free. Pain free is very important. You should also not be breathing hard AT ALL, no matter what.

Six years after bypass surgery, I recently played basketball for 40 minutes with not a single moment of chest pain or shortness of breath. Years of slow and careful rehab helped me get here.

Get all fats out of your diet. Only fresh foods, lots of fruit, especially berries. I have pomegranate juice almost every meal, and blueberries multiple times a week.

Assume you have heart disease, and adopt a diet for it to save your life. There is no way this suggestion could hurt you, and over the course of months may make a HUGE difference in reducing your symptoms.

I am not a doctor, but my doctors have told me that whatever I am doing, keep doing it. Nurses tell me to write a book for others to follow all the things I have learned. Meanwhile I am a model of fitness for people of almost any age, with a scar up my chest from bypass surgery.

WebMD, the Magazine, will have a short biography on me in an upcoming edition.

DMW


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