Worried about extreme tightness in chest during day

[Goofproof]

I had no chest pain, but waited 4 days after the heart attact to get to a ER.

I just kept getting weaker and weaker. In retrospect, bad choice, turns our I wasn't invincible after all. As it turns out, I had had a heart attack 10 years earlier at work that I ignored, the pain from that one knocked me to the ground. I was outside, working alone, in zero degree weather I n a foot of snow, I just laid there for 15 minutes, then got up and made my way uphill to the building, sat drank my coffee, went back outside to work. Cold air was the possible trigger.

The big one came in 2005, after I retired due to health reasons, felt nothing, just thought it was the flu or something. Finally on day 4 had t o be taken to the ER, they took me to the Cath Lab, put in 2 stents, sent me home t o get better or die, I was too far gone to repair. In a month they did a quad.

While I think it's just muscles working, but advise you to have it checked out as waiting isn't prone good outcomes. Also being checked out isn't a clear bill of health, it's possible to be cleared and have a attact going back to your car, life doesn't come with a garrentee. Jim

[jab1972]

I have been feeling an extreme tightness in my chest/out of breath feeling the last few days (during the day). This is after 1 week of my most consistent PAP therapy (meaning I use every night and stays on all night). Should I be worried?

I experienced exactly the same symptoms the first week or so after I really got started consistently using the xPAP. I asked the same question here, and got the same "go to the doctor" advice. While for me it was just my chest muscles getting adjusted to exhaling against the treatment pressure, I strongly suggest you follow that "go to the doctor" advice. Chest pains aren't something you ignore.

[DeepFriedDuck]

I strongly suggest you follow that "go to the doctor" advice.

She already has an appointment with her doctor today.

BTW, there is a downside to this type of over caution. I have four friends who have had unnecessary heart catheterizations. There is the high cost, the risk of an invasive procedure and the unnecessary scarring of the blood vessels by the catheter. Those scars encourage the development of clots and add to the risk of heart attack down the road.

[PoolQ]

No one should ever have unnecessary procedures. Period. The point is that the Doctor should decide that. I personally was told straight up that if I hade gone to sleep that night in December that I would have died. Period. 95% blocked and only detected with catheterization. I walked in. I asked the Doctor. He said your going in. That saved my life. Do some get the procedure that should not, no doubt. As my wife says "that is why they call it medical practice, it's not like counting pennies"

[Hang Fire]

I walked in. I asked the Doctor. He said your going in.

If you are going to write something like this, you should state what symptoms and signs you had and what you asked the doctor. Otherwise, your post is of little value.

No one should ever have unnecessary procedures.

That I agree with.

When The New York Times reported Tuesday that doctors at HCA Health Care hospitals in Florida might have performed cardiac procedures on patients who didn't need them, it raised questions about the risks of such unnecessary surgery.

ABCNews.com's Medical Unit breaks down the risks of such procedures for you, step by step:

Cardiac Catheterization

Since cardiac catheterization is a diagnostic test, doctors tend to disagree about when it is necessary to subject patients to it. As such, this area is a bit more "gray" than unnecessary stents, doctors told ABCNews.com.

"If you have a massive heart attack, almost everyone would agree you should undergo cardiac catheterization," Dr. Deepak Bhatt, who directs the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital in Boston, told ABCNews.com. "That's one end of the spectrum where really there's little room for debate."

On the other end, there are symptom-free patients who perhaps have abnormal stress-test results. Or maybe they're having chest pains in the emergency room but are only experiencing indigestion. Either way, they're told they need the test.

"How does a patient, when they're having a heart attack, say, 'I don't think so?'" Dr. Mark Adelman, the chief of Vascular Surgery at NYU Langone Medical Center, asked ABCNews.com.

When a patient undergoes cardiac catheterization, a wire tube, or sheath, is inserted into the arteries in the patient's groin or wrist area (femoral or radial arteries). The sheath carries equipment up to the heart, but before it can get there, the patient faces an initial set of risks:

Bleeding from the artery in the groin or wrist

Blood clot in the arm or leg, which could cause the patient to lose a limb

Bleeding into the belly (if the artery near the groin is punctured too high)

"Any of those can be life-threatening problems," Adelman told ABCNews.com. "Those are the local complications."

Next, the doctors thread the sheath up the artery toward the heart, resulting in the second set of risks:

Sheath disrupts plaque in the arteries, causing a clot

Equipment punctures artery walls

Stents

Once doctors have threaded their equipment inside the body, they can choose whether to insert a stent, which is a metal mesh tube that works with a balloon to expand and open up a narrow artery. If a stent is inserted, the patient faces another set of immediate risks:

Equipment disrupts plaque in coronary artery, clogging a blood vessel and blocking oxygen from the heart

Stent punctures coronary artery

Regardless of whether a stent is necessary, Bhatt said one or two out of every 100 patients undergoing stent surgery experiences major complications, such as heart attack or stroke, even death. He said the risk is higher in people who have heart disease, but even for patients who don't need stents, the risk isn't "zero."

Bhatt said there's less than a 1 percent chance a patient would experience complications from plaque breaking off and traveling downstream in the same artery to cause a heart attack.

Once patients makes it through stent surgery, they also face long-term risks as the body reacts to the foreign object.

Stents can develop blood clot

Stents accumulate scar tissue over a period of months

The blood clot risk is rare at this stage, however, occurring less than 1 percent of the time, Bhatt said.

"When it does happen, it can result in a heart attack," he said. "One minute the stent is open, and in less than a minute, it's closed."

Less than 10 percent of patients now develop scar tissue in stents -- before 2003, when stent technology was less developed, the risk was greater.

https://www.google.com/search?q=unneces ... 8&oe=utf-8

[Physician]

I haven't been here very long, but I have read a lot of posts, both new ones and old ones. There are many new CPAPers who report chest pains in the beginning. I never read that any one of these was having a heart attack.

If you go along without chest pains and then you start CPAP and have chest pains, then why be scared of a heart attack?

!

That is very bad advice, we do not give that kind of advice on this forum. ALWAYS check out chest pains ALWAYS. Heart attacks can happen to anyone, anywhere, anytime. A healthy 32 year old coworker died at a pool party from a heart attack in front of his kids.

I agree...chest pain and shortness of breath during the day?.....play it safe...see your doctor TODAY.

Agree with seeking medical care immediately, but "constant chest discomfort and shortness of breath for days" is almost certainly anxiety. Give us follow-up on the diagnosis and treatment.

[Hang Fire]

Agree with seeking medical care immediately, but "constant chest discomfort and shortness of breath for days" is almost certainly anxiety. Give us follow-up on the diagnosis and treatment.

So doc, what do you do with this patient when she shows up in your examining room?

[PoolQ]

Hang fire. I had chest pain, nothing else and by the time I got in the car it was almost gone. Almost went back in the house, but my wife said no to that. For me the hooked up to an EKG and admitted me. They took blood and tested for enzymes. I have no idea if these test results cam back before the entrance into the cath lab, but the EKG should I was having a cardiac event right there in the ER lobby (this is quite rare and they usually can only tell by the blood test)

RE the article, exactly how the heck am I supposed to know if I am having a heart attack if the Doctors with YEARS of schooling disagree? In the end, if you are in front of a Doctor, you as the patient can always listen to them and refuse treatment. After having had a heart attack, my Doctors advice to me now is if I think at all that I am having heart issues I need to call an ambulance and not drive myself in again. I am going to follow his advice, you do whatever you want.

What does the Doc do? Blood test looking for heart enzymes for sure. While waiting for the results probably an EKG. Other than that I personally have no idea, but I bet the Doc does.

Good luck with your quest to not see a Doctor when you are having chest pain.

[Hang Fire]

PoolQ, I am going to guess you are obese, probably morbidly obese, and have a history of sedentary lifestyle and poor diet and high cholesterol levels. Right?

[BlackSpinner]

PoolQ, I am going to guess you are obese, probably morbidly obese, and have a history of sedentary lifestyle and poor diet and high cholesterol levels. Right?

Most of the people I know who had heart attacks were neither. That includes the coworker that died at 32 - very fit and handsome guy who played hockey.

[Hang Fire]

Most of the people I know who had heart attacks were neither. That includes the coworker that died at 32 - very fit and handsome guy who played hockey.

Oh, pardon me! There was a typo in my post. I meant to say being morbidly obese, leading a sedentary lifestyle and having high cholesterol and a poor diet protects you from heart attacks.

Thanks for the correction!

[SewTired]

I haven't been here very long, but I have read a lot of posts, both new ones and old ones. There are many new CPAPers who report chest pains in the beginning. I never read that any one of these was having a heart attack.

If you go along without chest pains and then you start CPAP and have chest pains, then why be scared of a heart attack?

!

That is very bad advice, we do not give that kind of advice on this forum. ALWAYS check out chest pains ALWAYS. Heart attacks can happen to anyone, anywhere, anytime. A healthy 32 year old coworker died at a pool party from a heart attack in front of his kids.

I agree...chest pain and shortness of breath during the day?.....play it safe...see your doctor TODAY.

Agree with seeking medical care immediately, but "constant chest discomfort and shortness of breath for days" is almost certainly anxiety. Give us follow-up on the diagnosis and treatment.

Chest discomfort can also be caused by muscle strain from finally sleeping on your back or in one place. They call it discomfort, but it was agonizing. Doc just told me to take the pain pills I already had and within a couple of days, all was fine again.

[PoolQ]

PoolQ, I am going to guess you are obese, probably morbidly obese, and have a history of sedentary lifestyle and poor diet and high cholesterol levels. Right?

Sorry, but no.
Turned 60 in April this year
6'0" 170 pounds
I do sit at a desk for work when in the office, but my wife and I walk 2.6 miles a night 7 days a week (yes we measured it). I end up walking all over the building and always take the stairs.
as for diet most likely too much red meat, but cholesterol levels were and are just fine.
type 2 diabetic controlled totally with diet, ZERO meds for it. (doc thinks this is what caused the heart damage) when I was diagnosed my glucose was at 350 fasting.
so hang fire, you made a lot of assumptions and missed the mark on every single one of them. Oh well.

Peace.

[chunkyfrog]

There is no one set of symptoms for heart attack.
Some are more common than others, and lazy "physicians" often only go after the low-hanging fruit.
{{{maybe YOU are too difficult for their above and beyond!}}}
I wish every doctor were as driven and curious as the ones on TV,
but real life is not so well-arranged.
Behind the mask, you may find Frank Burns or Dr. House.
Now think about all the dips you knew in school. Yeah, that's what I mean.

[Chevie]

Turned 60 in April this year
6'0" 170 pounds
I do sit at a desk for work when in the office, but my wife and I walk 2.6 miles a night 7 days a week (yes we measured it). I end up walking all over the building and always take the stairs.
as for diet most likely too much red meat, but cholesterol levels were and are just fine.
type 2 diabetic controlled totally with diet, ZERO meds for it. (doc thinks this is what caused the heart damage) when I was diagnosed my glucose was at 350 fasting.

Just being 60 years old with untreated sleep apnea, which you probably had for years, qualifies you as high risk for heart attacks. (Sleep apnea most likely was the major contributor to your type 2 diabetes.)

I am 99% certain I had three heart attacks before I started CPAP. I sought medical attention on none of them.

Since starting CPAP and working myself into much better shape, I think I am at low age-adjusted risk for heart disease.

The next time I have symptoms of a heart attack, I will seek medical attention. I don't want the fourth one to be a widow maker.