Not sure what to do....heart pains

Type 2
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For the past year i have experience slight fluttering pains about 1 inch below my clavicle bone on the left side. They are not sharp pains but they seems to travel around the perimeter of the upper breast. I have even had them close to the sternum. They come and go and there doesn’t seems to be a pattern or consistant time they come. I have noticed when I am a little stressed they come but then I don’t have to be stressed at all and they come. This has been happening since last year.

I did see a Cardiologist and I did have a battery of tests done like the treadmill and such. The Cardiologist was not alarmed by anything and had a wait and see approach… I switched insurances and now I have to start the process over with an HMO because this is all my employers offered. The new PCP put me on a 24 hour monitor and didn’t seem bothered by the results even when I did have my symptoms during the monitoring.

After all this monitoring, I am still having these little pains and I am not sure what to do? I am thinking about asking to see a Cardiologist with this new insurance. I really don’t feel the PCP is being very tentative to my needs. I am taking blood pressure pills I am not sure if this needs to be adjusted.

Any suggestions…

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That sounds concerning. But if you got checked out maybe it’s just stress or anxiety.

I had some symptoms of low heart rate and low blood pressure. I wore a heart monitor for 3 days and they found nothing.

At least maybe you will sleep better knowing there isn’t something Psyiological wrong

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The problem with chest pain is, it can be caused by so many different things: of course the heart, which can be an emergency, or by the blood vessels around the heart (aorta, for example), but can also be pleuritic (relating to the lung lining), or gastrointestinal (esophagus), or musculoskeletal (ribs, intercostal muscles) or something within the breast tissue, or even referred from the back/spine, potentially a response to a psychological process.
So the serious potential causes need to be examined and ruled out to the extent possible, and then the common causes need to be considered, and sometimes diagnosis requires a trial of treatment, and finally you’re stuck with the “I don’t knows”.
This isn’t medical advice but rather a framework for thinking about chest pains. Don’t ignore them, but once satisfied that they’re unlikely life -threatening you must get on with your life, paying attention to potential changes in symptoms but not letting them rule you!
I don’t know whether any of this helps at all, but it sounds like your initial approach was reasonable, leaving only a requirement to broaden a diagnostic tree that includes the less common but serious causes and perhaps addresses trial-of-therapy (eg GI causes).
But medicine sometimes leaves one with insoluble mysteries. I’m not sure that you have arrived there however.

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Those pains could be serious or non-serious. It depends on a lot of things.

You should see a cardiologist again.

After the treadmill test, there are a number of relatively easy and noninvasive tests that can be done.

You can get a calcium score if you haven’t already done that. That one is super easy. They can look at your lipid tests (certainty they have been doing that already).

Another very easy thing they can do is let you wear a heart monitor for a few weeks (it is a small little stick-on, much like wearing a Dexcom), and whenever you feel a pain, you enter it in the phone app they give you. After a few weeks, they take the heart monitor off and look at what your heart was doing whenever you recorded the pain.

And then the next thing is cardiac CT imaging test with contrast dye. That is a pretty easy test, not invasive like the angiogram.

For a cardiac CT, they give you some medicine to slow your heart rate, and then they inject contrast dye into a vein, so they can see it a little better.

Depending on the cardiac CT result, they might want to go to the next level of testing, which is the more invasive angiogram.

Anyway, those are a few of the different test options you have. Don’t hesitate. See a cardiologist, and discuss the different test options that are available. Of the ones I listed, only the angiogram is truly invasive. The others are just a dye injection, a scan much like an x-ray, or wearing a monitor for a few weeks. Pretty easy stuff.

Here is a little summary of different tests from a while back. Just simplified explanations.

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Everyone is giving you good advice here. I have heart stents, so have had a bit of experience. I think you should see a second cardiologist. Since you have had quite a few negative tests, I think your pain is from anxiety, but it certainly is a good idea to see someone new.

I have gone to emergency 3 times since getting two stents 11 yrs ago. I had no pain when needing stents just very heavy arms and fatigue. The pain I have had since then has been caused twice by anxiety and once by costcochondritis which is inflammation of the breast bone. Since your pain comes and goes I would guess that it is from stress whether you feel stressed or not. Once I have pain near my heart I start worrying and stress myself out over it. Always get chest pain checked out though, because women with heart attacks present differently than men, and a woman with diabetes can also present differently because of undiagnosed neuropathy.

Try not to worry.

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Hi,nice to have you join us. Since you have had this a while sounds like monitoring things and making a plan with your PCP might be the way to go. Years ago ,I had similar issues,I used meditative short walks and breathing exercises to calm myself. Let’s face it diabetes and COVID can give all of us anxiety. Best of luck. Nancy50

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thanks for the tips…i have done mostly everything you have suggested. I am going to request to see a cardiologist and ask about the calcium test. I will let my ENDO know also so they are aware… I just dont get warm fuzzy feelingsfrom my PCP.

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I have with tudiabetes since the 2000’s. I just don’t come around often since the change in the platform…I am starting to increase. my exercise routine… cuz I am worried about this…

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Been reading through this discussion with interest. I had my first stress test shortly after diagnosis because of some intermittent and wondering chest pains. This was strictly a stress test with ECG and BP. SInce then I have had regular stress tests with contrast. The first one of these caused me to have a cardiac catheterization, because of suspected scar tissue on the bottom rear of my heart. It was negative, but has been seen in everyone of these stress test with contrast.

My cardiologist convinced me to do a chemical stress test with PET scan. He said this would light up all of the coronary arteries. Thankfully it was negative.

Why am I telling you all this? It’s because there are several kinds of stress tests. My pride in being fit caused me to do the treadmill even though I have knee problems when the speed and incline are increased. But, the choice between another catheterization and a PET scan was easy.

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Here is a great website and blog about women and heart disease. Be sure to read the articles under the tab “Women & Heart Disease.” You’ll see Myths and Facts, Gender Differences, Am I having a Heart Attack, etc.

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The fluttering sounds like it could be an irregular heartbeat. An irregular heartbeat can be serious, or it can be nothing, depending on what’s causing it to be irregular. Many times, it can be triggered bystress, or it can be caused by abnormal electrical activity, which is more serious.

I sometimes have an extra heartbeat when stressed. My doctor has heard the extra beat and has caught it on an electrocardiogram. They tell me it is harmless but worth monitoring, so they monitor and I don’t worry.

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thank you for this!!!

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I wore a monitor and Ihave the results. I honestly don’t know what they really mean. I have nothing to compare it too. I know since the superbowl I have experienced some more pains also on the inner right breast close to the sternum. I was extremely excited. I finally got a referral to a cardiologist but that is not till April… I am so pissed.

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Usually you don’t get the results, they go to your doctor first.
When I had mine I saw all of the “ events” and none were alarming. I had one event of a fast heart beat, but I’m thinking I was drinking coffee on a walk during it.

My main concern was bradycardia, which was confirmed by wearing the monitor. My average resting heart rate was 50 beats per min. But I went as low as 44.

The thinking is that it’s just my normal and I’m not doing anything about it.
The raw data I got only came after I requested it from my cardiologist.
Did you get a report along with yours?
I’m guessing if they saw your results and scheduled you in April then there wasn’t much to report

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I would also find a doctor (easier said than done) that will draw a full nutritional panel. Deficiencies in several nutrients can cause the symptoms you are describing, such as magnesium or potassium. Thyroid disease could also be a culprit. Most doctors are not trained to order a full thyroid panel, but that is something you should request as well. A TSH test alone is not enough info to diagnose thyroid problems. There are places you can order these labs yourself if you have to go that route. If you end up needing the info, PM me and I can point you to a couple companies.

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I also started having something like that and my heart was having racing episodes. It would even wake me up, and I would quickly go to my blood pressure machine. Sometimes it was 140 and higher, think my highest was 168. The did the holter monitor for 24 hrs, which showed nothing, then an event monitor for 7 days. That was the right thing that showed what was going on. Also had an echocardiogram to check out out the structure of the heart. Anyways, to make a long story short, I was diagnosed with Atrial Flutter and now am on a Calcium Channel Blocker. I was at first put on a Beta Blocker, but because I have severe asthma, I started having trouble. Had chest pain/tightness, swollen legs/ankles, and felt like I was drowning. My respirologist freaked out when she found I was on it, as people with asthma should not take a beta blocker. Then I was switched over to the CCB. So, keep checking it out, as it can sometimes take awhile to find the issue, and if you have asthma, don’t let them give you a beta blocker. All the best.

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