Did Stress Test

[randylan2]

Everything looked good
FAST FOWARD
Still having upper back middle  pain.
Not constant but feel the pain/ feel like preasure and pain.
I was put on high blood pressure meds.
My family doctor told me no other testing is needed.
But I continue to have this preasure pain feeling in center upper back
My question is anyone with any suggestions what I should request more testing?
I am 54 slender and mostly good health.
Still concerned about the preasure pain I continue to feel.
Likely am having little anxiety
Slight anxiety attacks
Sometimes rapid heart beat
Can’t breath feelings  
Considering it could be just the stress of the pain.

[ayl291]

A vq is physiological vs anatomical.

V = ventilation
Q= perfusion= Blood/ time/ tissues ( volume)...

But it sounds almost more like gerd or a hiatal hernia may be at play here...

That would require


An endoscopy and or barium swallow, and or manometry.

Do you get heart burn?

[randylan2]

No But me trying to explain the upper back pressure pain feeling kinda has that heartburn feeling. The pain is upper center back. not constant. Comes and goes. I do have high cholesterol history and last year or so high blood pressure.  Currently on HB small dose medication.   other then that I am in good health.
I have read other articles about upper back pain might be caused by neuro or  possible early signs of arteries partial blocked.
However the Nuclear Stress Test came back good.
Downsloping noted, But  the heart pics show normal. My cholesterol levels have been high since I was In my late teens. Blood pressure issues only started In the past year or so.

[ayl291]

Echo with bubble simply uses agitated saline and ultrasound... completely safe.

It could be as simple as gerd or hiatal hernia.

But I do think you shouldnt let it go.  It's your health and you should pursue it with other clinicians if you still feel bad.

Things often get over looked!!

[ayl291]

I think you need a more comprehensive panel of testing.

Have you had a vq scan?
Chest ct/cta?
Echo with bubble?

To start with.

[randylan2]

I had a ekg and stress test with dye.
And My Family doctor does not seem to concerned about the back pain pressure feeling.
Put me on HBP med.

[randylan2]

What is echo with buble?
VQ scan?
I am guessing maybe I should myself call a new cardiologist
And make apmt.
I have good medical but not certain if I would need mandatory refferal from mr
Family doctor.
Family doctor does not seem to concerned of my symptoms
The upper center back pain and pressure feeling comes and goes Kinda like heartburn
I would like other testing
That might help diagnose the upper back center pain

[erijon]

Did you have a stress test with imaging? If so these things are about 97% accurate in finding heart disease. The next test would be an angiogram which carries a very real risk of complication and I doubt anyone would do one without additional symptoms. You may be best served by getting a second opinion.

[ayl291]

Hi Erijon,

I'm sorry to say 97% is not an accurate statistic.

For example PE is missed on initial cta about 28% of the time.

PAH initial testing misses it over 70% of the time unless in 4th stage.

CAD also has an especially false negative rate, especially in women.

So, I am not sure where you are getting your numbers but the only testing that is 97% accurate is probably looking for a pavm with bubble.

[erijon]

Thanks for the clarification, I'll have to check my sources.

[erijon]

OK, checked my sources and the NIH shows a specificity of 94% for stress test using thallium imaging to find coronary artery disease, I was off by 3 points. I had some old data.