Heart Health: Symptoms, Tests, and Concerns Explained

Cardiac health check-ups and related diseases?

Hello Doctor: I do not have hypertension, diabetes, or hyperlipidemia.
My height is 153 cm and my weight is 41 kg, resulting in a BMI of 18.
My arterial stiffness index is 2.4.
In November of last year, after having dinner one evening, I began experiencing pain in my upper left back and discomfort in my upper abdomen (located just below the chest), accompanied by mild gastroesophageal reflux, which lasted for about two hours before subsiding.
In December, I underwent a health check-up that included an electrocardiogram (ECG), a stress test, and an echocardiogram.
The ECG results indicated "ectopic atrial rhythm," while the stress test showed no abnormalities.
The echocardiogram findings were interpreted as "normal chamber sizes; normal left ventricular systolic function; normal left ventricular diastolic function; no signs of hypertrophy; borderline atypical mitral valve prolapse with mild mitral regurgitation; mild tricuspid regurgitation; no pulmonary hypertension; no pericardial effusion; borderline atypical mitral valve prolapse with mild mitral regurgitation." This week, I visited the cardiology department at a major hospital to discuss the ECG findings from my health check-up.
I also had another ECG done at the hospital, and the doctor reviewed the report and stated that there were no abnormalities and that everything was fine.
I mentioned the left upper back pain and upper abdominal discomfort I experienced after dinner last November and asked the doctor if this could be related to my heart, considering I do not have any of the three high-risk conditions.
The doctor simply replied, "How could someone so young have any issues?" My question is, could the symptoms I described from last November be related to my heart? Since I also had gastroesophageal reflux at that time, I am unsure if it is a heart issue or a gastrointestinal issue.
(The health check-up also included a gastroscopy, which showed no abnormalities in my stomach.) I have read online that left upper back pain could potentially indicate "myocardial infarction" or "aortic dissection," which is quite concerning.
If both the stress test and echocardiogram show no abnormalities, does that make it less likely to be "myocardial infarction" or "aortic dissection"? Is there a need for further testing?

Xiao Jie, 30~39 year old female. Ask Date: 2022/02/17

Dr. He Dongjin reply Cardiology

Hello, myocardial infarction and aortic dissection are both emergencies.
If you have been doing well since last November, it is unlikely to be a myocardial infarction or aortic dissection, so there is no need to worry.
It could possibly be a gastrointestinal issue.
Since so much time has passed and you have undergone tests including an electrocardiogram, exercise electrocardiogram, and echocardiogram, and the results of the electrocardiogram are normal, there is no need for concern.
Changhua Hospital cares about you.

Reply Date: 2022/02/17

More Info

Understanding heart health is crucial, especially when experiencing symptoms that could be indicative of cardiovascular issues. Based on your description, it seems you have undergone a comprehensive evaluation, including an electrocardiogram (ECG), exercise stress test, and echocardiogram, all of which have shown normal results or only minor findings. This is reassuring, as it suggests that significant heart disease is less likely.

Your symptoms of left upper back pain and upper abdominal discomfort, particularly after meals, could indeed be related to gastrointestinal issues rather than cardiac problems. The fact that you also experienced gastroesophageal reflux (GERD) symptoms at the same time supports this idea. GERD can cause chest discomfort and mimic heart-related pain, leading to confusion about the source of your symptoms.
The left upper back pain you mentioned can also be attributed to musculoskeletal issues, which are common and can occur due to poor posture, muscle strain, or even stress. It is essential to consider the context of your symptoms, such as their timing, duration, and any associated factors like eating or physical activity.

Regarding your concern about serious conditions like myocardial infarction (heart attack) or aortic dissection, it is important to note that these conditions typically present with more severe and acute symptoms, such as intense chest pain, shortness of breath, sweating, and sometimes radiating pain to the arms, neck, or jaw. Given your age and the normal results from your heart tests, the likelihood of these serious conditions is significantly reduced.

Your healthcare provider's reassurance that your heart tests are normal is a positive sign. The presence of "ectopic atrial rhythm" noted in your ECG is often benign, especially in young individuals without other risk factors. It is essential to maintain a healthy lifestyle, including regular exercise, a balanced diet, and stress management, as these can significantly impact your overall heart health.

If your symptoms persist or worsen, or if you experience new symptoms such as severe chest pain, shortness of breath, or fainting, it would be prudent to seek immediate medical attention. Additionally, if you continue to have concerns about your heart health, consider discussing further evaluations with your cardiologist, such as a Holter monitor to assess your heart rhythm over an extended period or a stress echocardiogram.

In summary, while your symptoms are understandably concerning, the normal results from your heart evaluations suggest that significant heart disease is unlikely. It may be beneficial to explore gastrointestinal causes for your symptoms, particularly given the history of GERD. Always trust your instincts; if you feel something is not right, do not hesitate to seek further medical advice.

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