Chest Discomfort While Walking Could be a Warning Sign

Q:  I have always been a walker, and now have switched walking indoors at the mall. For at least ten years, as I walk, I get a lump in my throat and then pain in my ears and sometimes between my eyes. Even my teeth hurt on occasion. Sometimes I have a discomfort (not pain) in the upper left chest. I now find that I must sit down for a minute, and then all the pain disappears. I will continue to walk and it will reappear. Consequently, I have stopped walking. Walking around the house or shopping, etc. does not bother me. Any suggestions?

A:  The first thought that came into my mind while reading about the lump in your throat and pain in your eyes and ears was that you are allergic to something in the mall. Then I got to the part about discomfort in your chest that goes away when you sit down, and a red flag went up right away. Most people know that lack of blood flow in the coronary arteries leads to chest pain, often described as a squeezing, heavy, or pressure sensation, but lack of blood flow may also cause discomfort in the shoulders, arm, neck, jaw, teeth, back or stomach. Typically, physical exertion, like walking fast or shoveling snow, will bring on the symptoms and the pain then resolves with resting.

I don't know how old you are, but coronary artery disease is very common among people over the age of 65 and still the leading cause of death in the United States. If you haven't had your coronary circulation evaluated, I would strongly recommend that you see your physician about this soon. There are several noninvasive ways to have this done, like a treadmill stress test or a stress echocardiogram using sound waves. If these are suggestive of blockage, then an angiogram (also called heart catheterization) would be necessary. A small tube is inserted into the artery of the thigh and threaded to the heart where moving pictures are taken of the heart blood vessels as dye is injected.

Not everyone with heart disease has chest pain. Your symptoms may be an early warning sign.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.