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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 58359
Experience:  Cardiology Expert
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I am worried I might have coronary artery disease. Based on

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I am worried I might have coronary artery disease. Based on the following, could you please advise me if I may be at risk?
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!
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 and other Cardiology Specialists are ready to help you
Customer: replied 2 years 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.
This is simply deconditioning
As your fitness improves, this will get better
Also quitting smoking will help.
Customer: replied 2 years ago.

Thanks very much :)

Welcome. :)