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High Blood Pressure

Is it a reason for further investigations?

08/25/2008

Question:

I am extremely obese, 39 yr old, Asian female. I hv hypertension, PCOD, and high cholestrol - all controlled by medication. Non-diabetic but strong family history of cardiac deaths, diabetes related complications. In my recent annual check-up I tested negative for heart disease - Stress Test, Stress Echo, Lipids etc. all were normal. Yet I have severe discomfort in my chest, pain in jaw and shoulders etc. Shud I rush each time these symptoms appear? I also have high PTH.

Answer:

If you had a normal stress test and a normal stress echocardiogram (and presumably a normal ECG), the likelihood of significant coronary artery disease is low.

There are many possible causes of acute chest paint that are not cardiac in origin, but that can be serious.  These include blood clot in the lung (pulmonary embolism), gastroesophageal reflux and/or peptic ulcer disease or gallbladder disease.  If these conditions have been ruled out, you can assume that your chest pain does not represent a serious condition.

Chest pain can also be caused by arthritis, chostochondritis or anxiety.  These conditions can be painful and chronic, but do usually not require immediate medical attention.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati