Do I have a heart problem?

Q: I am a 31 years old male and about three months back, some T wave abnormalities were found in my ECG. Subsequently ECHO and Treadmill test was also taken and they were all right. Just to rule out the possibility of any problems I went for CT angiography and no block was found in the result. By then I had GERD and I did not treat it. Now my GERD got worsened, so I got a UREA breath test done and it was negative. My GP prescribed Omeprezole 40 once in a day, which I am still taking. I also get chest pain and burning sensation. In an incident I felt tired and had palpitation, so I went to emergency and ECG was taken again, TROP I test and CKMD test were also done. The cardiologist said that the ECG still has T wave abnormality as seen in my old X ray, since we ruled out the problem by CT angiography, nothing to worry and the pain was not due to heart. Even the TROP I test was 0.00 and CKMD was 7, so doctor said that it’s normal. But after that I have some other instances of such chest pain and once I had mild pain in left hand also. Now with the tests done, is the risk with heart problem is eliminated? Please suggest.

A:In general terms, at a young age of 31 years, if treadmill test is negative, CT angio shows no coronary blocks and all other tests are within normal limits, then the chances are that the pain could be from gastro-oesophageal reflux or any other cause like muscle aches and pain rather from the heart. ECG changes can occur in normal individuals also and non specific ST T changes may not have any sinister connotation. However, if the symptoms persists and if they are suggestive of angina pain (which in your case, they do not look to be), then one may have to resort to the final court of appeal and that is coronary angiography. Based on the report that you have submitted, the chances of your pain being from the heart are relatively remote.