Hello. I'm new here. Can't find any previous discussion on the following so here goes...

I went to see my GP mid July with high BP, chest pain, breathlessness (and feeling generally rather stressed). I have a major family history of heart problems. He referred me to cardiology chest pain clinic where I have had:

ECG - normal

Treadmill/ECG - normal

Stress EKG (the one where they inject dubotamine and atropine to get your heart going)- despite being 6 weeks ago and a number of enquiries from me I have still heard nothing and was beginning to assume that no news was good news. Not impressed with the lack of communication.

Then today I received a call out of the blue from someone (a nurse I think) asking me to come for a Myocardial Perfusion Scan (radionuclide - nuclear medicine test).

Are they just covering all the bases and only doing this because they have found nothing so far or does calling me for this new scan mean they have found something and need to investigate further? Is the nuclear option something they bother with when there is nothing wrong or can I assume that progressing this far means they are onto something? As I said, they haven't really been commmunicating very well with me so I'm in the dark.

Any thoughts welcome.

Hi Jon

Sorry to hear that you have been going through it a bit. From what you tell me the medics have done all that they could reasonably do to find out if you were in any imminent danger. It is surprising what symptoms can cause. Very real pain as in the chest pain and other pains can be manifest just from stress and I think that you need to address whatever is causing that. Of course if it was the fear that you might have heart disease, then at least now you know that you are normal, medically, which should help.

Thanks. I know a little bit about stress being a clinical psychologist wiorking in a physical health context. I know that stress can cause virtually any symptom you care to mention. And yes - stress is undoubtedly part of the picture for me - I'm just not sure yet where between 1% and 100% it is though.

I've now been given a rationale for why they are going for the nuclear option (myocardial perfusion scan). It is because, although most tests have come up negative so far, the stress echo was a suboptimal test in that they reached the maximal dose of dobutamine and atropine without my heart rate reaching the target level. So it seems that they are just covering all the bases and going for the myocardial perfusion scan because of the stress EKG being incomplete/inconclusive - and not because they've actually found something. Still - the nuclear option does seem a bit like overkill. But from what I've read, a negative myocardial perfusion scan predicts that going on to have a future major cardiac event is very unlikely - so I guess I should be pleased that they are prepared to spend money doing it for me.

Hi Jon

How are thing going now? Have you got any further with trying to get to the bottom of what is wrong with you? I know that recently I went thorough a very rough patch and had chest pains all the time, that now that things are back to normal have disappeared! I hope you are doing very well.

Thought I would touch base again to see how you are. I have a female friend, 53, fit and slim, exercises everyday. Got a little stressed at work, did not feel well and pitched up at her doctors. Diagnosed with 2 minor strokes, DVT and a hole in her heart. Booked in for surgery for a heart repair, but living life on eggshells.

You never know!