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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 53171
Experience:  Cardiology Expert
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I am worried I might have coronary artery disease. Based on

Customer Question

I am worried I might have coronary artery disease. Based on the following, could you please advise me if I may be at risk?
Symptoms:
1) Palpitations.
2) Mild chest pain, left arm pain, and pain between shoulder blades. This pain comes and goes and does not seem to worsen with exercise. Occasionally it is sharp and has a 'stabbing' quality.
3) Low exercise tolerance after which it takes upwards of 30-45 minutes for my heart rate to drop below 100bpm.
Personal info:
Age: 32.
Sex: Male.
Weight: 171 lbs / 77.3 kg.
BMI: 23.8 (normal).
Estimated body fat % - 23% (approx).
Alcohol: Rarely. 4 to 8 units per month.
Smoking: Yes. 9 pack/year history. Also I grew up in a smoking household so I have a lifelong history of passive smoking.
Drugs: No history of illegal drugs of any kind.
Total Cholesterol: 3.0 (UK measurement. Unsure of US equivalent. Was assured by my Dr. that it was in normal range).
HDL: Unknown.
LDL: Unknown.
Diet: Generally poor. Lots of junk food.
Exercise: Almost never.
Family history:
Mother's side: None.
Father's side: History of heart trouble. Father has had 1 mild heart attack (teetotal smoker, aged 63 at the time). Grandfather had four heart attacks (smoker, drinker, first attack at 40).
Past medical tests:
1). Echocardiogram - Normal result.
2). 24hr ECG - Normal result.
3). 72hr ECG - Normal result.
4). Treadmill test - Normal result.
My concern is these tests are not sensitive (as far as I know) for coronary artery disease.
I have made efforts to improve my lifestyle recently (stopped smoking, eating healthier) but am worried the damage may have already been done. My Dr. thinks it may be anxiety but I am unconvinced as I have no history of anxiety and do not live a stressful life.
I realise I'm very young to be worrying about this. However, such things aren't unheard of. A good friend of mine had a major heart attack aged only 34!
Many thanks in advance for your help!
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.
I'm basically 100% convinced that you don't have CAD based on these tests
the risk factors, age and negative tests make it totally unlikely
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 53171
Experience: Cardiology Expert
Dr. Phil, MD and other Cardiology Specialists are ready to help you
Customer: replied 1 year ago.
Thank you for your prompt and reassuring response. It is very much appreciated! I just have one follow up question. As I mentioned, my heart rate tends to take an inordinately long time to drop below 100bpm after moderate cardio exercise (eg. 30 minutes easy jogging). As I understand it, this is unusual. Can you think of any reason why this might be? Alternatively, am I mistaken in my belief that this is unusual?
Many thanks.
Expert:  Dr. Phil, MD replied 1 year ago.
This is simply deconditioning
As your fitness improves, this will get better
Also quitting smoking will help.
Customer: replied 1 year ago.

Thanks very much :)

Expert:  Dr. Phil, MD replied 1 year ago.
Welcome. :)

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